What to Do If Someone Is Choking

If someone is choking and cannot speak, breathe, or cough effectively, act immediately. Ask someone to call emergency services while you provide first aid. For a conscious adult or child over 1 year, give five back blows followed by five abdominal thrusts, repeating until the blockage clears or the person becomes unresponsive. Infants under 1 year need five back blows and five chest thrusts instead.

How Can You Tell If Someone Is Choking?

Choking happens when food or another object blocks the airway, making it difficult or impossible for air to reach the lungs. Recognizing the signs quickly helps you decide whether the person needs immediate assistance.

According to the American Red Cross, signs that may occur during choking include:

• Inability to speak, cry, or breathe normally.
• A weak, ineffective cough or no cough at all.
• Noisy breathing or high-pitched sounds when trying to breathe.
• Grabbing the throat with one or both hands.
• Skin, lips, or nails that become pale, blue, or gray.
• Loss of consciousness if the blockage remains.

A person who can speak, breathe, and cough forcefully may have a partial airway blockage. Ask whether they are choking and encourage them to keep coughing. Stay nearby and watch for changes. If they cannot speak or breathe effectively, do not wait for the situation to improve on its own; begin choking first aid.

What Should You Do If an Adult or Child Is Choking?

For a conscious adult or child older than 1 year with a severe airway blockage, use repeated cycles of five back blows and five abdominal thrusts. If another person is present, ask them to call your local emergency number and bring an automated external defibrillator (AED), if available. Do not delay first aid while waiting for help.

Step 1: Give five back blows

1. Stand to the side and slightly behind the person.
2. Lean the person forward at the waist so their chest points toward the ground.
3. Support their upper body with one arm.
4. Use the heel of your other hand to deliver five firm, separate blows between the shoulder blades.
5. Check after each blow to see whether the object has come out.

Step 2: Give five abdominal thrusts

If the back blows do not clear the blockage, give five abdominal thrusts, also called the Heimlich maneuver.

1. Stand behind the person and wrap your arms around their waist.
2. Make a fist with one hand and place the thumb side against the abdomen, just above the navel and below the breastbone.
3. Hold your fist with your other hand.
4. Give a quick, firm thrust inward and upward.
5. Repeat until you have given five thrusts, checking whether the object has been dislodged.

Continue alternating five back blows with five abdominal thrusts until the person can breathe effectively, the blockage clears, or they become unresponsive. Use controlled, firm movements and avoid pressing on the breastbone or lower ribs.

Mayo Clinic's choking first-aid guidance also describes these steps and explains how to adapt them for infants, pregnant people, and other special situations.

How Do You Help Someone Who Is Pregnant or Cannot Have Abdominal Thrusts?

Abdominal thrusts are not appropriate for everyone. If the person is visibly pregnant or you cannot safely wrap your arms around their abdomen, use chest thrusts instead.

1. Stand behind the person and place your arms around their chest.
2. Position your fist against the middle of the breastbone, avoiding the lower tip of the breastbone and the ribs.
3. Hold your fist with your other hand.
4. Deliver firm, quick thrusts straight backward into the chest.
5. Continue until the blockage clears or the person becomes unresponsive.

For a person who uses a wheelchair, provide assistance in their current position if possible, adjusting your position and access as needed. If abdominal thrusts cannot be performed effectively, chest thrusts may be an alternative. Avoid movements that could cause the person to fall.

What Should You Do If a Baby Under 1 Year Is Choking?

Infants need a different technique because their bodies are smaller and more delicate. Never use abdominal thrusts on a baby under 1 year. If the baby cannot cry, breathe, or cough effectively, begin infant choking first aid and get emergency help.

Step 1: Give five back blows

1. Sit or kneel and place the baby face down along your forearm, supporting the head and jaw.
2. Rest your forearm on your thigh to help support the baby.
3. Keep the baby's head lower than the body.
4. Use the heel of your free hand to give five firm back blows between the shoulder blades.

Step 2: Give five chest thrusts

1. Turn the baby face up while supporting the head and neck.
2. Keep the baby's head lower than the body.
3. Place two fingers in the center of the chest, just below the nipple line.
4. Give five quick chest thrusts, pressing down about 4 cm (1.5 inches) in an average-sized infant, while allowing the chest to return to its normal position between thrusts.

Repeat five back blows followed by five chest thrusts until the blockage clears or the baby becomes unresponsive. Ask someone to call emergency services as soon as possible. If you are alone, use your local emergency service's call procedure without unnecessarily interrupting lifesaving first aid.

For further guidance, MedlinePlus's infant choking instructions explain how to support the baby, deliver back blows and chest thrusts, and respond if the baby loses consciousness.

What If the Person Becomes Unconscious?

If the person collapses or becomes unresponsive, carefully lower them onto a firm, flat surface. Have someone call emergency services immediately if this has not already been done. Begin cardiopulmonary resuscitation (CPR), starting with chest compressions, and follow the emergency dispatcher's instructions. If you are trained in CPR, use the technique appropriate for the person's age.

1. Check whether the person responds and whether they are breathing normally. Gasping is not normal breathing.
2. Begin chest compressions and continue CPR according to your training and the dispatcher's instructions.
3. Whenever you open the airway to give rescue breaths, look inside the mouth for the object.
4. Remove the object only if you can clearly see it and can safely reach it. Never perform a blind finger sweep.
5. Continue CPR until the person shows signs of life, trained help takes over, or you cannot continue.

MedlinePlus guidance for an unconscious choking person explains why CPR and chest compressions are used instead of abdominal thrusts once someone loses consciousness. If an AED is available, have another person prepare it and follow its voice instructions.

What Should You Do If You Are Choking and Alone?

If you cannot breathe, speak, or cough effectively and nobody is nearby, act immediately. Call your local emergency number if possible, using speakerphone if that allows you to continue helping yourself.

1. Make a fist and place it just above your navel, below your breastbone.
2. Hold the fist with your other hand.
3. Give quick inward and upward thrusts to your abdomen.
4. Alternatively, bend over a firm, stable surface, such as the back of a sturdy chair, and press your upper abdomen against it to produce an inward and upward thrust.
5. Continue until the object comes out or help arrives.

Do not use a sharp edge or an unstable object. If you can cough forcefully, keep coughing while seeking help if needed. If the blockage clears, arrange medical assessment because choking and the measures used to clear the airway can cause injury.

What Should You Avoid When Someone Is Choking?

Well-intended actions can sometimes make a blockage worse. Keep these points in mind while providing first aid:

• Do not interfere with an effective cough. If the person can cough forcefully and breathe, encourage coughing and monitor them closely.
• Do not put your fingers blindly into the mouth. You may push the object farther down the airway.
• Do not give food or water. These will not reliably clear an airway blockage and may complicate the situation.
• Do not use abdominal thrusts on an infant. Babies under 1 year require back blows and chest thrusts.
• Do not delay emergency help. If the person cannot breathe effectively or becomes unresponsive, treat it as an emergency.

When Should Someone Get Medical Attention After Choking?

Medical assessment is important after a significant choking episode, even if the object appears to have come out. The blockage itself or the first-aid maneuvers may cause injury, and a small amount of material may remain in the airway.

Seek urgent medical care if the person has ongoing breathing difficulty, persistent coughing, wheezing, trouble swallowing, chest or abdominal pain, or difficulty speaking after the episode. Fever or a cough that develops later also warrants prompt medical evaluation. Call emergency services for severe or worsening breathing problems, collapse, or other signs of an immediate emergency.

Anyone who received abdominal or chest thrusts should be medically assessed, particularly if pain or other symptoms develop. Babies and children also need careful evaluation when symptoms persist or there is concern that an object remains in the airway.

How Can You Reduce the Risk of Choking?

Although not every choking episode can be prevented, simple precautions can reduce common risks:

• Eat slowly and chew food thoroughly before swallowing.
• Avoid talking, laughing, or playing with food in your mouth.
• Cut food into age-appropriate pieces and prepare potentially hazardous foods safely for young children.
• Keep small objects, loose toy parts, and other choking hazards away from infants and toddlers.
• Make sure dentures fit properly and seek advice if chewing or swallowing is difficult.
• Follow any swallowing-safety advice provided by a healthcare professional if a medical condition affects eating or swallowing.

Learning first aid and CPR through a recognized practical training course can help you respond more confidently. Because the correct technique differs by age and circumstance, hands-on training is particularly useful for parents, caregivers, and people who regularly assist others.