Choking is one of the most frightening emergencies you may ever face. It can happen anywhere — at the dinner table, in a restaurant, or even while a child is playing with a small toy. In those moments, knowing what to do can make the difference between a scare and a tragedy.
This guide explains the signs of choking and the exact steps you can take to help adults, children, and babies. It follows recognised UK first aid guidance so you can act quickly and confidently when it matters most.
Recognising the Signs of Choking
Before you act, it’s important to understand whether the choking is mild or severe.
- Mild choking: The person can still breathe, speak, or cough (though often with difficulty). Encourage them to keep coughing, as this may clear the blockage.
- Severe choking: The person cannot breathe, speak, or make a sound. They may clutch their throat, their face may turn red or blue, and they may quickly lose consciousness if untreated.
To make sure they can make a sound, ask them a question (Are you choking? What is your name?), if noise is coming out, air is moving and it’s more likely mild choking. Call 999 immediately if the person cannot breathe, cough, or talk. Don't delay even if you believe you can get it out.
First Aid for Adults and Children Over 1 Year
If someone is severely choking:
- Encourage coughing if they can still partially breathe or speak.
- Give up to 5 back blows:
- ~Stand slightly behind and to the side.
- ~Support their chest with one hand and bend them forward.
- ~Deliver firm blows between the shoulder blades with the heel of your hand.
- ~Check after every back blow to see if air is moving again.
- If not cleared, give up to 5 abdominal thrusts:
- ~Stand behind the person.
- ~Place your arms around their waist.
- ~Make a fist and place it just above their belly button.
- ~Pull sharply inwards and upwards.
- ~Check after every abdominal thrust to see if air is moving again.
- Alternate between 5 back blows and 5 abdominal thrusts until the object clears, help arrives or casualty become unresponsive.
⚠️ Important: If you perform abdominal thrusts, the person should see a healthcare professional afterwards, as the procedure can cause internal injury.
First Aid for Babies Under 1 Year
Choking is especially dangerous for babies. The steps are slightly different, and a baby should never be given abdominal thrusts:
- Check for signs (unable to breathe, cry or cough, silent coughing, lips turning blue).
- Call for help: if someone is with you, ask them to call 999 straight away.
- Give up to 5 back blows:
- ~Sit or kneel and lay the baby face down along your thigh, supporting their head.
- ~Keep their head lower than their chest.
- ~Use the heel of your hand to give firm blows between the shoulder blades.
- ~Turn them over on your thigh and check their mouth. Only remove an object you can clearly see. Never sweep the mouth with your finger.
- If not cleared, give up to 5 chest thrusts:
- ~Turn the baby onto their back and lay them on your knees, keeping their head lower than their chest.
- ~Wrap your hands around their chest and place both thumbs on the lower half of the breastbone.
- ~Give sharp chest thrusts with your thumbs, checking their mouth after each one.
- Still blocked? If nobody has called yet, call 999, taking the baby with you. Keep repeating 5 back blows and 5 chest thrusts until the object comes out or help arrives.
If the baby becomes unresponsive, make sure 999 has been called and start baby CPR, following the call handler’s instructions. Every baby who has been given chest thrusts should be checked in hospital, even if they seem well.
What Not to Do
When someone is choking, avoid these common mistakes:
- Don’t poke around in the mouth unless you can clearly see and safely remove the object. Blind sweeps risk pushing it further in.
- Don’t shake or hit the person anywhere other than between the shoulder blades.
- Don’t assume a mild case will resolve on its own — monitor closely as it can worsen quickly.
Aftercare
Even if the choking episode seems resolved:
- Seek medical advice if abdominal thrusts or chest thrusts were used.
- Watch for ongoing difficulty breathing, swallowing, or pain.
- Offer emotional reassurance, especially to children, who may be frightened after the event.
Final Thoughts
Choking emergencies are sudden, scary, and can happen to anyone. The good news is that simple first aid steps can save lives. The more you practice and prepare, the more confident you’ll be in the moment.
Ready to build life-saving skills? Book a certified First Aid course with Promet today and gain the confidence to act when it matters most.
