First Aid for Choking (Heimlich Maneuver) -

 A foreign object that is stuck at the back of the throat can either block the throat or induce muscular spasm. This is choking. Adults may choke on food that has been inadequately chewed and hurriedly swallowed. Young children and babies are curious and like putting objects in their mouths. Choking requires prompt action from the First Aider; be prepared to resuscitate if the casualty stops breathing. The process is also called the Heimlich Maneuver


  • Difficulty in speaking and/or breathing
  • Congested face initially
  • Grey—blue skin cyanosis later
  • Troubled signs from the casualty, for example the casualty may point to his/her throat, or grasp the neck


  1. If the casualty is breathing, encourage her to cough as this will help to dislodge the obstruction
  2. If the casualty stops coughing or breathing, give five sharp slaps to her back between the shoulder blades.
  3.  If the back slaps fail, stand behind the casualty Place your arms around her abdomen, bend her slightly forwards and put your fist just below the base of the breastbone. Put your other hand on top and pull sharply inwards and upwards five times.
  4.  Repeat steps 2 and 3 three times. If the obstruction does not clear, call an ambulance

If the casualty becomes unconscious, or is found unconscious and is known to have choked:

  1. Open the airway and check breathing. Remove any obvious obstruction from the mouth. If the casualty is not breathing, attempt up to five artificial ventilation. If not successful, proceed to step 2.
  2. Turn the casualty on to his side and give up to jive sharp back slaps with the flat of your hand between his shoulder blades Check his mouth and remove any obvious obstructions. IF this is not successful, proceed to step 3.
  3. IF at any stage, the casualty begins to breathe normally, place him in the recovery position. Monitor and record breathing, pulse, and level of response every ten minutes.
  4.  Turn the casualty on to his back and kneel by his side or straddle him Place the heel of one hand below his breastbone and cover it with your other hand. Press sharply inwards and upwards up to five times. Cheek the mouth and remove any obvious obstruction.
  5.  If the casualty is still not breathing, attempt another five breaths of mouth—to-mouth ventilation. Continue the cycle of backslaps, abdominal thrusts, mouth checks, and ventilation attempts until the ambulance arrives or the casualty resumes breathing.


  1. Avatar
    December 30, 2013 19:22 Reply

    My neighbor has been diagnosed with ALS. I want to be able to keep her from chocking. Does the local Greenville Red Cross offer courses in the Heimlich Maneuver?

    • Lisa Madison
      December 31, 2013 12:51 Reply

      Usually all comprehensive first aid training include Heimlich Maneuver.

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