Choking
Cannot speak, cough or breathe. Back blows and abdominal thrusts.
RECOGNIZE
- MILD: the person can cough forcefully, speak or breathe.
- SEVERE: they cannot speak, cannot cough effectively, cannot breathe, or make no sound.
- Hands clutching the throat, panic, silent coughing, lips turning blue.
CALL
- Call 112 for severe choking — get help coming while you act.
- Call 112 if the person becomes unresponsive at any point.
- Call 112 after any abdominal thrusts, because internal injury is possible.
DO NOW
- 1ASK: CAN YOU SPEAK?If they can cough or speak, encourage hard coughing and stay with them.
- 2GET HELP COMINGIf they cannot speak, cough or breathe, call 112 or send someone to call.
- 3GIVE 5 BACK BLOWSLean them forward and strike firmly between the shoulder blades with the heel of your hand.
- 4GIVE 5 ABDOMINAL THRUSTSStand behind, fist just above the navel, and pull sharply inward and upward.
- 5REPEAT UNTIL IT CLEARSKeep alternating 5 back blows and 5 abdominal thrusts.
- 6IF THEY COLLAPSE, START CPRLower them safely to the floor, call 112 and begin chest compressions.
DO NOT DO
- DO NOT do blind finger sweeps in the mouth — you can push the object deeper.
- DO NOT slap the back of a person who is coughing effectively; let them cough.
- DO NOT give water to 'push the food down'.
- DO NOT use abdominal thrusts on an infant under 1 year.
- DO NOT leave the person alone.
WHILE WAITING FOR HELP
- Keep alternating back blows and thrusts until the object clears or help takes over.
- If the object comes out, keep watching breathing — they may still need review.
- During CPR, look inside the mouth before breaths and remove only an object you can clearly see.
WHEN TO ESCALATE
- Unresponsive → start CPR immediately.
- Object cleared but persistent cough, drooling, chest pain or breathing difficulty → urgent medical care.
AFTERCARE
- Anyone who received abdominal thrusts should be checked by a doctor.
- Anyone who was unresponsive needs hospital assessment.
Special cases
Pregnancy or a very large person
- If you cannot get your arms around the abdomen, or the person is visibly pregnant, use chest thrusts instead of abdominal thrusts.
- Place your fist on the centre of the breastbone and pull sharply straight backwards.
Child (1 year to puberty)
- Kneel or sit so you are at their level.
- Give 5 back blows between the shoulder blades, then 5 abdominal thrusts, using less force than for an adult.
- If they become unresponsive, start child CPR and call 112.
Infant (under 1 year)
- Never use abdominal thrusts on an infant.
- Support the head and lay the baby face-down along your forearm, head lower than the chest.
- Give 5 back blows between the shoulder blades with the heel of your hand.
- Turn the baby face-up and give 5 chest thrusts with two fingers on the centre of the chest.
- Repeat until the airway clears or the baby becomes unresponsive; then start infant CPR and call 112.
CPR rhythm · 110 per minute
Push hard in the centre of the chest. At least 5 cm deep, not more than about 6 cm. Let the chest come fully back up each time.
Keep going until the person breathes normally or trained responders take over.
MEDICAL SOURCES
American Heart Association
Guidelines for CPR and ECC — Basic Life Support / First Aid
Published / updated 2020 · Evidence reviewed for this app on 2026-08-18
Open sourceEuropean Resuscitation Council
ERC Guidelines — Basic Life Support and First Aid
Published / updated 2021 · Evidence reviewed for this app on 2026-08-18
Open sourceAmerican Red Cross
Focused Updates and Guidelines for First Aid
Published / updated 2024 · Evidence reviewed for this app on 2026-08-18
This content is educational first-aid guidance and does not replace emergency medical care. Guidelines can change. Verify clinical guidance periodically.