Many of us have been in that situation when someone around you starts to choke. It’s scary for everyone involved and, if assistance isn’t given, can quickly deteriorate further.
Immediate action is required. Someone who is choking may have difficulty in speaking and breathing, they may be coughing or gagging, they’ll likely be clutching their throat and might be pointing to their mouth. They may also have pale, grey/blue coloured skin and might become unresponsive.
You need to quickly ascertain that they are indeed choking. You should ask “Are you choking?” If the casualty nods then you can also quickly gain consent by asking “Can I help?”
You should then encourage your casualty to cough whilst remaining calm and offering reassurance. Once they’re unable to cough any further you should check their mouth and remove any obvious obstruction before moving on to back blows.
Bend your casualty forward and give up to five back blows by standing to the side and slightly behind them and supporting the chest with one hand. The back blows will need to be firm, between the shoulder blades with the heel of your hand. After each blow, check to see if the obstruction has cleared. Back blows create pressure in the airway which is often enough to dislodge any obstruction and help them breathe normally.
If these are unsuccessful you should move on to abdominal thrusts (what you might previously have known as the ‘Heimlich maneuver’). Abdominal thrusts squeeze air out of the lungs hopefully dislodging any obstruction. Lean the casualty forward, brace yourself behind them and reach around their abdomen. Clench your fist and place it above their belly button and below the bottom end of their sternum/breastbone. Grasp your fist with your other hand and pull sharply inwards and upwards. Repeat this up to five times checking after each attempt to see if the obstruction has cleared.
If you have performed back blows or abdominal thrusts on a casualty successfully, they should seek medical attention.
If you’re not able to clear the obstruction after one cycle of five back blows and five abdominal thrusts, you (or someone nearby) should call 999 immediately. Continue the process of five back blows and five obdominal thrusts until the casualty recovers or the emergency services take over from you. If your casualty becomes unresponsive and is no longer breathing, help them gently to the floor, call 999 if you haven’t already done so, and commence CPR immediately. Before each rescue breath, check in the mouth to see if a visible obstruction can be removed easily.
Learn how to deal with a choking casualty in real life on a North Wales First Aid first aid training course. We cover disorders of respiration on our one-day Emergency First Aid at Work, two-day Outdoor First Aid and three-day First Aid at Work courses.