Choking: what to do when someone is choking (adult, child, infant)

Panic is the number one enemy in a choking situation. Yet, with the right actions, one can clear a person's airway in a matter of seconds and save their life. This guide explains exactly what to do, depending on the person's age and the severity of the situation.

Choking: Silent, Sudden, and Potentially Fatal

Choking occurs when a foreign object — food, a small item, liquid — partially or completely blocks the airway. According to Parachute Canada, an estimated 32 children aged 14 and under die each year in Canada from choking or suffocation, and another 800 are hospitalized for serious injuries. Choking is among the leading causes of accidental death, particularly in children under 5 and the elderly.

There are two types of obstruction. A partial obstruction still allows a trickle of air to pass: the person coughs, can make sounds, and their face reddens. A total obstruction completely blocks the passage of air: this is an absolute emergency. If a person can still cough vigorously, their lungs are working to dislodge the foreign object themselves. If they can no longer speak, cough, or breathe, every second counts. Note: approximately 80% of choking incidents occur during meals.

How to Recognize Total Choking

Here are the signs of a complete obstruction to look for immediately:

  • The person brings their hands to their throat — this is the universal sign of choking.
  • They are unable to speak, cough, or breathe.
  • Their complexion turns bright red, then blue (cyanosis), a sign that oxygen is no longer reaching the brain.
  • Their eyes express panic, and their movements are uncoordinated.
  • No sound comes out, or a high-pitched, ineffective wheeze is heard.

Given these signs, do not waste time looking for water or hesitantly patting their back. Intervene immediately according to the current Canadian protocol: 5 back blows, then abdominal thrusts.

Partial Choking: Encourage Coughing

If the person can still cough forcefully, speak, or make sounds, the airway is not completely blocked. In this case, do not perform the Heimlich maneuver: an awkward intervention could push the foreign object further in. Encourage them to cough vigorously while leaning slightly forward, and monitor closely. If the situation worsens — if they stop coughing or lose the ability to speak — immediately proceed to emergency actions.

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Total Choking in Adults — Step-by-Step

As soon as the person can no longer speak, cough, or breathe, act according to this protocol:

  1. Lean the person forward, placing your forearm on their chest for support.
  2. Administer 5 firm back blows with the heel of an open hand, between the shoulder blades. Each blow should be distinct and vigorous.
  3. After each blow, check if the foreign object has been expelled.
  4. If back blows are not sufficient, proceed to 5 abdominal thrusts (Heimlich maneuver).
  5. Alternate cycles of 5 back blows and 5 thrusts until the foreign object is expelled or the person loses consciousness.
  6. If the person loses consciousness: lay them on the ground, call 911 immediately, and begin cardiopulmonary resuscitation (CPR) starting with chest compressions.

The Heimlich maneuver in detail:

  • Stand behind the person, feet spread for stability.
  • Wrap your arms around their waist, with the person leaning forward.
  • Make a fist between the navel and the sternum, covering it with your other hand.
  • Deliver sharp thrusts inwards and upwards (a J-motion).
  • Do not compress the ribs — pressure is applied to the abdomen only.

If the person is pregnant or cannot be encircled at the waist, replace abdominal thrusts with chest compressions: fist in the center of the sternum, pull directly towards you.

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Choking in Children Over One Year Old

The principle is identical to that for adults, adapted to the child's size and fragility. Kneel behind them to be at their height. Back blows should be firm but proportionate, and abdominal thrusts less powerful. After each attempt, visually check the mouth: if you clearly see the object, remove it. Never perform a blind finger sweep. Call 911 if the foreign object is not quickly dislodged or if the child loses consciousness.

Choking in Infants (Under One Year Old)

In an infant under 12 months, the Heimlich maneuver is contraindicated — the risk of injuring internal organs is too high. The technique used combines back blows with chest compressions.

  1. Place the baby face down on your forearm, head lower than the body, jaw supported by your hand.
  2. Deliver 5 firm blows between the shoulder blades with the heel of your hand.
  3. Turn the baby face up on your other forearm, head still lower than the body.
  4. Use 2 fingers in the center of the sternum (below the nipple line): deliver 5 rapid chest compressions.
  5. Alternate until the object is expelled, or until the baby cries, coughs, or breathes.

Visually check the mouth after each attempt. If it doesn't resolve quickly, call 911 immediately — the operator can guide you in real time.

Calling 911 — In These Specific Situations

You should call 911 without delay in the following situations:

  • The person loses consciousness.
  • The foreign object is not expelled after several cycles of maneuvers.
  • It is a baby or a young child.
  • The person is pregnant or has reduced mobility.
  • You are not sure you have performed the maneuvers correctly.

Reminder: even if the foreign object is expelled, medical consultation is recommended after a severe episode.

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Training: 30 Minutes That Can Save a Life

Reading a guide is a good start. But the Heimlich maneuver is truly learned by practicing on a mannequin, under the supervision of an accredited instructor. In just 30 minutes, you can integrate the right reflexes for adults, children, and infants — whether you are a parent, daycare educator, restaurateur, or workplace first aider. It's one of the most useful first aid skills one can have. The Canadian Red Cross and St. John Ambulance offer recognized training throughout Quebec, including CPR for the most critical situations.

Disclaimer: This article is provided for educational purposes only. It does not replace first aid training provided by an accredited organization. In case of emergency, call 911 immediately. The techniques described here are based on current Canadian guidelines, but supervised practice is essential to master them correctly.

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Written By : SuperMedic

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