It could happen to you someday — you’re sitting with your family at a favorite restaurant. Suddenly a noise grabs your attention. Someone across the room is coughing hard, trying to clear his throat.

That happens all the time in restaurants, but this guy isn’t stopping, and others are also starting to notice the commotion. You vaguely remember that helping isn’t always the best choice, so you sit there with everyone else hoping he’ll work it out on his own. How do you know when to step in when someone is choking? Keep reading and we’ll share some of the signs to look for to know that the situation has escalated to the point where you should get involved.

What is Choking?

Choking is what medical professionals call a foreign body obstruction. Put simply, something like food gets stuck in the throat, blocking the passage of air to the lungs. A person with foreign body obstruction can’t breathe in fully or expel the air from their lungs. Choking is the fourth leading cause of death from an injury and a true medical emergency if the blockage doesn’t clear.

What Causes Choking to happen?

Food is the answer that might first pop into your head, but there are other possibilities such as:

  • Allergic reaction
  • Inedible items
  • Disease

Food is the most common cause, though, especially in children and the elderly. Use special caution with foods like hot dogs, grapes, popcorn, nuts, and peanut butter. These are some of the most common foods that may lead to choking.

Types of choking

All forms of choking are serious, but there are variations and each requires different emergency actions.

Mild choking

Mild Choking is due to a partial blockage. When this happens, the person might be able to speak and will be trying to cough. You might hear wheezing or a gagging sound.

You should encourage them to cough hard to clear the blockage. In some cases, back blows with the heel of your hand can loosen the object. Bend the person over at the waist to help gravity pull out the obstruction as you apply the blows.

Severe Choking

Severe choking means there is a full airway blockage and this is a medical emergency. Have someone call 911 while you attempt to clear the blockage. Before doing anything, assess the patient to look for signs that indicate a full obstruction, such as:

  • Clutching the throat – This is the universal sign for choking, and it means this person needs immediate help.
  • Blue lips, face, or fingertips – Turning blue indicates a lack of oxygen.
  • Putting fingers down their throat – This is another sure sign of choking. The affected person is attempting to vomit.
  • Losing consciousness – This means the brain is not getting oxygen.

For a conscious victim, bend their body forward at the waist and do back blows while standing behind them. After five blows, pull their body up and reach your arms around their abdomen. Then:

  • Put your hands together to make a fist.
  • Place your fist in the middle of the victim’s stomach with the thumb side pressing against the skin.
  • Do five quick and hard thrusts upward. The move forces air out of the lungs to push the obstruction outward.

Continue the maneuver until help arrives, the victim loses consciousness, or the object comes out. If the person choking does pass out, roll them on their side so fluids like saliva or vomit do not go into their lungs. If they stop breathing or have no pulse, do CPR until help arrives.

What to do if a baby is choking

For conscious choking in an infant less than 12 months:

  • First, do a quick assessment to determine if the baby can cry. If so, wait to see if there is coughing as the baby tries to push the obstruction out. If the infant is making very little noise or no sound, the airway is fully obstructed.
  • Once you have an idea of what is happening, the first step is always to ensure someone is calling 911. If you are alone and have to make the call, spend two minutes providing care and then grab your phone. If you know the throat is closed due to an allergic reaction or illness like croup, make the call immediately.
  • Hold the baby face up with one forearm. Hold the infant’s head with your hand.
  • Place the other forearm over the baby’s front side with your thumb and forefinger supporting the jaw.
  • Flip the baby face down with head angled towards the floor. The infant’s head should be below the heart.
  • Use the heel of your hand to apply five back blows between the shoulder blades.
  • Turn the baby over, carefully supporting the head, and place two or three fingers in the middle of the chest to do five chest thrusts.

Continue this process until the baby loses consciousness or the object comes out and the infant starts to breathe.

If the choking victim is an unconscious infant less than 12 months:

Begin infant CPR immediately. After a full round of rescue breaths and chest compressions, look into the baby’s mouth, searching for the obstruction. If you see it, reach in and try to remove it. If not, continue CPR. Recheck the mouth after each round of breaths and compressions.

What to do if a child is choking

The actions for a choking child and adult are very similar.

For a conscious child:

  • Ask if they are choking or if they can breathe and do a quick assessment, looking for blue lips and other signs of full airway obstruction. If the child is coughing, tell them to keep trying to cough out whatever is causing them to choke. If the child can’t talk, assume there is a full obstruction.
  • Ask someone to call 911
  • Open the child’s mouth and look for the obstruction. Remove it if you can see and reach it safely.
  • Stand behind and bend the child over to apply five back blows between the shoulder blades.
  • Wrap your arms about the abdomen and place one fist in the middle of the stomach and put your other hand over it to perform five quick abdominal thrusts upward.
  • Continue care until help arrives or the child loses consciousness.

For an unconscious choking child:

  • Ask someone to call 911 and begin CPR.
  • If you are alone, do one round of CPR and then call 911.
  • Check after each series of chest compressions to see if you’ve dislodged the object enough to remove it. If not, begin again with rescue breaths.

What to do if an adult is choking

  • If the adult is conscious, ask them if they can speak or if they need help. If they cannot talk, proceed with the next step.
  • Ask someone to call 911
  • Begin back blows and chest thrusts. Keep going until the person passes out or you dislodge the object.
  • If this person was found unconscious or becomes unconscious during the process, begin CPR

The most important thing to remember in any choking emergency is to get help. Ask someone to call 911. If no one is around, try yelling for help. If no one comes, start choking assistance for one round and then call 911 yourself.

Always verify that someone is choking before doing back blows and performing abdominal thrusts. Otherwise, you may turn a partial obstruction into a full one. Ask the choking victim if they need help and look for the universal signs of choking before doing anything. Also, do not do finger sweeps unless you can see what is blocking the throat. You might inadvertently push the obstruction down farther.

Thousands of people die every year from choking. The more people that know how to help, the better chance the choking victim has of surviving a choking emergency. For full instructor-led training on choking, CPR, and assisting with other medical emergencies, be sure to check out ProTrainings’ free CPR and first aid training courses.


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