First Aid for Choking

ByJanis Updated

Choking occurs when an object partially or completely blocks a person’s airway, preventing air from reaching the lungs. This can happen to anyone but is especially common in young children and older adults. In adults, food is the most common cause. In children, small toys or household objects are often to blame.

Choking can turn life-threatening within minutes. A fully blocked airway cuts off oxygen to the brain, which can lead to permanent brain damage or death. Recognizing the signs and acting quickly can save a life.

Recognizing the Signs of Choking

The sooner you identify that someone is choking, the faster you can help. Signs include:

  • Clutching at the throat (the universal sign of choking)
  • Inability to speak, cry, or cough
  • Noisy or high-pitched breathing, or complete silence
  • Bluish or gray skin, lips, or fingernails
  • Panic or distress
  • Loss of consciousness if not treated quickly

Not all choking is complete. In partial obstruction, the person may be able to cough or talk. In these cases, monitor them closely while encouraging forceful coughing.

What You Can Do at Home

Responding properly before emergency help arrives is critical. Follow these steps:

1. Encourage Coughing (If Able to Breathe). If the person is still breathing or speaking, encourage them to continue coughing. This may be enough to dislodge the object.

2. Give Back Blows. If coughing is ineffective, stand behind the person and give five firm back blows between their shoulder blades using the heel of your hand.

3. Perform Abdominal Thrusts (Heimlich Maneuver):

  • Stand behind the person.
  • Wrap your arms around their waist.
  • Make a fist with one hand and place it just above the navel.
  • Grasp your fist with your other hand.
  • Thrust inward and upward with quick force.
    Repeat abdominal thrusts up to five times, alternating with back blows.

4. If the Person Becomes Unconscious:

  • Check the mouth for visible obstructions before each breath.
  • Lower them to the floor.
  • Call 911 if you haven’t already.
  • Begin CPR immediately (see “CPR for Unconscious Individuals” section).

Self-Treatment if You Are Alone

If you’re choking and no one is around to help:

  • Call 911 immediately or activate speakerphone if possible.
  • Make a fist and place it just above your belly button.
  • Use your other hand to press your fist into your abdomen with quick, upward thrusts.
  • You can also bend over a firm surface like the back of a chair or countertop and press your upper abdomen firmly against it.

Signs It Could Be Serious

While any choking episode is serious, look for these red flags:

  • Total inability to breathe, speak, or cough.
  • Skin turning blue or gray, particularly around lips or nails.
  • Severe wheezing or gurgling sounds.
  • Visible distress or panic.
  • Collapsing or becoming unresponsive.

Even if the object is dislodged, seek medical evaluation if the person had a prolonged lack of oxygen or shows any lingering symptoms such as chest pain or hoarseness.

When to Seek Emergency Help

Call 911 immediately if:

  • The person cannot breathe, speak, or cough.
  • The object is not expelled after first aid attempts.
  • The person becomes unconscious.
  • A baby or small child is unresponsive or turning blue.
  • Choking is caused by an unknown object or chemical.
  • The person has a known medical condition (e.g., neuromuscular disorder, swallowing difficulty).
  • A scarring or recurrent choking episode occurs.

The dispatcher may guide you through further steps such as CPR or instruct you on how to use an automated external defibrillator (AED) if needed.

Choking in Babies and Small Children

Infants under one year require different techniques than older children or adults:

Back Blows and Chest Thrusts (Not Abdominal Thrusts)

  • Hold the baby face-down on your forearm with the head supported and lower than the body.
  • Deliver five gentle but firm back blows between the shoulder blades.
  • If the object doesn’t come out, turn the baby over and give five chest compressions with two fingers, just below the nipple line.
  • Repeat the cycle until the airway clears or help arrives.

Never perform abdominal thrusts on infants.

CPR for Unconscious Individuals

If a choking person becomes unresponsive:

  1. Lay them flat on their back on a firm surface.
  2. Call 911 or ensure emergency help is on the way.
  3. Start CPR:
    • Begin chest compressions (30 compressions at a rate of 100–120 per minute).
    • Open the airway and check for any visible obstruction. Remove it only if you can see it clearly.
    • Give two rescue breaths.
  4. Continue CPR until the object is expelled or emergency responders take over.

Do not perform blind finger sweeps, especially in children, as this can push the object further down.

Prevention Tips

Prevention is key, especially for children and those at higher risk:

  • Cut food into small, manageable pieces for children and older adults.
  • Avoid giving high-risk foods (e.g., whole grapes, hot dogs, hard candy, popcorn, and nuts) to toddlers.
  • Chew food slowly and avoid talking or laughing while eating.
  • Keep small objects out of reach of young children.
  • Supervise children while eating or playing.
  • Encourage sitting while eating—don’t allow children to eat while running or playing.

If someone in your household has a medical condition that increases their choking risk, discuss preventive care and emergency planning with a healthcare provider.

Health Writer

Janis's areas of expertise include nutrition, exercise, stress management, and mental health. She is passionate about educating and empowering people to take control of their health and make positive changes that can last a lifetime. Janis believes that small, sustainable changes are the key to long-term success, and she works with her clients to develop personalized plans that fit their individual needs and lifestyles.