First Aid Series 3 – Choking

One of the most successful skills that a first aider can learn is the treatment of chocking. Things such as food, sweets, or small objects can easily be lodged in the airway if they are accidentally ‘breathed in’ rather than swallowed. Recognising that someone is chocking is essential to a successful outcome.


It is fairly obvious when someone is chocking. They will clutch their throat, go a little red in the face and be panicked.
If chocking is mild, the causality will be able to cough and answer “yes” indicating that they are getting some air through to the lungs. The silent chocker is not good and is unable to speak with a weakened cough, will be very distressed and may become unconscious if untreated.

What to do? Treatment – adult or child (over 1 year)

Instruct the casualty to cough. If the choking is mild, this will clear the obstruction and they should be able to speak to you.

If the cough becomes ineffective

Lean the casualty forwards. Give 5 sharp blows between the shoulder blades with the heel of your hand. The aim is to relieve the chocking with each blow rather than to give all 5.
If it’s a child, then put them over your knee to slap, or hold them upside down along your leg for support – check airway again.
If still unsuccessful you will need to perform abdominal thrusts (Formerly the Heimlich Manoeuvre)
In an adult, stand behind them and place both your arms around them. Put the thumb edge of your hand into their abdomen just below the sternum in the centre and at the first soft point you can feel. Put your other hand over the top and then pull inwards and upwards to drive the obstruction up and out. Do this 5 times if necessary. Check the airway again.

If the obstruction has not resolved, you should prepare to resuscitate the patient with CPR and call 999.

In infants age 1 year or less, you must not do abdominal thrusts, we do chest thrusts instead.

Sit or kneel and lay the baby over your lap, face down , head lowest. Supporting the head.
Give up to 5 sharp blows between the shoulder blades with the heel of your hand. The aim it to relieve the chocking with each blow.
If the obstruction is still not cleared, then turn the child over with head still down, and perform a 2-finger chest thrusts. These are similar to chest compressions, but sharper in nature and delivered at a slower rate.
Repeat the back slaps and thrusts until the child becomes unresponsive or the obstruction is gone and they recover
NEVER perform abdominal thrusts on a baby.

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