Choking
Overview
- Adapted from St John’s Ambulance guidance and NHS
Child
- Encourage them to cough to try to clear the blockage themselves. If this is ineffective, and the child is still conscious, use back blows followed by chest or abdominal thrusts (depending on age of the child) if necessary. Check the mouth after each cycle of blows or thrusts and remove any visible obstruction. If the object is still not dislodged after the first cycle, call 999 and continue the alternating pattern of back blows and chest/abdominal thrusts until the obstruction clears or the child becomes unresponsive
- Even if the object has come out, it is best to seek medical advice in case some of it remains or any damage has been done. Any child who has received abdominal thrusts should be assessed in hospital afterwards, even if they appear to have fully recovered
- If the child is/becomes unconscious, put them on a flat surface and call 999 (have the phone on speaker/hands-free mode). Remove the object if it is visible and you can grasp it easily. Start cardiopulmonary resuscitation (CPR) immediately (see separate section) — in a child or infant, begin with 5 rescue breaths. Chest compressions may themselves dislodge the obstruction
Back blows (child)
- Lie the baby face down along your thighs as you sit and support their head with your hand. Do the same for a small child or support them in a forward-leaning position (see the adult section on back blows which will also apply to older children)
- Give up to five sharp blows with the heel of one hand in the middle of their back between the shoulder blades
Chest thrusts (for under one year)
- Lie your baby face up along your thighs. Use the two-thumb encircling technique: place both thumbs side by side on the lower half of the baby's sternum, with your fingers encircling the chest and supporting the back (this matches the technique on the CPR page)
- Give up to five sharp chest thrusts, compressing the chest by about a third each time
Abdominal thrusts (for one year and over)
- Stand or kneel behind the child and place your arms around their upper abdomen (see the adult section on abdominal thrusts which will also apply to older children)
- Clench your fist and place it between the umbilicus and ribs
- Grasp this hand with your other hand and pull in and up sharply. Repeat up to five times
Adult
- Encourage them to cough to try and clear the blockage themselves and to spit out the object. If this is ineffective, and the adult is still conscious, use back blows followed by abdominal thrusts, if necessary. Check the mouth after each cycle of blows or thrusts and remove any visible obstruction. If the object is still not dislodged after five abdominal thrusts, call 999 and continue the alternating pattern of back blows and abdominal thrusts until the obstruction clears or the person becomes unresponsive
- Anyone who has received abdominal thrusts should be assessed by a healthcare professional afterwards, as internal injuries can sometimes occur
- If the person is/becomes unconscious, put them on a flat surface and call 999 (have the phone on speaker/hands-free). Start cardiopulmonary resuscitation (CPR) immediately (see separate section) — in a child or infant, begin with 5 rescue breaths. Chest compressions may themselves dislodge the obstruction
Back blows (adult)
- Stand behind the person and support their chest with one hand. Lean them forward
- Give up to five sharp blows with the heel of one hand in the middle of their back between the shoulder blades
Abdominal thrusts (adult – not suitable for pregnant women; give chest thrusts instead)
- Stand behind the person who is choking. Place your arms around their waist and bend them forward
- Clench one fist and place it right above their umbilicus
- Put the other hand on top of your fist and pull sharply inwards and upwards. Repeat up to five times