Choking is a common problem that can occur anytime, to anyone. It is a condition, when airflow in your windpipe is restricted as your throat is blocked by some foreign particles. It can occur to children as well as adults. Usually, adults experience choking as hard food particles get lodged in the throat and windpipe. However, in case of children, it can be food as well as toys and other items that they unknowingly swallow.

This might lead to blocking the airways and as a result, the oxygen supply to the lungs through the windpipe is restricted. If oxygen does not reach the brain for 4 to 6 minutes at a stretch, it can be fatal, leading to death. With rapid first aid, the life of a choking person can be saved. Let us first see what are the different reason for which choking can happen, its symptoms and what to do when someone is choking.

What to do When Someone is Choking?

Why Does Choking Occur?

Choking can occur due to a number of reasons. Knowing the causes will help in avoiding such situations and also empower you to help people who are experiencing choking.

  • Eating too fast, without chewing
  • Eating with unfitting dentures
  • Breathing small objects
  • Enlarged tonsils and tumour in throat, creating blockage in path of swallowing food
  • Breathing in vomit
  • Problem in oesophagus
  • Swelling, bleeding and injury to face and head
  • Swallowing problems after a stroke.

Symptoms of Choking

Initially, the person might give signals of choking. However, if that doesn't happen, the other signs and symptoms that need to be looked for are –

  • Clutching throat with hands, a universal sign of choking – a natural response to the condition
  • Difficulty in breathing; laboured and partial breathing; noisy breathing
  • Gasping
  • Sudden inability to talk
  • Losing consciousness
  • Unable to cough forcefully
  • Panicking
  • Lips and skin around the nails turning blue.

There can be partial choking as well as complete obstruction of the trachea or windpipe. In either case, be ready to provide the first-aid to the choking person as soon as possible.

What to do When Someone is Choking?

  1. First Aid for Adults Who are Choking:

    According to Red Cross, a "five-and-five" approach is the first step to first aid for the adults. These are –

    • 5 back blows: Give 5 back blows to the person between the shoulders, with the heel of your hand. For this, you need to stand behind the person and make the person lean forward to form a parallel line with the floor.
    • 5 Heimlich manoeuvre: Give 5 Heimlich manoeuvre or abdominal thrusts to the person. This can be given by standing behind the person who is choking and giving a quick squeeze in the middle of the abdomen, slightly over the navel. This sends strong and prompt burst of air from the lungs, upwards. This can effectively dislodge the object.
    • Alternating 5 back blows and 5 Heimlich manoeuvres: Repeat this process in this manner, until the object is dislodged.

    The American Heart Association doesn't approve of the technique of back blows. However, both are acceptable, provided you know how to do them right.

  2. First Aid for Children Below the Age of 1 Year Who are Choking:

    For children below the age of 1 and who are choking, the following first aid technique can be followed.

    • Have the infant seated on your thigh, with facedown on the forearm.
    • With the heel of your hand, thump for five times on the back of the infant. The back blows and the gravity will dislodge the object.
    • If these don't work, hold the infant on your forearm, facing up. Place two fingers in between the breastbone of the infant and give 5 prompt compressions.
    • If breathing doesn't resume, start Cardiopulmonary Resuscitation (CPR) and call emergency help.

    Before starting CPR, know how to do it.

  3. First Aid for Choking in Children Above the Age of 1 Year:

    In case the child that is choking is above 1 year in age, the following first aid method can be useful.

    • Kneel down behind the child and lean him forward on your forearm.
    • Give 5 back blows in between the shoulder blades.
    • If this doesn't help give 5 quick, upward and inward abdominal thrust as described above.
    • Make sure the thrust is not too hard for the child but it must be of the intensity that is capable of dislodging the clogged object.
  4. First Aid for Pregnant and Obese People Who are Choking:

    In case the patient is obese or in the later stage of pregnancy, abdominal thrusts may be of no use. In that case –

    • Wrap your hands around the chest of the patient, through under the armpits.
    • Place the fist in such a way that the thumbs face the chest in the middle of the breastbone, through the nipples.
    • Start giving backward thrusts, by grabbing your fist with the other hand.

    Immediate medical attention must be ensured if the person is pregnant or if becomes unconscious.

What to do When Someone has Choked and is Unconscious?

None of the above methods might be useful if the person is unconscious. You need to follow a different method for providing first aid. The steps are:

  • Roll the person, adult or child on a tough surface with support to the head and neck.
  • Kneel down on one side of the victim.
  • Open the mouth with your index finger and thumb. Place the thumb over the tongue. If a loose object can be seen, remove it with your hands.
  • If the object cannot be seen, there is no need to put your fingers inside as this might push the object further down the throat.
  • Lift the head and tilt it backwards to check for breathing.

If breath cannot be felt, start giving CPR.

  • Give 30 chest compressions by placing the heel of one palm 2 inches below an imaginary straight line drawn from the nipples.
  • Place the other hand just over the palm placed.
  • Give deep compressions (minimum 2 inches or 5 cms) straight down in the chest at a speed of 100 compressions per minute.
  • As soon as you finish 30 compressions, check for breathing by head-tilt and chin-lift manoeuvre. Gently push the forehead down with the palm of one hand and lift the chin with the other hand to open the mouth.
  • If normal breath has not yet returned, give 2 mouth-to-mouth breathings by pinching the nostrils of the person with your thumb and index finger. Now by covering his or her mouth with yours, blow in two full breaths with a pause in between.
  • If chest does not rise, repeat the 30 chest compression and 2 mouth-to-mouth breathing until breathing starts or medical help arises.

In most cases, compressions release the lodged objects. Up to 30 compressions can be given at a stretch. While giving chest compressions, make sure to keep the mouth open and check regularly for the lodged object.

In case of unconscious victims, make sure to call the emergency medical services at once and then continue the first aid CPR by yourself. Call for help from people nearby, if any. If you are alone and the person choking is an adult call the emergency medical help first before proving first aid. In case it is a child, provide the first aid for choking first for 2 minutes and then call for help.

At times, the prolonged chest compressions may damage the rib bones. Seek medical help immediately to make sure that no further complications arise due to this.

What to do When You are Choking?

Although it is of much use that someone else assists you in dislodging the object that gets stuck in your windpipe, you can still help yourself in case of an emergency. Make sure to call for emergency help if you can speak. In other case, try to perform the Heimlich manoeuvres on yourself.

  • Make a fist and hold both of your fists with either hand, placed right above the navel.
  • Bend over a solid surface, facing downwards the floor.
  • Push your fist up and in.
  • Try to cough along with this, so that the object gets completely removed and dislodged.

You need to continue this procedure as long as the object is not removed completely. This can lead to severe damage of the ribs, abdomen and the breastbone. Seek medical help immediately.

The first aid must be provided immediately for a person who is choking as if delayed it can cause serious damage and can be fatal as well. DO NOT forget to call medical help in case someone is choking in front of you. However, rather than the first aid solutions, it is more useful to be careful, so that choking doesn't occur at all. Being careful while eating and keeping the toys out of reach of children when they are eating, are great ways of prevention.

Written, Edited or Reviewed By:

, MD, FFARCSI

Last Modified On: July 7, 2016

Pain Assist Inc.

Pramod Kerkar
  Note: Information provided is not a substitute for physician, hospital or any form of medical care. Examination and Investigation is necessary for correct diagnosis.

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