Choking occurs when a foreign object becomes lodged in the throat or windpipe, blocking the flow of air. In adults, a piece of food often is the culprit. Young children often swallow small objects. Because choking cuts off oxygen to the brain, administer first aid as quickly as possible.

The universal sign for choking is hands clutched to the throat. If the person doesn't give the signal, look for these indications:

• Inability to talk
• Difficulty breathing or noisy breathing
• Inability to cough forcefully
• Skin, lips and nails turning blue or dusky
• Loss of consciousness

If choking is occurring, begin to perform the the Heimlich manoeuvre. If you're the only rescuer, perform the Heimlich manoeuvre before calling 999 (or your local emergency number) for help.


If another person is available, have that person call for help while you perform the Heimlich manoeuvre.

To perform the Heimlich manoeuvre on someone else:

• Stand behind the person. Wrap your arms around the waist. Tip the person forward slightly.
• Make a fist with one hand. Position it slightly above the person's navel.

• Grasp the fist with the other hand. Press hard into the abdomen with a quick, upward thrust - as if trying to lift the person up.

• Repeat until the blockage is dislodged.
  

To perform the Heimlich manoeuvre on yourself:

• Place a fist slightly above your navel.
• Grasp your fist with the other hand and bend over a hard surface — a countertop or chair will do.
• Shove your fist inward and upward.
  

Clearing the airway of a pregnant woman or obese person:

• Position your hands a little bit higher than with a normal Heimlich manoeuvre, at the base of the breastbone, just above the joining of the lowest ribs.

• Proceed as with the Heimlich manoeuvre, pressing hard into the chest, with a quick thrust.
• Repeat until the food or other blockage is dislodged or the person becomes unconscious.

Clearing the airway of an unconscious person:

• Place the person on his or her back on the floor.

• Clear the airway. If there is a visible blockage at the back of the throat or high in the throat, reach a finger into the mouth and sweep out the cause of the blockage. Be careful not to push the food or object deeper into the airway, which can happen easily in young children.

• If the object remains lodged and the person doesn't respond after you take the above measures, begin cardiopulmonary resuscitation (CPR). The chest compressions used in CPR may dislodge the object.

• Remember to recheck the mouth periodically.

Clearing the airway of a choking infant younger than age 1:

• Act quickly, assume a seated position and hold the infant facedown on your forearm, which is resting on your thigh.

• Thump the infant gently but firmly five times on the middle of the back using the heel of your hand. This combined with  gravity should release the blocking object.

• If this doesn't work, hold the infant face up on your forearm with the head lower than the trunk. Using two fingers placed at the centre of the infant's breastbone, give five quick chest compressions.

• If breathing doesn't resume, repeat. Call for emergency medical help.

• If one of these techniques opens the airway but the infant doesn't resume breathing, begin infant CPR.

• If the child is older than age 1, give abdominal thrusts only.

• To prepare yourself for these situations, learn the Heimlich manoeuvre and CPR in a certified first-aid training course.