What should you do first for a choking victim with a full obstruction who is still responsive?

It could happen to you someday — you’re sitting with your family at a favorite restaurant. Suddenly a noise grabs your attention. Someone across the room is coughing hard, trying to clear his throat.

Índice Show

What is Choking?
What Causes Choking to happen?
Types of choking
Mild choking
Severe Choking
What to do if a baby is choking
What to do if a child is choking
What to do if an adult is choking
Signs of Choking
Performing First Aid on a Choking Victim
First Aid on a Conscious Choking Victim
Determine if Victim Needs Aid
Get Permission to Assist
Heimlich Maneuver
First Aid using Back Blows
First Aid for a Choking infant
Treating an Unconscious Victim

That happens all the time in restaurants, but this guy isn’t stopping, and others are also starting to notice the commotion. You vaguely remember that helping isn’t always the best choice, so you sit there with everyone else hoping he’ll work it out on his own. How do you know when to step in when someone is choking? Keep reading and we’ll share some of the signs to look for to know that the situation has escalated to the point where you should get involved.

What is Choking?

Choking is what medical professionals call a foreign body obstruction. Put simply, something like food gets stuck in the throat, blocking the passage of air to the lungs. A person with foreign body obstruction can’t breathe in fully or expel the air from their lungs. Choking is the fourth leading cause of death from an injury and a true medical emergency if the blockage doesn’t clear.

What Causes Choking to happen?

Food is the answer that might first pop into your head, but there are other possibilities such as:

Allergic reaction
Inedible items
Disease

Food is the most common cause, though, especially in children and the elderly. Use special caution with foods like hot dogs, grapes, popcorn, nuts, and peanut butter. These are some of the most common foods that may lead to choking.

Types of choking

All forms of choking are serious, but there are variations and each requires different emergency actions.

Mild choking

Mild Choking is due to a partial blockage. When this happens, the person might be able to speak and will be trying to cough. You might hear wheezing or a gagging sound.

You should encourage them to cough hard to clear the blockage. In some cases, back blows with the heel of your hand can loosen the object. Bend the person over at the waist to help gravity pull out the obstruction as you apply the blows.

Severe Choking

Severe choking means there is a full airway blockage and this is a medical emergency. Have someone call 911 while you attempt to clear the blockage. Before doing anything, assess the patient to look for signs that indicate a full obstruction, such as:

Clutching the throat – This is the universal sign for choking, and it means this person needs immediate help.
Blue lips, face, or fingertips – Turning blue indicates a lack of oxygen.
Putting fingers down their throat – This is another sure sign of choking. The affected person is attempting to vomit.
Losing consciousness – This means the brain is not getting oxygen.

For a conscious victim, bend their body forward at the waist and do back blows while standing behind them. After five blows, pull their body up and reach your arms around their abdomen. Then:

Put your hands together to make a fist.
Place your fist in the middle of the victim’s stomach with the thumb side pressing against the skin.
Do five quick and hard thrusts upward. The move forces air out of the lungs to push the obstruction outward.

Continue the maneuver until help arrives, the victim loses consciousness, or the object comes out. If the person choking does pass out, roll them on their side so fluids like saliva or vomit do not go into their lungs. If they stop breathing or have no pulse, do CPR until help arrives.

What to do if a baby is choking

For conscious choking in an infant less than 12 months:

First, do a quick assessment to determine if the baby can cry. If so, wait to see if there is coughing as the baby tries to push the obstruction out. If the infant is making very little noise or no sound, the airway is fully obstructed.
Once you have an idea of what is happening, the first step is always to ensure someone is calling 911. If you are alone and have to make the call, spend two minutes providing care and then grab your phone. If you know the throat is closed due to an allergic reaction or illness like croup, make the call immediately.
Hold the baby face up with one forearm. Hold the infant’s head with your hand.
Place the other forearm over the baby’s front side with your thumb and forefinger supporting the jaw.
Flip the baby face down with head angled towards the floor. The infant’s head should be below the heart.
Use the heel of your hand to apply five back blows between the shoulder blades.
Turn the baby over, carefully supporting the head, and place two or three fingers in the middle of the chest to do five chest thrusts.

Continue this process until the baby loses consciousness or the object comes out and the infant starts to breathe.

If the choking victim is an unconscious infant less than 12 months:

Begin infant CPR immediately. After a full round of rescue breaths and chest compressions, look into the baby’s mouth, searching for the obstruction. If you see it, reach in and try to remove it. If not, continue CPR. Recheck the mouth after each round of breaths and compressions.

What to do if a child is choking

The actions for a choking child and adult are very similar.

For a conscious child:

Ask if they are choking or if they can breathe and do a quick assessment, looking for blue lips and other signs of full airway obstruction. If the child is coughing, tell them to keep trying to cough out whatever is causing them to choke. If the child can’t talk, assume there is a full obstruction.
Ask someone to call 911
Open the child’s mouth and look for the obstruction. Remove it if you can see and reach it safely.
Stand behind and bend the child over to apply five back blows between the shoulder blades.
Wrap your arms about the abdomen and place one fist in the middle of the stomach and put your other hand over it to perform five quick abdominal thrusts upward.
Continue care until help arrives or the child loses consciousness.

For an unconscious choking child:

Ask someone to call 911 and begin CPR.
If you are alone, do one round of CPR and then call 911.
Check after each series of chest compressions to see if you’ve dislodged the object enough to remove it. If not, begin again with rescue breaths.

What to do if an adult is choking

If the adult is conscious, ask them if they can speak or if they need help. If they cannot talk, proceed with the next step.
Ask someone to call 911
Begin back blows and chest thrusts. Keep going until the person passes out or you dislodge the object.
If this person was found unconscious or becomes unconscious during the process, begin CPR

The most important thing to remember in any choking emergency is to get help. Ask someone to call 911. If no one is around, try yelling for help. If no one comes, start choking assistance for one round and then call 911 yourself.

Always verify that someone is choking before doing back blows and performing abdominal thrusts. Otherwise, you may turn a partial obstruction into a full one. Ask the choking victim if they need help and look for the universal signs of choking before doing anything. Also, do not do finger sweeps unless you can see what is blocking the throat. You might inadvertently push the obstruction down farther.

Thousands of people die every year from choking. The more people that know how to help, the better chance the choking victim has of surviving a choking emergency. For full instructor-led training on choking, CPR, and assisting with other medical emergencies, be sure to check out ProTrainings’ free CPR and first aid training courses.

Sources:

https://www.nsc.org/home-safety/safety-topics/choking-suffocation
https://www.babycenter.com/0_infant-first-aid-for-choking-and-cpr-an-illustrated-guide_9298.bc

How to Help a Choking Victim

Choking occurs when a person’s airway becomes blocked by food or another foreign object. When this happens, the choking victim will be unable to breath normally and is at risk of suffocating. When treating a choking victim, the first goal is to remove the obstruction to restore normal breathing function.

Thousands of choking deaths occur each year. While choking can happen to anyone, young children and the elderly are at increased risk.

Signs of Choking

Choking can be a serious emergency. Because of this, it is important to quickly recognize the signs of choking and take appropriate action.

A conscious choking victim may clutch their throat with their hands. This is a universal signal and is easy to recognize. However, if the person does not give this signal, look for other signs:

Difficulty speaking. If someone is choking, they will be unable to speak.
Coughing or wheezing. Sometimes, a choking victim will cough of wheeze excessively. This happens when the airway is only partially obstructed. Pay attention to the victim’s breathing; if coughing or wheezing suddenly stop, it may mean that their airway is now fully obstructed and they need immediate help. On the other hand, if the victim is coughing forcefully, allow them to cough, because it may help clear the obstruction.
Changes in skin color. For instance, the skin, lips, and nails may change to a pale or bluish color, indicating a lack of oxygen in the blood.
Loss of consciousness.

Performing First Aid on a Choking Victim

There are several techniques that can be used to help a choking victim. However, which ones you should use depend on a number of factors. For example, is the person conscious, or unconscious? Are they a child or infant? Are they pregnant or obese? Consider these factors when performing first aid.

Heimlich Maneuver – How to help someone who is choking.

First Aid on a Conscious Choking Victim

Determine if Victim Needs Aid

You must obtain permission before providing any First Aid. If your victim is choking, ask them “Are you choking?” followed by “Can you speak?” If they can speak, encourage them to cough to relieve the obstruction without assistance If they can not speak, the obstruction is significant and assistance may be necessary.

Get Permission to Assist

Tell the victim: “I’ve been trained, I’m going to help you”. If they allow you to assist them then perform the Heimlich Maneuver. If they push you away or don’t allow you to assist, call 911. Without air moving, your victim will become unconscious within minutes. Consent is not required on an unconscious victim.

Heimlich Maneuver

The Heimlich Maneuver (aka Abdominal thrusts) is the most common first aid technique for choking. However, it is important to note that this technique is used on conscious victims only. To perform abdominal thrusts:

Stand behind the person and place one foot ahead of the other for balance.
- If the choking victim is a child, crouch or kneel behind them and keep your head on their shoulder.
Put your arms around the person’s waist. Make a fist with one hand and grab your fist with the other hand. Keep your hands rested slightly above the person’s navel (belly button).
- Note: If the person is overweight or pregnant, position your hands higher, around their breastbone.
Next, make quick upward and inward thrusts, as if you were trying to lift the person up.
Perform 6-10 thrusts, or until the blockage is cleared.

It is important to know when to call for an ambulance. If you are the only rescuer on the scene, try to use 6-10 abdominal thrusts before calling 911. But if you’re not alone, have someone else call for an ambulance while you perform first aid. Also, call 911 if the victim becomes unresponsive at any point.

First Aid using Back Blows

Back blows are another technique you can use to help a choking victim. Typically, we do not teach back blows in our classes. It’s important to note, if done incorrectly, back blows can cause the obstruction to worsen. To perform back blows correctly:

Stand to the side of and slightly behind the choking victim.
Keep one arm around their waist for support and have them bend over at the waist at a 90-degree angle (important).
Firmly deliver several blows to the center of the victim’s back. You should aim for the area in between their shoulder blades using the palm of your hand.

The jolt of the back blow can help to free the foreign object. When helping a choking victim, try to alternate between 5 abdominal thrusts and 5 back blows. However, if you only know how to do abdominal thrusts, stick with those.

First Aid for a Choking infant

If an infant is choking you can attempt to dislodge the object by doing the following:

Support the child’s head and neck firmly.
Perform back blows in between the shoulder blades.
Perform Chest Thrusts by pushing on their chest with two or three fingers. You’ll want to push down about one and a half inches.
Alternate between 5 back blows and 5 chest thrusts.
If you cannot get the object dislodged, or the victim falls unconscious or turns blue, call 911 or have someone else call if it hasn’t been done yet.

Be careful what infants eat or can put in their mouths. Because most child choking incidents are preventable.

Treating an Unconscious Victim

As stated before, if a choking victim has fallen unconscious or become unresponsive at any point, make sure that an ambulance or 911 has been called. After that:

Lay the unconscious victim on their back on the ground.
If the obstruction is visible in their mouth, you may try to use your finger to remove it. However, be careful to not push the object further into the airway. If the object is not visible, do not try to reach for it.
Perform CPR on the victim.
- Perform 2 rescue breaths, followed by 30 chest compressions. For more detailed information on how to perform CPR, click here.
Periodically check the victim‘s mouth to see if the obstruction has become visible.