If someone is choking and cannot speak, cough, or breathe, give up to 5 firm back blows between the shoulder blades, followed by up to 5 abdominal thrusts, alternating until the object clears. For infants, use back blows and chest thrusts instead β never abdominal thrusts. Call +91-8282 8989 18 if it doesn't clear quickly.
Choking can happen in seconds, and every second without oxygen matters. Most people have heard of the Heimlich manoeuvre but have never actually practiced it β here's exactly what to do, for adults, children, and infants.
What this guide covers
How to Recognise Choking
A choking person often cannot speak, cough, or make sound, and may clutch their throat with one or both hands β the universal choking sign. Their face may turn red or bluish. If they can still cough forcefully or speak, encourage them to keep coughing β this is often enough to clear a partial obstruction on its own. Intervene directly only if they cannot make sound, breathe, or cough.
Figure 1: The correct choking response for adults, children, and infants.
Response for Adults and Older Children
β Step-by-step
- Stand behind the person and lean them slightly forward.
- Give up to 5 firm back blows between the shoulder blades using the heel of your hand.
- If that doesn't clear it, stand behind them, make a fist above the navel, grasp it with your other hand, and give up to 5 quick inward-and-upward abdominal thrusts (Heimlich manoeuvre).
- Alternate between back blows and abdominal thrusts until the object clears or the person can breathe, cough, or speak.
- Call +91-8282 8989 18 or 108 if the obstruction doesn't clear quickly, or once it does, to get them checked.
Response for Infants Under 1 Year
π« Never use abdominal thrusts on an infant
- Lay the infant face-down along your forearm, head lower than the chest, supporting their jaw.
- Give up to 5 firm back blows between the shoulder blades with the heel of your hand.
- If that doesn't clear it, turn the infant face-up, and give up to 5 chest thrusts using two fingers on the centre of the chest.
- Call for emergency help immediately and continue alternating until help arrives or the object clears.
"Choking response is one of those skills that feels intimidating until you actually learn it β and it takes just a few minutes to understand. It's genuinely one of the most useful things a parent or caregiver can know."β Dr. Chaitanya Pilladi, Consultant Anaesthesiologist & Intensivist
After the Object Clears
Even after successfully clearing an obstruction, it's worth getting the person checked β abdominal thrusts can occasionally cause internal injury, and there's a chance a fragment remains in the airway. Sri Ganga Hospital's emergency team is available 24Γ7 for post-choking evaluation.
What Happens When You Arrive at Sri Ganga
- Airway and breathing check β the team confirms the airway is fully clear and oxygen levels are normal.
- Examination for injury β checking for any internal injury from abdominal thrusts, or irritation in the throat from the obstruction itself.
- Imaging if needed β an X-ray may be done if a fragment of the object is suspected to remain in the airway or if swallowing was affected.
- Observation period β a short period of monitoring before discharge, especially for children or if there was any loss of consciousness during the episode.
Frequently Asked Questions
How do I know if someone is actually choking?
A choking person often cannot speak, cough, or breathe, and may clutch their throat. If they can still cough forcefully or speak, encourage them to keep coughing rather than intervening. If they cannot make sound or are struggling to breathe, act immediately.
What is the correct first aid for choking in an adult?
Give up to 5 firm back blows between the shoulder blades with the heel of your hand. If that does not clear the obstruction, give up to 5 abdominal thrusts (Heimlich manoeuvre). Alternate between the two until the object is dislodged or the person can breathe or cough.
Is the technique different for a choking infant?
Yes. For infants under 1 year, do not perform abdominal thrusts. Instead, give back blows while the infant is face-down along your forearm, followed by chest thrusts with two fingers if needed, and call for emergency help immediately.
Key takeaways
- If they can cough or speak, let them keep coughing β don't intervene yet
- Adults: alternate 5 back blows and 5 abdominal thrusts
- Infants under 1: back blows and chest thrusts only β never abdominal thrusts
- Get checked after any choking episode, even once resolved
This guide is for general awareness and does not replace formal first-aid training. Consider a certified first-aid course for hands-on practice. In any choking emergency, call for help immediately.
- American Heart Association. Choking Relief Guidelines.
- Indian Resuscitation Council. Basic Life Support Guidelines.
- St John Ambulance. First Aid for Choking.
After a Choking Episode, Get Checked
Our emergency team is available 24Γ7 for post-choking evaluation, even if the obstruction has already cleared.
π¨ Call +91-8282 8989 18 π Book an AppointmentRelated reading: 24Γ7 Emergency Care in Rajahmundry β Complete Patient Guide