Choking occurs when a person’s airway becomes blocked by food or another foreign object. When this happens, the choking victim will be unable to breath normally and is at risk of suffocating. When treating a choking victim, the first goal is to remove the obstruction to restore normal breathing function.
Thousands of choking deaths occur each year. While choking can happen to anyone, young children and the elderly are at increased risk.
Signs of Choking
Choking can be a serious emergency. Because of this, it is important to quickly recognize the signs of choking and take appropriate action.
A conscious choking victim may clutch their throat with their hands. This is a universal signal and is easy to recognize. However, if the person does not give this signal, look for other signs:
- Difficulty speaking. If someone is choking, they will be unable to speak.
- Coughing or wheezing. Sometimes, a choking victim will cough of wheeze excessively. This happens when the airway is only partially obstructed. Pay attention to the victim’s breathing; if coughing or wheezing suddenly stop, it may mean that their airway is now fully obstructed and they need immediate help. On the other hand, if the victim is coughing forcefully, allow them to cough, because it may help clear the obstruction.
- Changes in skin color. For instance, the skin, lips, and nails may change to a pale or bluish color, indicating a lack of oxygen in the blood.
- Loss of consciousness.
Performing First Aid on a Choking Victim
There are several techniques that can be used to help a choking victim. However, which ones you should use depend on a number of factors. For example, is the person conscious, or unconscious? Are they a child or infant? Are they pregnant or obese? Consider these factors when performing first aid.
First Aid on a Conscious Choking Victim
Determine if Victim Needs Aid
You must obtain permission before providing any First Aid. If your victim is choking, ask them “Are you choking?” followed by “Can you speak?” If they can speak, encourage them to cough to relieve the obstruction without assistance If they can not speak, the obstruction is significant and assistance may be necessary.
Get Permission to Assist
Tell the victim: “I’ve been trained, I’m going to help you”. If they allow you to assist them then perform the Heimlich Maneuver. If they push you away or don’t allow you to assist, call 911. Without air moving, your victim will become unconscious within minutes. Consent is not required on an unconscious victim.
Heimlich Maneuver
The Heimlich Maneuver (aka Abdominal thrusts) is the most common first aid technique for choking. However, it is important to note that this technique is used on conscious victims only. To perform abdominal thrusts:
- Stand behind the person and place one foot ahead of the other for balance.
- If the choking victim is a child, crouch or kneel behind them and keep your head on their shoulder.
- Put your arms around the person’s waist. Make a fist with one hand and grab your fist with the other hand. Keep your hands rested slightly above the person’s navel (belly button).
- Note: If the person is overweight or pregnant, position your hands higher, around their breastbone.
- Next, make quick upward and inward thrusts, as if you were trying to lift the person up.
- Perform 6-10 thrusts, or until the blockage is cleared.
It is important to know when to call for an ambulance. If you are the only rescuer on the scene, try to use 6-10 abdominal thrusts before calling 911. But if you’re not alone, have someone else call for an ambulance while you perform first aid. Also, call 911 if the victim becomes unresponsive at any point.
First Aid using Back Blows
Back blows are another technique you can use to help a choking victim. Typically, we do not teach back blows in our classes. It’s important to note, if done incorrectly, back blows can cause the obstruction to worsen. To perform back blows correctly:
- Stand to the side of and slightly behind the choking victim.
- Keep one arm around their waist for support and have them bend over at the waist at a 90-degree angle (important).
- Firmly deliver several blows to the center of the victim’s back. You should aim for the area in between their shoulder blades using the palm of your hand.
The jolt of the back blow can help to free the foreign object. When helping a choking victim, try to alternate between 5 abdominal thrusts and 5 back blows. However, if you only know how to do abdominal thrusts, stick with those.
First Aid for a Choking infant
If an infant is choking you can attempt to dislodge the object by doing the following:
- Support the child’s head and neck firmly.
- Perform back blows in between the shoulder blades.
- Perform Chest Thrusts by pushing on their chest with two or three fingers. You’ll want to push down about one and a half inches.
- Alternate between 5 back blows and 5 chest thrusts.
- If you cannot get the object dislodged, or the victim falls unconscious or turns blue, call 911 or have someone else call if it hasn’t been done yet.
Be careful what infants eat or can put in their mouths. Because most child choking incidents are preventable.
Treating an Unconscious Victim
As stated before, if a choking victim has fallen unconscious or become unresponsive at any point, make sure that an ambulance or 911 has been called. After that:
- Lay the unconscious victim on their back on the ground.
- If the obstruction is visible in their mouth, you may try to use your finger to remove it. However, be careful to not push the object further into the airway. If the object is not visible, do not try to reach for it.
- Perform CPR on the victim.
- Perform 2 rescue breaths, followed by 30 chest compressions. For more detailed information on how to perform CPR, click here.
- Periodically check the victim‘s mouth to see if the obstruction has become visible.