Choking occurs when an object becomes lodged in the throat or windpipe, blocking the flow of air. In adults, food is the most common cause. Young children often choke on small items such as toys or household objects. Choking is life-threatening because it cuts off oxygen to the brain.

Immediate first aid is critical. Learning the Heimlich maneuver and CPR through a certified first-aid course can help you respond effectively in an emergency.

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When to Seek Emergency Help

If you are the only rescuer, give back blows and abdominal thrusts first, then call 911.
If another person is present, have them call for help while you begin first aid.

If you are the one choking and no one is nearby, call 911 immediately, then perform abdominal thrusts on yourself.

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Symptoms of Choking

Signs that someone is choking include:

• Hands grasping at the throat
• A look of panic, confusion, or shock
• Inability to speak
• Noisy, strained, or squeaky breathing
• Weak or forceful coughing
• Blue or gray skin, lips, or fingernails
• Loss of consciousness

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Treatment

Infants (Under 1 Year Old)

To clear a choking infant’s airway:

1. Position the infant face down on your forearm, supported on your thigh, with the head lower than the chest.
2. Give five back blows between the shoulder blades using the heel of your hand.
3. If breathing does not resume, turn the infant face up while keeping the head lower than the body.
4. Give five chest compressions, using two fingers placed just below the nipple line, pressing down about 1½ inches.
5. Repeat cycles of five back blows and five chest compressions until breathing starts or help arrives.
6. If the airway becomes clear but the infant is not breathing, begin infant CPR.

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Children and Adults

If the person can cough forcefully, encourage them to continue coughing.
If they cannot cough, speak, cry, or breathe effectively, begin first aid.

American Red Cross–recommended steps:

1. Give five back blows.
   • Stand behind and slightly to the side of the person (kneel behind a child).
   • Support their chest with one arm and bend them forward.
   • Strike firmly between the shoulder blades five times.
2. Give five abdominal thrusts (Heimlich maneuver).
   • Stand behind the person and wrap your arms around their waist.
   • Make a fist and place it just above the navel.
   • Grasp your fist and press inward and upward sharply.
   • For children, use gentler pressure.
3. Alternate five back blows and five abdominal thrusts until the object is expelled.

Some organizations teach abdominal thrusts alone. Either method is acceptable for adults and children over 1 year old.

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If the Person Becomes Unconscious

1. Lower them to the floor on their back.
2. Look into the mouth and remove the object only if you can clearly see it.
   • Never perform a blind finger sweep—this can push the object deeper.
3. Begin CPR if the person is unresponsive.
   • Chest compressions may help dislodge the object.
   • Give only two rescue breaths per CPR cycle, checking the mouth frequently for the object.

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Pregnant People or Those You Cannot Wrap Your Arms Around

Use chest thrusts instead of abdominal thrusts:

• Place your hands on the lower half of the breastbone, above the bottom ribs.
• Press straight inward with quick, firm thrusts.
• Repeat until the blockage is cleared.

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If You Are Choking Yourself

1. Call 911 immediately.
2. Perform abdominal thrusts on yourself:
   • Make a fist just above your navel.
   • Grasp your fist with your other hand.
   • Bend over a firm surface such as a countertop or chair.
   • Push your fist inward and upward forcefully.