What should I do if someone is choking?

The critical distinction is between mild and severe choking. Someone who can cough is clearing it themselves and intervening can make it worse; someone who cannot cough, speak or breathe needs immediate help.

Safety

What you'll need

• A phone
• First aid training, ideally (optional)

Step by step

1. Work out whether it is mild or severe.Can they cough, speak or breathe? If yes, it is mild. If they cannot make a sound, are clutching their throat, or are going blue, it is severe.
2. For mild choking, encourage them to cough.Coughing is the most effective way to clear an obstruction. Stay with them and do not slap their back or intervene while they are coughing effectively.
3. For severe choking, shout for help and call emergency services.Or have someone else call while you act. Do not delay treatment to make the call yourself if others are present.
4. Give up to five back blows.Lean them forwards, support the chest with one hand, and strike firmly between the shoulder blades with the heel of your other hand. Check after each one.
5. If that fails, give up to five abdominal thrusts.Stand behind them, place a fist above the navel and below the ribcage, grasp it with the other hand, and pull sharply inwards and upwards.
6. Alternate between the two until it clears or help arrives.Five back blows, five thrusts, repeat. Keep going — obstructions often clear after several cycles.
7. If they become unresponsive, start CPR.Lower them to the floor and begin chest compressions. The emergency operator will talk you through it if you are unsure.
8. Seek medical assessment afterwards.Anyone who has received abdominal thrusts should be checked, as they can cause internal injury. Also seek help if anything may still be lodged.

Tips

• Do a first aid course. This is the clearest example of something reading about is not equivalent to being trained in, and courses are short and widely available.
• Babies under one year need different techniques — back blows and chest thrusts rather than abdominal thrusts. Get specific training if you care for an infant.
• Someone choking often cannot make any sound at all, which is why silence plus distress is more alarming than noisy coughing.

Common mistakes

• Intervening while someone is coughing effectively — Coughing is the most effective clearing mechanism there is. Interrupting it can dislodge the obstruction into a worse position.
• Putting fingers in the mouth to sweep for the object — Blind finger sweeps can push an obstruction further in. Only remove something you can clearly see and easily grasp.
• Not seeking medical assessment after abdominal thrusts — They can cause internal injury even when successful. Anyone who has received them should be checked.

Questions people ask