Choking First Aid: The Heimlich Maneuver for Adults, Children & Infants

Choking occurs when a foreign object lodges in the throat or windpipe, blocking airflow to the lungs. According to the National Safety Council, choking is the fourth leading cause of unintentional injury death in the United States. The American Heart Association provides clear, evidence-based protocols for responding to choking emergencies in adults, children, and infants — and knowing these techniques can mean the difference between life and death.

Recognizing choking: A person who is truly choking cannot cough, speak, or breathe effectively. They may clutch their throat with one or both hands (the universal choking sign), turn blue or gray around the lips, make high-pitched wheezing sounds, or become silent and unable to make any noise at all. If the person can cough forcefully, encourage them to keep coughing — do not interfere. Only intervene with abdominal thrusts when the airway is severely or completely blocked.

For conscious adults and children over age 1: Stand behind the victim and wrap your arms around their waist. Make a fist with one hand and place the thumb side against the abdomen, just above the navel and well below the breastbone. Grasp your fist with your other hand and deliver quick, firm, upward thrusts. Each thrust should be a distinct, forceful movement aimed at creating enough pressure to expel the object. Repeat until the object is dislodged or the person becomes unconscious.

For pregnant women or obese individuals: The AHA recommends chest thrusts instead of abdominal thrusts. Stand behind the person, place your arms under their armpits and around the chest. Position your fist on the center of the breastbone (sternum) between the nipples. Pull sharply backward to deliver chest thrusts. Continue until the obstruction is cleared.

For infants under age 1: The technique is completely different. Hold the infant face-down along your forearm, supporting the head and jaw with your hand. Rest your forearm on your thigh for support. Using the heel of your free hand, deliver 5 firm back blows between the infant's shoulder blades. Then turn the infant face-up, supporting the head, and deliver 5 chest thrusts using two fingers placed on the center of the breastbone just below the nipple line. Alternate between 5 back blows and 5 chest thrusts until the object is expelled or the infant becomes unconscious.

If the person becomes unconscious: Lower them gently to the ground and call 911 if not already done. Begin CPR immediately, starting with chest compressions. Before delivering rescue breaths, open the mouth and look for the object. If you can see it, carefully sweep it out with your finger. Never perform a blind finger sweep, as this can push the object deeper. Continue CPR cycles of 30 compressions and 2 breaths until help arrives.

Prevention is the best medicine. Cut food into small pieces for young children. Avoid giving children under 4 high-risk foods like hot dogs, grapes, nuts, popcorn, and hard candy. Supervise mealtimes and teach children to chew thoroughly. For adults, chew food slowly, avoid talking or laughing with food in your mouth, and limit alcohol consumption during meals. Our CPR and First Aid certification courses in Tallahassee provide extensive hands-on practice with choking response techniques for all age groups.