First Aid for Inhaled Foreign Objects

Inhaling a foreign object can be frightening and life-threatening, especially if it causes a blocked airway. Acting quickly and correctly can save a life. Whether the object is food, a small toy, or another item, it’s crucial to know the signs of choking and how to respond appropriately based on the situation.

Recognizing When Immediate Action Is Needed

Quickly identifying a blocked airway is vital. If someone cannot speak, cough forcefully, breathe, or make noise, this may indicate a complete airway obstruction. Immediate help is required to avoid loss of consciousness or more severe outcomes.

Common Signs

• Wheezing or high-pitched sounds when inhaling.
• Clutching the throat (a universal sign of choking).
• Lips or skin turning blue or gray (cyanosis).
• Panic, gasping, or inability to talk.
• Sudden silence when trying to cough.

If the person can cough or talk, encourage them to continue coughing to expel the object naturally. However, if the airway is fully blocked and no air is passing, immediate first aid is necessary. Never ignore these signs, even if the person appears calm.

What To Do First

When someone is choking:

• If alone with the victim, begin first aid immediately and call 911 as soon as possible.
• If someone else is nearby, ask them to call emergency services while you begin helping.
• If you are choking and alone, call 911 right away, then attempt self-rescue techniques.

Steps to Help Remove a Foreign Object (For Adults and Children Over 1 Year)

1. Encourage Coughing

If the person is conscious and able to cough or talk, let them try to cough it out. Do not perform any other action yet, as coughing is the body’s natural way of clearing the airway.

2. Perform Back Blows

If the person cannot cough, speak, or breathe:

• Stand slightly behind them and to the side.
• Support their chest with one arm.
• Bend them forward at the waist so the object may exit the mouth.
• Use the heel of your free hand to give five firm back blows between the shoulder blades.

3. Perform Abdominal Thrusts (Heimlich Maneuver)

If back blows are ineffective:

• Stand behind the person, placing one foot slightly forward for balance.
• Wrap your arms around their waist.
• Make a fist with one hand and place it just above the navel.
• Grasp your fist with the other hand.
• Pull sharply inward and upward five times.

Repeat cycles of five back blows and five abdominal thrusts until the object is expelled or the person begins breathing or coughing again.

If the Person Becomes Unconscious

If the person loses consciousness while choking:

1. Lower Them to the Ground
   • Lay them flat on their back.
2. Look in the Mouth
   • Open the mouth and check for a visible object.
   • Only sweep with your finger if you see something. Avoid blind sweeps, especially in children.
3. Begin CPR
   • Start with 30 chest compressions.
   • After compressions, check the mouth again.
   • Try giving 2 rescue breaths if the chest rises.
   • Continue CPR until help arrives or breathing resumes.

Note: Even if the object is removed, CPR may still be needed if breathing has not restarted.

Special Instructions for Pregnant or Obese Individuals

For those where abdominal thrusts cannot be performed (e.g., due to pregnancy or body size):

• Stand behind the person.
• Place your hands on the lower half of the breastbone (sternum), above the abdomen.
• Perform chest thrusts straight inward.
• Repeat until the object is expelled or professional help takes over.

Population	Hand Placement	Motion	Notes
Non-pregnant adults	Just above the navel	Inward & upward	Abdominal thrusts recommended
Pregnant or larger adults	Center of breastbone	Straight inward	Chest thrusts are safer in these cases

If You Are Alone and Choking

If you are the one choking and no one is around:

1. Call Emergency Services
   • Dial 911 (or your local emergency number).
2. Use Self-Abdominal Thrusts
   • Place one fist above your navel.
   • Grasp your fist with the other hand.
   • Lean over a hard surface (like a counter or chair back).
   • Drive your fists inward and upward sharply.
   • Repeat until the object is dislodged or help arrives.

Key Reminders During First Aid

• Never leave a choking person alone unless you must call for help.
• Abdominal thrusts and back blows are only for people over one year old.
• For infants under one year, different techniques (not covered here) are used.
• Do not perform finger sweeps unless the object is clearly visible.

Signs That the Object Has Been Dislodged

• The person starts breathing normally.
• They can talk, cough, or cry.
• Color returns to the face and lips.
• Choking symptoms (clutching throat, gasping) stop.

Why Follow-Up Medical Care Matters

Even if the object appears to be expelled, medical evaluation is important. A healthcare provider may check for:

• Injuries to the throat or airway
• Residual fragments or irritation
• Swelling that could return
• Aspiration into the lungs

Consider visiting a doctor or urgent care, especially if symptoms like wheezing, difficulty swallowing, or hoarseness persist after the choking episode.