How to Respond to Choking

By Caitlin Bootsman


Sadly, thousands of people die each year as a result of choking. In this sort of emergency, when someone is gasping for air or frantically clutching their throat, it can be difficult to respond quickly and effectively. That's why experts suggest reviewing maneuvers regularly so that you are better equipped to respond in the moment.



For adults and children older than one, there are a few things to remember:

  • If they are coughing, encourage them to keep coughing—this may be the quickest way to clear their airways.
  • If they are having trouble coughing, talking, or breathing, immediate help is needed. You can attempt the Heimlich maneuver (also known as "abdominal thrusts"), which uses thrusts directed toward the abdomen to attempt to dislodge the object that is blocking their airways. The following steps are from the National Safety Council (NSC)1: Alternately, you can click here to view video instructions from the NCS.2
  1. Stand behind the adult victim with one leg forward between the victim's legs; for a child, move down to their level and keep your head to one side
  2. Reach around the abdomen and locate the navel/belly button
  3. Place the thumb side of your fist against the abdomen just above the navel
  4. Grasp your fist with your other hand and thrust inward and upward into the victim's abdomen with quick jerks. (For a responsive pregnant victim, or any victim you cannot get your arms around, or for whom abdominal thrusts are not effective, you can stand behind them, wrap your arms around their chest and provide chest thrusts to the middle of their breastbone; avoid squeezing the ribs with your arms)
  5. Continue thrusts until the victim expels the object or becomes unresponsive



Infants under a year of age require a different sort of procedure to help if they are choking. First, attempt to clear their airway. The following steps from NSC should be applied if a baby can't cough, cry or breathe.

  • Support the infant "face down" by holding the head in one hand with the torso on your forearm against your thigh
  • Give up to five back thumps/slaps between the shoulder blades with the heel of your other hand
  • If the object is not expelled, roll the infant face up, supporting the back of the infant's head/neck with your hand
  • Place two fingers on the breastbone just below the nipple line
  • Give five chest thrusts—about one per second, about 1 ½ inches deep
  • Continue cycles of five back slaps and five chest thrusts until the object is expelled or the infant becomes unresponsive



In all situations, even after choking stops, seek medical attention.

If the person has passed out or is unresponsive, they need CPR. Follow these steps from the NSC and call 911 as soon as possible. It is also recommended to be trained in CPR to become more effective at the process:

  • Tilt the head and lift the chin to open the airway
  • Give two rescue breaths
  • Compress the chest about 2 inches deep, 30 times, at a rate of at least 100 per minute while counting aloud
  • Continue the cycle of two breaths and 30 compressions until the victim wakes up, an AED is brought to the scene3 or professional help arrives





References
1 https://www.nsc.org/community-safety/safety-topics/choking
2 https://nscmediacdn.azureedge.net/videos/nscu/FIRST_AID_CPR_AED_17_Choking.mp4
3 https://www.nsc.org/safety-training/first-aid/supplies





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