Choking and Abdominal Thrusts

When food or some other foreign object becomes stuck in the airway it can cause choking. Choking prevents oxygen from getting to the lungs and the brain. Lack of oxygen to the brain for more than 4 minutes may cause brain damage or death. It's important for all people to recognize and know how to handle choking at home and in public places. Experts advise using back blows and abdominal thrusts to treat an adult or child over age one year who is choking.

How can I prevent choking?

You can prevent choking in adults with these safety measures:

• Cut food into small pieces.

• Chew food slowly and thoroughly, especially if wearing dentures.

• Don't laugh and talk while chewing and swallowing.

• Don't drink lots of alcohol before and during meals.

You can prevent choking in children with these safety measures:

• Keep marbles, beads, thumbtacks, latex balloons, coins, and other small toys and objects out of reach, particularly in children younger than 4 years old.

• Prevent children from walking, running, or playing when they have food and toys in their mouth.

• Don't feed children younger than age 4 foods that can easily get lodged in the throat. This includes hot dogs, nuts, chunks of meat or cheese, grapes, hard or sticky candy, popcorn, chunks of peanut butter, or raw carrots.

• Supervise mealtimes with young children.

• Prevent older siblings from giving a dangerous food or toy to a young child.

What is the advised first aid technique for choking?

A series of back blows and under-the-diaphragm abdominal thrusts are advised for adults and children over age one year who are choking on a piece of food or a foreign object and are conscious. Choking is when a person can't speak, cough, or breathe because something is blocking (obstructing) the airway. No air can get through. If the airway stays blocked, it can lead to a loss of consciousness and death. When applying the abdominal thrusts, be careful not to use too much force so you don't damage the ribs or internal organs. If the person is unconscious, use chest compressions.

First, perform a series of 5 back blows.

• If you are able, gently lean the person forward so their upper body is parallel with the ground. Use one arm across the person's chest for support. If the person is a child, kneel down behind them.

• Use the heel of your free hand to give 5 quick thumps (back blows) between the person's shoulder blades.

Then perform 5 abdominal thrusts. Abdominal thrusts lift the diaphragm. They force enough air from the lungs to create an artificial cough. This cough helps move air through the windpipe, pushing and expelling the obstruction out of the airway and mouth:

• Reach around the person's waist.

• Position one clenched fist above the navel (belly button) and below the rib cage.

• Grasp your fist with your other hand. Pull the clenched fist sharply and directly backward and upward under the rib cage 5 times quickly.

• If the person is obese or in late pregnancy, give chest thrusts.

• Keep doing back blows and abdominal thrusts without stopping until the obstruction is relieved, the person becomes unconscious, or advanced life support is available. In either case, the person should be examined by a healthcare provider as soon as possible.

If you are by yourself and choking, you can do thrusts on yourself. Or you can thrust your upper abdomen against the back of a chair or the edge of a counter.

Back blows and abdominal thrusts can be painful and even injure the person. Only use them in actual emergencies, when it is certain that the person is choking. Use this method only in adults and children over 1 year old.

A different method is used in infants under 1 year old. Discuss the correct first aid choking method for your child with their healthcare provider.

How can I learn the right way to help someone who is choking?

Using back blows and abdominal thrusts is simple to learn. It is often taught during first aid and cardiopulmonary resuscitation (CPR) classes. Contact your local chapter of the American Red Cross or American Heart Association. Or contact your local hospital or healthcare facility for a class schedule and more information.