It often happens at the dinner table. Someone is eating, laughing, talking — and suddenly goes quiet. Their hands go to their throat. They cannot speak, cough, or breathe.
Choking is one of the most common preventable emergencies, and it can turn deadly in as little as four to six minutes. There is rarely time to wait for an ambulance.
The person standing closest — a parent, sibling, coworker, or friend — is almost always the one who saves the life. That person could be you.
Recognizing Choking
First, tell the difference between mild and severe choking:
Mild blockage — they can still cough
- Coughing forcefully
- Able to speak or make sounds
- Breathing, though with difficulty
What to do: encourage them to keep coughing. Do not slap their back or interfere — coughing is the most effective way to clear the airway.
Severe blockage — act immediately
- Cannot speak, cry, or make sounds
- Cannot cough, or cough is weak and silent
- Clutching the throat (the universal choking sign)
- Lips or skin turning bluish
- Losing consciousness
First Aid for a Choking Adult or Child
1
Ask: “Are you choking?”
If they nod and cannot speak or cough, tell them you are going to help. Have someone call emergency services while you act.
2
Give 5 back blows
Stand to the side and slightly behind them. Support their chest with one hand and lean them forward. With the heel of your other hand, give up to five firm blows between the shoulder blades.
3
Give 5 abdominal thrusts
Stand behind the person and wrap your arms around their waist. Make a fist and place it just above their navel, thumb side in. Grasp the fist with your other hand and pull sharply inward and upward, up to five times. For pregnant women or people you cannot reach around, give chest thrusts instead.
4
Alternate until the object comes out
Keep alternating five back blows and five abdominal thrusts until the object is forced out, the person can breathe or cough, or they become unresponsive.
5
If they become unresponsive, start CPR
Lower them gently to the ground, make sure emergency services have been called, and begin chest compressions — the same Hands-Only CPR we teach. Compressions can also help dislodge the object. If you see the object in the mouth, remove it; never do a blind finger sweep.
Babies Under One Year Are Different
Never use abdominal thrusts on an infant. Instead:
- Sit down and lay the baby face-down along your forearm, resting on your thigh, with the head lower than the chest.
- Give up to five firm back slaps between the shoulder blades with the heel of your hand.
- If the object does not come out, turn the baby face-up and give up to five chest thrusts — two fingers on the center of the breastbone, just below the nipple line.
- Alternate until the object comes out or the baby becomes unresponsive — then begin infant CPR and make sure emergency services are on the way.
Do NOT:
- Sweep a finger blindly in the mouth — it can push the object deeper.
- Give water or food to “wash it down.”
- Hold a choking baby upside down by the feet.
- Leave the person alone — stay with them even after the object comes out, and seek medical care after any abdominal thrusts.
Preventing Choking at Home
- Cut food into small pieces for young children; avoid whole nuts, hard candies, and whole grapes for children under four.
- Encourage everyone to sit while eating and avoid talking or laughing with a full mouth.
- Keep small objects — coins, buttons, batteries, small toys — out of reach of babies and toddlers.
- Supervise young children during meals and play.
A few minutes of learning today can mean a lifetime for someone at your table tomorrow.
