Choking - adult or child over 1 year


Choking is when someone is having a very hard time breathing because food, a toy, or other object is blocking the throat or windpipe (airway).

A choking person's airway may be blocked so that not enough oxygen reaches the lungs. Without oxygen, brain damage can occur in as little as 4 to 6 minutes. Rapid first aid for choking can save a person's life.


Choking can be caused by any of the following:


When an older child or adult is choking, they will often grab their throat with the hand. If the person does not do this, look for these danger signs:

First Aid

First ask, "Are you choking? Can you speak?" DO NOT perform first aid if the person is coughing forcefully and is able to speak. A strong cough can dislodge the object. Encourage the person to keep coughing to dislodge the object.

If the person cannot speak or is having a hard time breathing, you need to act fast to help the person. You can perform abdominal thrusts, back blows, or both.

To perform abdominal thrusts (Heimlich maneuver):

  1. Stand behind the person and wrap your arms around the person's waist. For a child, you may have to kneel.
  2. Make a fist with one hand. Place the thumb side of your fist just above the person's navel, well below the breastbone.
  3. Grasp the fist tightly with your other hand.
  4. Make a quick, upward and inward thrust with your fist.
  5. Check if the object is dislodged.
  6. Continue these thrusts until the object is dislodged or the person loses consciousness (see below).

To perform back blows:

  1. Stand behind the person. For child, you may have to kneel.
  2. Wrap one arm around to support the person's upper body. Lean the person forward until the chest is about parallel to the ground.
  3. Use the heel of your other hand to deliver a firm blow between the person's shoulder blades.
  4. Check if the object is dislodged.
  5. Continue back blows until the object is dislodged or the person loses consciousness (see below).

To perform abdominal thrusts AND back blows (5-and-5 approach):

  1. Give 5 back blows, as described above.
  2. If the object is not dislodged, give 5 abdominal thrusts.
  3. Keep performing the 5-and-5 until the object is dislodged or the person loses consciousness (see below).



  1. Wrap your arms around the person's CHEST.
  2. Place your fist on the MIDDLE of the breastbone between the nipples.
  3. 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

When to Contact a Medical Professional

Seek medical help right away if you find someone unconscious.

When the person is choking:

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 right away if the person develops:

The above signs may indicate:


To prevent choking:

Review Date: 1/12/2019
Reviewed By: Jesse Borke, MD, FACEP, FAAEM, Attending Physician at FDR Medical Services/Millard Fillmore Suburban Hospital, Buffalo, NY. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

This information should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. © 1997- 2007 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.