Grabbing the throat with one or both hands is the universal sign for choking. Other danger signs include inability to speak, weak and ineffective coughing, difficulty breathing, high-pitched or noisy breathing sounds while inhaling, bluish skin color, and loss of consciousness. Choking is especially common in children under the age of 3 and in the elderly.
The Heimlich maneuver (abdominal thrusts) is recommended to help a person who is choking on a foreign object (such as food or a toy). If done correctly, abdominal thrusts force air from the lungs (creating an artificial cough) to expel the object.
How to do the Heimlich Maneuver on Children & Adults
The following is not to be used on infants under 1 years old. Click on images to enlarge.
Ask the person if they are choking and if they can speak.
If the child or adult is able to speak or cough forcefully, do not perform the Heimlich maneuver. Instead, stay with the person and be
ready to act immediately in case the person’s symptoms worsen.
Stand directly behind the person and wrap your arms around their waist. Make a fist with one hand (normally your dominant hand is best). Place the thumb side of your fist against the person’s stomach, just above their belly button (navel) and well below their breastbone. Place your other hand over your fist.
Make quick, inward-upward thrusts with your fist. Continue doing the thrusts until the object is expelled or the person loses consciousness.
If the person expels the object, it is recommended that the person see a doctor since complications can arise.
If the person becomes unconscious, continue with the following steps.
Lower the person to the floor (hard surface) on their back with their body straight and their arms by their side. Shout for help. Call 911.
Open the person’s mouth using the tongue-jaw lift (grasp the tongue and lower jaw between your thumb and fingers and lift the lower jaw).
If the person is 8 years old or older, do a finger sweep to feel for an object in their mouth. If the object is visible and loose, carefully remove it.
For children under 8 years old, do not do a finger sweep. Only remove the object if it is visible.
If you do not see an object to remove, check to see if the person is breathing. Tilt their head back by lifting their chin with one hand and pushing down their forehead with your other hand. Look for chest movement and listen and feel for air against your cheek.
If the child or adult is not breathing, attempt rescue breathing (mouth-to-mouth).
If their airway remains blocked, straddle the person’s thighs, place the heel of one hand above their belly button (well below the breastbone), and give 6-10 abdominal thrusts (pressing into the stomach with quick, inward-upward thrusts).
Repeat the sequence until the object is removed or medical help arrives: Look in the mouth for the object, do a finger sweep (if 8 years or older), attempt rescue breathing, perform abdominal thrusts.
If the object is removed and the person is still unresponsive, begin CPR.
How to do the Heimlich Maneuver on Children & Adults who are Obese or Pregnant
Instead of wrapping your arms around the person’s waist, wrap them around their chest. Place your fist on the middle part of their breastbone (between their nipples). Make firm, backward thrusts. Chest thrusts should also be used if unconscious.
How to do the Heimlich Maneuver on Yourself
Do not panic. Call 911, even if you can’t speak (dispatchers may be able to trace calls on land-lines).
Place your fist (thumb side) above your belly button (below the breastbone), grasp your fist with your other hand, and press into your stomach with quick, inward-upward thrusts. If pregnant or obese, do chest thrusts.
You can also lean over the back of a chair and press your stomach against the edge to produce a quick, inward-upward thrust.
The above information can be helpful, but I highly recommend you learn the Heimlich maneuver and CPR in a certified first-aid training course. Visit the American Heart Association to find a class near you.
Share this information with friends and family so they will know how to do the Heimlich maneuver.
American Heart Association: Heimlich Maneuver - https://www.americanheart.org/presenter.jhtml?identifier=4605
Medline Plus: Choking - adult or child over 1 year - https://www.nlm.nih.gov/medlineplus/ency/article/000049.htm
Emergency Care For You: Choking (Heimlich Maneuver) - https://www.emergencycareforyou.org/EmergencyManual/WhatToDoInMedicalEmergency/Default.aspx?id=224
All images courtesy of the National Library of Medicine (NLM).