Choking is when someone can't breathe because food, a toy, or other object is blocking the airway (throat or windpipe).
Heimlich maneuver - adult or child over 1 year
A choking person's airway may be completely or partially blocked, so that not enough oxygen reaches the lungs. A complete blockage is a medical emergency. A partial blockage can quickly become life threatening if the person cannot properly breathe in and out.
Without oxygen, permanent brain damage can occur in as little as 4 - 6 minutes. Rapid first aid for choking can save a life.
Occasionally an object will enter the lung. While the person may appear to improve and breathe normally, in a few days symptoms may develop, such as:
If you see something blocking the airway, try to remove it.
FOR PREGNANT OR OBESE PEOPLE
Wrap your arms around the person's CHEST.
Place your fist on the MIDDLE of the breastbone between the nipples.
Make firm, backward thrusts.
After removing the object that caused the choking, keep the person still and get medical help. Anyone who is choking should have a medical examination. Complications can occur not only from the choking, but also from the first aid measures that were taken.
DO NOT interfere if the person is coughing forcefully, able to speak, or is able to breathe in and out adequately. However, be ready to act immediately if the person's symptoms worsen.
DO NOT try to grasp and pull out the object if the person is conscious.
When to Contact a Medical Professional
Seek medical help right away if you find someone unconscious.
When the person is choking:
Tell someone to call 911 or the local emergency number while you begin first aid/CPR.
If you are alone, shout for help and begin first aid/CPR.
After the object is successfully dislodged, the person should see a doctor because complications can arise.
In the days following a choking episode, contact a doctor immediately if the person develops:
These could be signs that the object entered the lung instead of being expelled.
Eat slowly and chew food thoroughly.
Make sure dentures fit properly.
Don't drink too much alcohol before or during eating.
Keep small objects away from young children.
Manno M. Pediatric respiratory emergencies: Upper airway obstruction and infections. In: Marx J, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009: chap 166.
Thomas SH, Brown DFM. Foreign bodies. In: Marx J, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009: chap 57.
Hauda WE II. Pediatric cardiopulmonary resuscitation. In: Tintinalli JE, Kelen GD, Stapczynski JS, Ma OJ, Cline DM, eds. Emergency Medicine: A Comprehensive Study Guide. 6th ed. New York, NY: McGraw-Hill; 2004:chap 14.
Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, Washington, Clinic. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.