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Identification & Treatment


Choking occurs when a foreign object lodges in the throat or windpipe, blocking the flow of air. In adults, a piece of food often is the culprit. Young children often swallow small objects. Because choking cuts off oxygen to the brain, give first aid as quickly as possible.

The universal sign for choking is hands clutched to the throat. If the person doesn't give the signal, look for these indications:

  • Inability to talk

  • Difficulty breathing or noisy breathing

  • Squeaky sounds when trying to breathe

  • Cough, which may either be weak or forceful

  • Skin, lips and nails turning blue or dusky

  • Skin that is flushed, then turns pale or blueish in colour

  • Loss of consciousness

Chocking 1.jfif

If the person is able to cough forcefully, the person should keep coughing. If the person is choking and can't talk, approach to delivering first aid:

  • Give 5 back blows. Stand to the side and just behind a choking adult. For a child, kneel down behind. Place one arm across the person's chest for support. Bend the person over at the waist so that the upper body is parallel with the ground. Deliver five separate back blows between the person's shoulder blades with the heel of your hand.

  • Give 5 abdominal thrusts. Perform five abdominal thrusts (also known as the Heimlich manoeuvre).

  • Alternate between 5 blows and 5 thrusts until the blockage is dislodged.


To perform abdominal thrusts (Heimlich manoeuvre):

  • Stand behind the person. Place one foot slightly in front of the other for balance. Wrap your arms around the waist. Tip the person forward slightly. If a child is choking, kneel down behind the child.

  • Make a fist with one hand. Position it slightly above the person's navel.

  • Grasp the fist with the other hand. Press hard into the abdomen with a quick, upward thrust — as if trying to lift the person up.

  • Perform between six and 10 abdominal thrusts until the blockage is dislodged.


If the person becomes unconscious, perform standard cardiopulmonary resuscitation (CPR) with chest compressions and rescue breaths.


To clear the airway of a pregnant woman or obese person using Chest thrusts:

  • Position your hands a little bit higher than with a normal Heimlich manoeuvre, at the base of the breastbone, just above the joining of the lowest ribs.

  • Proceed as with the Heimlich manoeuvre, pressing hard into the chest, with a quick thrust.

  • Repeat until the food or other blockage is dislodged. If the person becomes unconscious, follow the next steps.


To clear the airway of a choking infant younger than age 1:

  • Assume a seated position and hold the infant face down on your forearm, which is resting on your thigh. Support the infant's head and neck with your hand, and place the head lower than the trunk.

  • Thump the infant gently but firmly five times on the middle of the back using the heel of your hand. The combination of gravity and the back blows should release the blocking object. Keep your fingers pointed up to avoid hitting the infant in the back of the head.

  • Turn the infant face up on your forearm, resting on your thigh with the head lower than the trunk if the infant still isn't breathing. Using two fingers placed at the center of the infant's breastbone, give five quick chest compressions.

  • Repeat the back blows and chest thrusts if breathing doesn't resume. Call HEMS.

  • Begin infant CPR if one of these techniques opens the airway but the infant doesn't resume breathing.

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