Choking Management
Choking in any age group is a life-threatening emergency and must be recognised and responded to as quickly as possible.
Signs of severe choking:
- Sudden onset of distress
- Universal sign of choking – holding both hands around front of the neck/throat
- Unable to cough effectively
- Unable to speak or breathe
- Possible bluish-purple colour around the lips
There may also be evidence that the person was eating before the onset of symptoms or in the case of children, they may have been playing with small objects.
Action – Choking adult or child over 1 year old:
- Immediately confirm if the victim is choking by asking them: ‘Are you choking?’
- Tell them you are going to help.
- Stand closely behind the victim and wrap your arms around their waist.
- Locate the victim’s bellybutton in front; this helps with correct positioning for your fist.
- Make a fist with your other hand, turn it and place it thumb-side against the victim’s belly directly above the bellybutton.
- Start delivering quick inward and upward thrusts into the belly in order to create an upward force to help remove the object.
- Continue to deliver thrusts as many times as is necessary while the victim remains conscious.
This technique, known as the Heimlich Manoeuvre must only be performed on a conscious choking victim.
Action – Choking infant under 1 year old:
- A choking infant may appear pale with bluish lips and cannot cry or breathe.
- Sit with the infant lying face-down along one of your arms using your thigh as a support, and ensure you support the infant’s head by placing your hand underneath the jaw.
- Keep the infant’s head low.
- Using the heel of your other hand, begin to deliver sharp back-slaps between the infant’s shoulder blades 5 times.
- If this is unsuccessful, turn the infant over onto his/her back along your opposite arm, supporting the head.
- Using 2 fingers, place them side by side in the centre of the infant’s chest and push downward 5 times.
- Continue to alternate between back-slaps and chest thrusts until you successfully remove the object and they can cry/breathe again.
- This technique should only be used on a conscious choking infant.
If these techniques are successful, you should see the object eject forcefully from the victim’s mouth and they can begin to breathe/cough/speak again. It is advised to have the victim checked over by a healthcare provider.
Remember, if any choking victim loses consciousness, becomes unresponsive and stops breathing normally, you must call 999 or 112 for an ambulance and begin to provide CPR until the ambulance arrives or the victim shows definite signs of life.