Choking – First Aid for a Choking Adult or Child (over one year)

Government figures show that there were 289 deaths as a result of choking in England, Scotland and Wales in 2016.

How do I know if someone is choking?

Inability to breathe or speak or cough
Reddening of the face
Distressed look
Hands clutching throat

Treating a choking adult or child (over 1 year):

Instruct the casualty to cough

Most mild cases of choking can be resolved by the casualty coughing their airway clear. If this is unsuccessful or the casualty cannot cough, move to step 2.

Back Blows

Lean the casualty forward
Provide 5 sharp blows to the casualty’s back using the heel of your hand. Place the blows in between the shoulder blades of the casualty
If this does not clear the casualty’s airway, move onto step 3.

Abdominal Thrusts

Place both of your arms around the casualty, after standing behind them.
Create a fist with one hand and tuck your thumb in to create a flat surface
Place your fist above the belly button of the casualty, but below the ribs of the casualty
Grab your fist with your other hand.
Pull your fist upwards and inwards in a sharp motion
Repeat this process up to 5 times if needed

The aim of this process is to clear the airway of the obstruction. However, if this does not clear the airway, repeat steps 2 and 3 until the airway is clear.

If you are unable to treat the casualty whilst they are choking, get somebody to call the emergency services. As long as the casualty is still conscious, continue to repeat the steps.

If the casualty falls unconscious, perform CPR on them.

Treating a choking child (under 1 year):

If you can see the object at the front of the baby’s mouth, tilt the baby on to its side (supporting the head at all times) allowing the baby to push the object out with its tongue. You can ‘Sweep’ your fingers around the inside of the baby’s cheek but, Do Not push your fingers deeply into the baby’s mouth as you may risk pushing the object deeper into the airway.

NOTE: The baby may try to cough. If the choking is mild this might clear the obstruction. If this is the case, the baby may cry and should then be able to breathe effectively.

If the obstruction is not cleared, follow the sequence below:

When a baby is choking, he/she will cough and this is usually enough to clear a mild choking hazard. The baby may cry afterwards, but this is a sign of a clear airway.

When coughing alone is not enough, attempt step 1:

Back Blows

Immediately call out for help for anyone nearby.
Sit and lie the baby down across your lap face down.
Support the baby’s head with your hand, keeping the head at the lowest point.
Sharply give 5 blows to the baby’s back, in between the shoulder blades.

The aim of each back blow is to clear the airway with one blow, not all five. If this fails to clear the airway, move onto step 2:

Chest thrusts

Turn the baby so that he/she is face up.
Lie the baby on your arm to appropriately support them, ensure the baby’s head is below the chest level of the baby.
Use two fingers to give around 5 chest thrusts in an attempt to clear the baby’s airway. These chest thrusts are similar to giving chest compressions to a baby. Unlike chest compressions, the thrusts are at a slower pace and sharper. Much like in adults, the aim is to clear the airway with each thrust you give.

It is very important to NEVER perform abdominal thrusts on a baby.