Choking (for unconscious adult or child over 1 year)

Alternative names:

The first aid procedure for choking is also referred to as the Heimlich maneuver or abdominal thrusts.

First aid:

1. Roll the victim onto their back on a hard surface, keeping their back in a straight line, firmly supporting their head and neck. Expose the victim's chest.
   
   
2. Open the victim's mouth with your thumb and index finger, placing your thumb over his tongue and your index finger under his chin. If the object is visible and loose, remove it. If the person is older than age 8, sweep two fingers from one side of the throat to the other to attempt to remove the object.
   
   
3. Lift the victim's chin while tilting the head back to move the tongue away from the windpipe. If a spinal injury is suspected, pull the jaw forward without moving the head or neck. Don't let the mouth close.
   
   
4. Place your ear close to the victim's mouth and watch for chest movement. For 5 seconds, look, listen, and feel for breathing.
   
   
5. If the victim is breathing, give first aid for unconsciousness.
   
   
6. If the victim is not breathing, begin rescue breathing. Maintain the head position, close the victim's nostrils by pinching them with your thumb and index finger, and cover the victim's mouth tightly with your mouth. Give two slow, full breaths, with a pause in between.
   
   
7. If the victim's chest does not rise, reposition the head and give two more breaths.
   
   
8. If the victim's chest still doesn't rise, begin abdominal thrusts, as follows. Kneel at the victim's feet or astride the thighs (or to the side if the victim is obese or pregnant). Place the heel of your hand in the middle of the abdomen just above the navel, well below the tip of their breastbone. (If the victim is obese or pregnant, place the heel of your hand in the middle of the victim's breastbone. Do not place your hand on the ribs or on the tip of the breastbone.) Place your other hand on top of the first hand.
   
   
9. Give five quick thrusts, pressing your hands inward and upward. Do not press to either side. Each thrust is a separate attempt to clear the victim's airway by forcing air out through the windpipe.
   
   
10. Open the victim's mouth with your thumb and index finger. If the object is visible and loose, remove it. Observe the victim's breathing. If the infant stops breathing, begin CPR.
    
    
11. If the object is not dislodged, give 2 breaths, 6 to 10 abdominal thrusts, and then check for the object. Repeat this sequence until the object is dislodged or help arrives.
    
    
12. If the victim starts having convulsions or seizures, give first aid for this problem (see convulsion, first aid).

Do not:

• DO NOT try to grasp an object that is lodged in the victim's throat. This might push it farther down the airway. If the object is visible in the mouth, it may be removed.



• DO NOT begin the chest compressions of CPR (if heartbeat has stopped) until the airway is cleared.

Call immediately for emergency medical assistance if:

• A person if found unconscious.

If you are not alone, have one person call the local emergency number while another person begins CPR. If you are alone, shout for help. If you are trained in CPR, call the local emergency number and then administer CPR.

Updated Date: 10/1/99

Updated By:J. Gordon Lambert, MD, Associate Medical Director, Utah Health Informatics and adam.com editorial