Sharon has 21+ years of experience as a qualified Emergency Care Nurse registered with the Australian Health Practitioner Regulation Agency (APHRA) and 12+ years as a First Aid Trainer.
She takes pride in FirstAidPro making first aid training available, comprehensive and affordable to everybody.
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When someone experiences an unexpected dining mishap, knowing how to respond can be the difference between a close call and a tragedy.
Understanding the proper sequence of actions of first aid for choking can greatly increase your chances of successfully aiding a choking victim.
From recognising the signs to performing life-saving manoeuvres, these seven steps are essential knowledge for anyone who wants to be prepared for such a critical situation.
Let’s explore how you can become a potential lifesaver in moments of distress.

First Aid for Choking: Key Takeaways
• Encourage coughing as the first response, supporting the upper body and instructing deep breaths before forceful diaphragm coughs.
• Deliver up to five sharp back blows between the shoulder blades if coughing is ineffective.
• Perform abdominal thrusts by wrapping arms around the waist and delivering quick, upward thrusts above the navel.
• Alternate between back blows and abdominal thrusts, performing five of each until the obstruction is expelled.
• Begin CPR if the person becomes unresponsive, performing chest compressions and rescue breaths until help arrives.

Recognise Choking Signs
To effectively help provide first aid for choking victims, you must first identify the signs quickly. Look for these key indicators: the person can’t speak, breathe, or cough forcefully. They may clutch their throat with one or both hands, which is the universal choking sign. Their face might turn red, then blue as oxygen deprivation sets in. In some cases, the person may lose consciousness if the airway remains blocked.
Be aware that choking doesn’t always involve dramatic gasping. Silent choking can occur, especially in children. Watch for wide, panicked eyes and an inability to make sounds. Don’t confuse choking with other conditions like heart attacks, which have different symptoms.
Understanding common choking hazards is vital for choking prevention tips. Be cautious with foods like hot dogs, grapes, nuts, and hard lollies. For children, small toys and coins pose significant risks. Always cut food into small pieces, especially for young children and the elderly. Encourage thorough chewing and avoid talking while eating.
Encourage Coughing

If you suspect someone is choking but they can still cough, encourage them to continue coughing.
Coughing is the body’s natural clearing mechanism and can effectively dislodge the obstruction from the airway.
Monitor their coughing progress closely, and be prepared to take further action if their condition worsens or if they can’t cough anymore.
Natural Clearing Mechanism
When someone’s choking, the first step of first aid for choking should be encouraging them to cough. This approach taps into the body’s natural reflexes and airway anatomy to clear the obstruction.
Coughing is a powerful, instinctive mechanism that can often dislodge foreign objects more effectively than external interventions.
To encourage coughing:
• Stand beside the person, supporting their upper body
• Instruct them to take deep breaths before each cough
• Remind them to cough forcefully from their diaphragm
The natural clearing mechanism works by creating a strong expulsion of air from the lungs. This sudden burst of pressure can often propel the obstruction out of the airway.
It’s crucial to give this method a chance before resorting to more invasive techniques.
If the person can speak, breathe, or cough, it’s a sign that some air is still passing through. In this case, continue encouraging them to cough while closely monitoring their condition.
However, if coughing doesn’t clear the obstruction and the person’s breathing becomes severely compromised, be prepared to move on to more aggressive first aid techniques like back blows and abdominal thrusts.
Clear Airway Effectively
Encouraging coughing is the most effective way to clear a person’s airway during a choking incident. When you encounter someone who’s choking, your first step should be to prompt them to cough forcefully. This natural reflex can often dislodge the obstruction without further intervention.
To encourage effective coughing, instruct the person to take a deep breath and cough from their diaphragm. This technique utilises the airway anatomy to create a powerful expulsion of air. Remind them to keep their chin tucked slightly to their chest, as this position helps to direct the force of the cough upwards through the throat.
If coughing doesn’t immediately clear the obstruction, don’t panic. Continue to encourage the person to cough while monitoring their condition. Be prepared to perform more aggressive techniques if needed, but allow the body’s natural mechanisms to work first.
Monitor Coughing Progress
Once you’ve encouraged coughing, it’s crucial to closely monitor the person’s progress and effectiveness in clearing their airway. Stay alert and observe their coughing techniques, evaluating whether they’re making progress in dislodging the obstruction. Monitor the severity of their distress, paying attention to any changes in their breathing or colour.
As you watch, look for these positive signs:
• The person’s cough becomes stronger and more productive
• They’re able to take in some air between coughs
• Their skin colour improves from blue or pale to a healthier tone
If the coughing isn’t effective or the person’s condition worsens, be prepared to take more aggressive action. Don’t interfere with their coughing unless it’s clear they’re no longer making progress.
If they can’t cough, speak, or breathe, or if they start to lose consciousness, you’ll need to perform abdominal thrusts or back blows immediately.
Deliver Back Blows
Back blows are the first physical intervention you’ll perform when it comes to first aid for choking victims. If coughing hasn’t dislodged the airway obstruction, it’s time to act.
Position yourself slightly behind and to the side of the person. Support their chest with one hand and lean them forward at about a 45-degree angle.
Using the heel of your other hand, deliver up to five sharp blows between the person’s shoulder blades. Each blow should be separate and forceful, aiming to create vibration that might dislodge the obstruction. After each blow, check if the object has been expelled.
If the back blows don’t work, you’ll need to move on to abdominal thrusts. Remember, your goal is to create enough force to expel the foreign object. Be prepared to alternate between back blows and abdominal thrusts if needed.
For children over one year and adults, the technique is the same. However, for infants, you’ll need to modify your approach. Place the baby face down on your forearm, supporting their head, and deliver five back blows with the heel of your hand between their shoulder blades.
Perform Abdominal Thrusts

If back blows don’t dislodge the object, you’ll need to perform abdominal thrusts to continue first aid for choking victims.
Stand behind the person, wrap your arms around their waist, and position one hand above their navel.
Make quick, upward thrusts with your other hand, repeating until the object is expelled or the person becomes unconscious.
Proper Positioning for Thrusts
Stand behind the choking person and wrap your arms around their waist to perform abdominal thrusts effectively. Position yourself with one foot slightly forward for stability. This thrust positioning guarantees ideal body mechanics, allowing you to exert the necessary force without straining yourself.
Locate the person’s navel with one hand, then make a fist with your other hand. Place the thumb side of your fist against the abdomen, just above the navel. Grasp your fist with your free hand and prepare to deliver quick, upward thrusts.
To create a clear mental image of proper positioning, consider these key points:
• Your chest should be close to the person’s back.
• Your arms should form a ‘C’ shape around their waist.
• Your elbows should be slightly bent, not locked.
Maintain a firm stance and lean the person slightly forward. This angle helps dislodge the obstruction more effectively.
Remember, each thrust should be distinct and forceful, aiming to create artificial coughs.
Continue the thrusts until the object is expelled or the person becomes unconscious. If unconsciousness occurs, immediately begin CPR and call for emergency medical assistance.
Technique for Effective Thrusts
Once you’ve positioned yourself correctly, deliver quick, forceful thrusts into the person’s abdomen to dislodge the obstruction.
Place your fist, thumb side in, just above the person’s navel. Grasp your fist with your other hand. Push your fist inward and upward with a sharp, rapid motion. Repeat this thrust technique five to six times.
If the object doesn’t dislodge, continue alternating between five back blows and five abdominal thrusts.
It’s essential to maintain proper form throughout the process to guarantee thrust safety and effectiveness. Don’t be afraid to use significant force; the goal is to create enough pressure to expel the blockage.
When to Stop Thrusting
Knowing when to stop performing abdominal thrusts is essential for the choking victim‘s safety and well-being. As you’re administering this emergency response technique, you must be aware of the signs that indicate it’s time to cease the thrusts.
Stop performing abdominal thrusts immediately if:
• The object is dislodged and expelled from the airway
• The victim loses consciousness
• You’ve performed five sets of thrusts without success
If the choking severity decreases and the victim can breathe or cough effectively, stop the thrusts and encourage them to continue coughing.
However, if the person becomes unresponsive, carefully lower them to the ground and begin CPR.
Alternate Blows and Thrusts
If initial attempts to dislodge the object fail, to continue first aid for choking victims you’ll need to alternate between back blows and abdominal thrusts.
This combination of alternate techniques is part of standard emergency protocols and can be more effective than using a single method. Here’s how to proceed:
Start with five back blows. Stand slightly behind the person, supporting their chest with one hand. Lean them forward and use the heel of your other hand to deliver firm blows between their shoulder blades. If this doesn’t work, immediately switch to abdominal thrusts.
For abdominal thrusts, stand behind the person and wrap your arms around their waist. Make a fist with one hand and place it just above their navel. Grasp this fist with your other hand and pull sharply inward and upward. Perform five quick thrusts.
Continue alternating between five back blows and five abdominal thrusts until the object is expelled or the person becomes unconscious.
If they lose consciousness, lower them to the ground and begin CPR immediately. Remember, your quick action using these techniques can be life-saving in a choking emergency.
Check for Responsiveness

Before attempting first aid for choking, you’ll need to quickly assess the person’s level of responsiveness. This step is essential for emergency preparedness and choking prevention.
Approach the person calmly but swiftly, and ask them loudly and clearly, ‘Are you choking?’ If they can speak, cough, or breathe, encourage them to continue coughing to clear the obstruction.
If the person can’t respond verbally, look for these signs of severe choking:
- Clutching the throat with one or both hands
- Inability to make sounds or speak
- Weak, ineffective coughs or no cough at all
- Skin turning blue or grey, especially around the lips and nails
If you observe these signs, the person needs immediate help.
For a conscious person, proceed with back blows and abdominal thrusts.
If the person becomes unresponsive, lower them to the ground and begin CPR immediately, starting with chest compressions.
Administer CPR if Necessary
When a choking victim becomes unresponsive, you’ll need to start CPR immediately. This emergency first aid for choking response is essential for maintaining blood flow to important organs.
Begin by laying the person on their back on a firm, flat surface. Kneel beside them and place the heel of one hand on the center of their chest, with your other hand on top. Interlock your fingers and position your shoulders directly above your hands.
Perform chest compressions by pushing hard and fast at a rate of 100-120 compressions per minute. Allow the chest to fully recoil between each compression. After 30 compressions, tilt the person’s head back slightly and lift their chin. Pinch their nose shut and give two rescue breaths, watching for chest rise. If the chest doesn’t rise, reposition the head and try again.
Continue this cycle of 30 compressions and two breaths until emergency services arrive or the person starts breathing on their own. If you’re trained in CPR techniques, you may also check for a pulse after every five cycles.
Frequently Asked Questions
How Often Should You Refresh Your First Aid for Choking Skills?
Refresh your training annually. Regular practice enhances skill retention. You’ll stay prepared for emergencies, ensuring you’re always ready to help when needed.
Are There Different First Aid for Choking Protocols for Infants and Pregnant Women?
For infants, you’ll use gentler back blows and chest thrusts. With pregnant women, you’ll perform abdominal thrusts higher on the chest. Always seek professional training to learn these specific techniques properly.
What Should You Do if Someone Chokes While Lying Down?
Roll them onto their side, support their head, and perform back blows. If ineffective, use abdominal thrusts. Follow emergency protocols and call for help immediately.
Can Certain Medical Conditions Increase the Risk of Choking?
Certain medical conditions can indeed increase choking risks. Dysphagia, GORD, and neurological disorders are common culprits. Be aware of these choking hazards and adjust eating habits accordingly. Always consult your doctor for personalised advice.