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Encountering someone in the midst of a choking incident can evoke fear, yet prompt action can be the difference between life and death. Typically, choking occurs when an individual has a piece of food (or another small object) lodged in their airway. Employing the Heimlich maneuver can assist in dislodging this foreign object and facilitating the resumption of breathing. But how does one execute this life-preserving measure? Continue reading to understand the correct procedures for rescuing another individual (or oneself) from choking.
Important: This guide pertains to adults and children over the age of one. For infants under one year old, refer to How to Administer First Aid to a Choking Baby.
Steps to Follow
Assisting Another Person
Evaluate the scenario. Confirm that the individual is indeed choking and ascertain whether the obstruction is partial or complete. If the choking is mild, or if there's only a partial blockage, it may be preferable to allow the person to cough to expel the obstruction.
- Signs of partial airway blockage include the ability to communicate, call for help, cough, or react to stimuli. Breathing may still be possible, albeit somewhat strained, and the individual may exhibit a pallid complexion.
- In contrast, someone with a completely blocked airway will be unable to speak, cry, cough, or breathe. Additionally, they may demonstrate the universal choking sign (both hands clutching the throat) and their lips and nails may turn blue due to oxygen deprivation.
Verify if the individual is choking by asking, 'Are you choking?'. If the person can respond verbally, wait. A truly choking person will be unable to speak, but they may indicate yes or no through gestures. It's crucial not to administer back blows if the obstruction is only partial, as this may worsen the situation. If the person responds:
- Offer reassurance and let them know you're prepared to help if necessary.
- Encourage them to cough in an attempt to dislodge the blockage. Avoid back blows.
- Continue monitoring the situation, ready to intervene if the airway becomes completely obstructed or the choking worsens.
Provide initial aid. If the individual is experiencing severe choking or a complete airway blockage and is conscious, inform them of your intention to administer first aid. It's advisable to seek consent from a conscious person before proceeding. This also allows them to communicate if they welcome your assistance.
- If you're the sole responder present, execute the outlined first aid steps before
contacting emergency services. If others are available, delegate the task of summoning help.
Perform back blows. Note that these instructions are intended for individuals in a seated or standing position.
- Position yourself behind the individual, slightly off to one side, depending on your dominant hand.
- Support their chest with one hand and tilt them forward, ensuring the obstruction moves toward their mouth rather than deeper into their throat.
- Deliver up to five vigorous blows between their shoulder blades using the heel of your hand. Pause after each blow to assess if the obstruction has cleared. If not, proceed with up to five abdominal thrusts (refer to below).
Administer abdominal thrusts (Heimlich maneuver). The Heimlich maneuver is an emergency technique applicable only to adults and children aged over 1 year. It must not be used on infants under 1 year old.
- Stand behind the choking individual.
- Wrap your arms around their waist and lean them forward.
- Form a fist and position it just above their navel but below the breastbone.
- Place your other hand atop the first and apply forceful, upward thrusts into their abdomen.
- Repeat this action up to five times, assessing after each thrust for clearance of the obstruction. Cease if the person loses consciousness.
Adapt the Heimlich maneuver for pregnant individuals and those who are obese. Adjust your hand placement higher than the conventional technique, positioning them at the base of the breastbone, slightly above the junction of the lowest ribs. Apply firm pressure to the chest with swift thrusts as described. However, the upward thrusts may not be feasible. Repeat until the choking subsides and the obstruction dislodges, or until the person loses consciousness.
Ensure complete removal of the object. After clearing the airway, remnants of the choking object may persist. If feasible, prompt the victim to expel any remaining fragments and resume normal breathing.
- Inspect for any lingering obstructions in the air passage. If present, cautiously sweep the mouth with your finger to dislodge the object. Exercise caution to avoid pushing it further into the throat.
Verify restoration of normal breathing. Following the removal of the obstruction, most individuals will resume regular breathing. If normal respiration does not resume or if the person loses consciousness, proceed to the subsequent step.
Provide assistance in case of unconsciousness. Should the choking victim lose consciousness, carefully lay them flat on their back. Subsequently, attempt to clear the airway if feasible. If the obstruction is visible, gently sweep it out of the throat and mouth. Refrain from performing a finger sweep in the absence of a visible object to prevent exacerbating the situation.
- If the obstruction persists and the individual remains unresponsive, assess their breathing status. Position your cheek near their mouth and observe for signs of respiration for a duration of 10 seconds.
- If no breathing is detected, proceed to initiate cardiopulmonary resuscitation (CPR). The chest compressions inherent to CPR may aid in dislodging the obstruction.
- Dispatch someone to contact emergency services, or if alone, call emergency services prior to resuming aid. Alternate between chest compressions, airway checks, and rescue breathing while awaiting assistance. Administer 2 breaths following every 30 chest compressions. Continuously monitor the mouth during CPR for potential obstructions.
- Resistance to chest expansion may persist until the obstruction is dislodged.
Seek medical advice. Following a choking incident, individuals experiencing persistent coughing, difficulty breathing, or a sensation of residual obstruction in the throat should promptly seek medical attention.
- Abdominal thrusts may also result in internal trauma and bruising. Individuals subjected to this maneuver or CPR should undergo medical evaluation subsequently.
Self-Assistance Techniques
Contact emergency services. If you find yourself alone and choking, dial 911 or your local emergency number immediately. Even if you're unable to communicate verbally, most emergency services dispatch assistance for all calls received.
Execute the Heimlich maneuver on yourself. While you may not apply this technique as forcefully as another person, attempting to dislodge the obstructing item is still possible.
- Create a fist and position it above your navel.
- Secure the fist with your other hand.
- Lean over a stable surface such as a chair, table, or counter.
- Drive your fist upward and inward as directed.
- Repeat until the object is expelled or until assistance arrives.
- Ensure complete removal of the object. Attempt to expel any remaining debris by spitting.
Seek medical advice. If you endure persistent coughing, breathing difficulties, or a sensation of lingering obstruction in your throat, promptly seek medical attention.
- Abdominal thrusts can result in serious injuries. If you've employed this technique on yourself, seeking medical evaluation afterward is advisable.
