Treatment of Choking for Adults, Children & Infants

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BLS Choking

Figure 15: Universal Sign of Choking

A common cause of cardiac arrest that is ultimately avoidable is choking. The right reaction to a choking person is dependent on the intensity of airway obstruction, whether or not the patient is responsive, and how old the patient is. Study Table 3 for actionable responses for dealing with choking adults and children.

Choking In Adults And Children

Degree of Obstruction Person's Response Rescuers Action
Mild Obstruction
  • Breathing but may also be wheezing
  • Coughing and making noise
  • Stay with the person, try to keep them calm
  • Encourage them to cough
  • Call 911 if the person seems to be getting worse
Severe Obstruction
  • Clutching the neck (universal sign of choking; Figure 15)
  • Weak or no cough
  • Unable to make noise or talk; may make high-pitched noise
  • Little or no breathing
  • Appears cyanotic (blue around lips and fingertips)
  • Use abdominal thrusts (Heimlich maneuver) to attempt to remove obstruction
  • Call 911
  • Begin BLS if the person becomes unresponsive

Table 3

Relief of Choking - Heimlich Maneuver - A
Relief of Choking - Heimlich Maneuver - B
Relief of Choking - Heimlich Maneuver - C

Figure 16: Heimlich Maneuver

Abdominal Thrusts (Heimlich Maneuver)

People who are responsive or who are older than one year of age should be the exclusive recipients of abdominal thrusts (Figure 16a).

To successfully execute abdominal thrusts, complete the following steps:

  1. Place yourself behind the person. Place both arms round the person’s waist and under the ribcage.

  2. Place the side of your fist above the person’s navel in the middle of the belly. Refrain from pressing on the lower part of the sternum (Figure 14a).
  3. With your free hand, hold the first fist and press onto the person’s abdomen and up toward their chest forcefully (Figure 16b and 16c)
  4. Continue executing the maneuver until the situation is stabilized or until the person starts becoming unconscious.
Take Note

In the event that you see a foreign object in an individual’s mouth, do not hesitate to remove it. Observe the patient’s breathing patterns. If the person does not breathe, proceed to providing CPR and rescue breaths until further assistance arrives.

Degree of Obstruction Responsiveness Rescuers Actions
Mild Obstruction
  • Breathing but may also be wheezing
  • Coughing and making noise
  • Stay with the person, try to keep them calm
  • Encourage them to cough
  • Call 911 if the person does not clear the obstruction or seems to be getting worse
Severe Obstruction
  • Clutching the neck (universal sign of chocking)
  • Weak or no cough
  • Unable to make noise or talk; may make high-pitched noise
  • Little or no breathing
  • Appears cyanotic (blue around lips and fingertips)
  • Use abdominal thrusts (Heimlich maneuver) to attempt to remove obstruction
  • Call 911
  • Begin CPR if person becomes unresponsive

Table 4

Relief of Choking in Infants - A
Relief of Choking in Infants - B
Relief of Choking in Infants - C
Relief of Choking in Infants - D

Figure 17

Back Blows and Chest Thrusts in Infants

If an infant is conscious and choking and is less than a year old, execute back blows and thrusts in lieu of the Heimlich maneuver. To execute these safely, complete the following steps:

  1. Hold the infant in your lap.
  2. Secure the infant’s position by holding them face-down with their head lower than their chest. In this case, the infant should be resting on your forearm. Place your forearm on your thigh. (Figure 17a)
  3. To avoid exerting too much force on the infant’s throat, support the infant’s head and neck using your hand.
  4. Use the heel of your free hand to deliver five blows on the back in between the infant’s shoulder blades.  (Figure 17b)
  5. Move the infant, placing him or her in your other arm, then place this arm on your thigh.

  6. Lower the infant’s head so that it is lower than his or her chest (Figure 17c).
  7. Use the heel of your free hand to deliver five compressions on the infant’s chest, over the lower half of the breastbone. These thrusts should be done every second (Figure 17d).
  8. If this is not successful, place the infant face down on your other forearm and perform the same process.
  9. Continue with the steps until the infant is relieved or becomes unconscious.

Online Basic Life Support (BLS) Certification Course

  • Relief of Choking

  • Treatment of Choking for Adults, Children & Infants
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