The tragic death of two-year-old Bentley Do, who choked on a gumball, evoked strong memories. I once saved my son from choking on a pizza crust by using the Heimlich Maneuver (abdominal thrust) even though I’d never taken a first aid course and had only seen it on TV. I also vividly recall my Mom saving a friend’s toddler who snatched a gumball out of a candy tray and was choking. Mom flipped the child upside down and thumped his back. Thankfully the gumball popped out.
Please take a moment to read how to provide emergency treatment for choking. Don’t count on emergency help to arrive in time. You need to take immediate action. Also learn how to save yourself from choking if you are alone. Besides learning the techqniques below, be sure to child proof your house to keep small objects out of young children’s reach--and avoid a preventable choking tragedy.
If someone appears to be choking
First, ask if they are choking. If they respond verbally, it’s only a partial airway obstruction; encourage the person to cough and try to clear the airway. Do NOT give fluids. Do NOT attempt to grab the object (unless all other efforts have failed and only if you can see the object) as you may force it to be become more tightly lodged farther down.
If the choking person nods but can’t speak, or is turning blue or not breathing, he or she needs emergency help. Call 911, then do the following:
In adults and children over one year of age: perform abdominal thrusts. Stand behind the person and lean them forward slightly. Make a fist with one hand. Put your arms around the person and grasp your fist with your other hand in the midline just below the ribs. Make a quick, hard movement inward and upward; repeat until the object becomes and the person can breathe, or the patient loses consciousness.
If the person loses consciousness, lay the patient on the floor, face up. Kneel beside him/her and put the heel of your hand against the middle of the abdomen, below the ribs. Put your other hand on top and press inward and upward five times with both hands. If the airway clears and the person is not responsive, start CPR.
For babies under one year of age: If the baby is coughing, allow the child to cough up the object.
If the infant is choking but not coughing, do not attempt abdominal thrusts. Instead, lay the infant face down along your forearm, using your lap or thigh for support. Hold the infant with head angled down lower than the body (to let gravity help), making sure to support the baby’s head and jaw. Give up to 5 quick, forceful blows between the infant's shoulder blades using the heel of your hand.
If that doesn’t work, turn the infant face up, supporting the head. Put two fingers over the middle of the breastbone, just below the nipples. Give up to 5 quick thrusts down, compressing the chest 1/3 to ½ the depth of the chest. Continue alternative 5 back blows and 5 chest thrusts. If the child becomes unresponsive, stops breathing, or turns blue, give infant CPR. NEVER attempt to remove an object unless you can see it and grab onto it, as you may force it farther down, making the obstruction worse.
If the person is seated: Wrarp arms around the victim and still perform the abdominal thrusts, or rotate the victim so the back of the chair is to the side.
If the person is much larger than you: Instead of standing behind the victim, have the victim lie down on their back. Put one hand halfway between the belly button and edge of the breastbone. Thrust upward and inward (same technique used on unconscious people). Even a child can save an adult with this technique. For pregnant or obese persons, chest compressions may be more effective; see links below for details.
If you are choking and you’re alone: Dial 911. Even if you can’t speak, they can pinpoint where your call came from and send help. Next, deliver an abdominal thrust with your own hands, inward and upward as described above. Another choice is to bend forward over a firm object such as the back of a chair, and thrust yourself against the object.
Always call 911 if someone is choking and can't speak. If your attempts to save the patient do not work, emergency workers can use other methods,including an emergency tracheotomy in some circumstances, to enable the person to breathe.
For additional tips, including how to treat a pregnant or obese victim, and how to administer CPR and mouth-to-mouth resuscitation for unconscious patients, see