First Aid for Choking

While we all know the Heimlich maneuver is the prescribed first aid for a choking victim, if a patient is unconscious you need to take extra care. Follow these steps for administering first aid for someone who is choking. 

Symptoms: Inability to breathe, speak, or cry out. If choking continues, victim becomes blue, convulsive, limp, and unconscious.

Infant, Conscious: 

1. Observe breathing difficulties. If infant is coughing forcefully, help the infant sit up, and monitor breathing.
   
2. If infant can no longer cry, cough, or breathe, lay infant facedown on your forearm, with your hand on bony portion of infant's jaw to support head. Keep infant's head lower than torso and support your arm on your thigh.­

   If infant can no longer cry, cough, or breathe, lay the infant facedown on your forearm. Deliver five blows to the back between shoulder blades.
3. Use heel of other hand to deliver 5 forceful back blows between infant's shoulder blades.

   If infant is not responding, use 2 fingers to deliver 5 chest thrusts to middle of breastbone just below level of nipples.
4. If back blows fail to dislodge object, turn infant over: With infant still lying facedown on your forearm, lay your other forearm on infant's back. Gently turn infant over so that infant now rests faceup on your other forearm. Support infant's head with your hand, keeping head lower than torso.
   
5. Use 2 fingers to deliver 5 chest thrusts to middle of breastbone just below level of nipples.
   
6. Repeat steps 2-5 until object is expelled and infant starts to breathe or until infant becomes unconscious (go to Infant, Unconscious).
   
7. Once infant expels object and starts to breathe, have infant checked by doctor.

Infant, Unconscious: 

1. Shout "Help," and have someone call for EMS.
   
2. Place infant on a flat surface and start CPR.

   Place an unconscious infant on a hard surface.
3. Look inside the mouth when you open it to give breaths and remove any object, if seen.
4. Only if object is visible, use a hooking action with your pinky to remove it.

   Look for anything lodged in the airway. Use only your pinky to remove it.

Child or Adult, Conscious: 

1. Ask victim, "Are you choking?" If victim can speak or is coughing or breathing, stay with victim and encourage them to keep coughing.
   
2. If victim cannot speak, cough, or breathe, state you can help them, and send someone to call for EMS as you perform the Heimlich maneuver:

   Begin the Heimlich maneuver while you wait for EMS.
3. Stand behind victim, with one foot between victim's feet for balance, and wrap your arms around victim's waist.
   
4. Make a fist with one hand. Place thumb side of fist against victim's stomach just above navel and well below lowest part of breastbone.
5. Grasp your fist with your other hand.
   
6. Press into victim's stomach with quick upward thrusts until object is expelled. Each thrust should be a separate attempt to get object out.
   
7. Repeat thrusts until EMS arrives, object is dislodged, or victim becomes unconscious (see Child or Adult, Unconscious).

Continue the Heimlich maneuver until EMS arrives or victim can breathe again.

Child or Adult, Unconscious: 

1. Ease victim faceup onto floor, making sure victim's head does not strike floor.
   
2. Shout "Help!" Have someone call for EMS.
   
3. Start  CPR.

   Begin CPR if victim is not breathing.

   
   

   Continue CPR until help arrives.
4. Look inside the mouth when you open it to give breaths and remove any object, if seen.
   
   

Check to see if there is anything in the victim's airway and remove it.