Choking occurs when something gets stuck in a person’s throat and blocks the flow of air. After four minutes without oxygen, brain cells start dying, which is why it’s important to be able to recognize choking and to act quickly to restore air flow. People cough all the time, but if they stop making noise as they cough, are unable to speak, put their hands to their throat in the choking sign, or start to turn blue they’re probably choking.
If you see someone choking, don’t hesitate to try to help them, but start by asking if they are choking and if it’s okay that you help them. If they nod yes, then the American Heart Association recommends using abdominal thrust (also known as the Heimlich maneuver):
- Stand firmly behind the person.
- Wrap your arms around the person’s waist.
- Make a fist with one hand and place it slightly above the person’s belly button, but well below the breastbone.
- Grasp that fist with your other hand and give firm upward thrusts into their abdomen.
- Give thrusts until the object is forced out and they can breathe, cough, or talk, or until they stop responding.
If you cannot get your arms around the person’s waist to do abdominal thrusts (the person is very large or pregnant): Wrap your arms around the person’s chest and give chest thrusts – using the same fist technique, place your fist in the center of the chest (same positioning you use for chest compressions) and pull straight back.
To help choking infants:
- Hold the infant face down on your forearm with their head/jaw in your hand.
- Keep the infant’s head lower than his torso.
- Using the heel of your other hand, deliver a series of up to 5 back slaps, mid-way between the infant’s shoulder blades. (Be careful not to deliver slaps too low – below the level of the infant’s shoulder blades.)
If the person stops responding lower them gently to the floor and call for help. Have someone call 911 and begin CPR until help arrives. Choking can be caused by simple things and can happen to anyone, which is why it’s important to know how to act quickly to restore air flow.
Rob Emory is an American Heart Association training center coordinator with Cone Health Staff Education. He received his Bachelor of Science in exercise physiology from the University of North Carolina at Greensboro.