How to Respond to Choking!

Imagine this: you’re at a party, having a great time, when suddenly you hear someone coughing and gasping for air. It’s a choking emergency! But fear not, because with a little know-how, you can be the hero of the day and save the choking victim. 

While we offer the steps in this article, we still highly recommend you take a basic first aid course like OFA Level One to learn what to do and practice with a trained instructor. 

Let’s dive into the basics of choking first aid and learn how to handle this situation with confidence!

Recognizing Choking

The first step in providing first aid for choking is to recognize the signs. Common signs of choking include coughing forcefully, inability to speak, clutching the throat, and a distressed facial expression. The person may also start turning blue due to lack of oxygen. It’s essential to act quickly and stay calm in this situation.

There are two levels of choking, a partial airway obstruction and a full airway obstruction. If the person is coughing, that means that it is just a partial airway obstruction, as some air is managing to get through. If they can’t choke or speak at all, this means there is a full airway obstruction. 

What to do if someone has a partial airway obstruction

If someone is coughing desperately and clutching at their throat because they have a partial airway obstruction, the best thing for you to do is to just encourage them to keep coughing. Most of the time, someone experiencing a partial airway obstruction will be able to cough the object up or until their airway clears enough to breathe comfortably. 

This does not mean that you should just say “keep coughing” and walk away. You should carefully monitor them and stand as close to them as you can. This person is at a very high risk to either have the object lodge further into their throat, causing a full airway obstruction, or pass out and collapse while coughing due to decreased oxygen levels. If either of these things happen, you need to be ready to help as soon as possible. In the case of passing out, you should be close enough to catch them. And, in the case of a full airway obstruction, you need to be there to provide care, as laid out in the next section of this article. So, just stay by their side and reassure them that you know first aid, and that the best thing they can do is keep coughing., 

What to do if someone has a full airway obstruction

If someone is experiencing a full airway obstruction, this is a serious medical emergency, and you must provide first aid immediately. The oxygen supply to their vital organs will quickly be depleted and the person will lose consciousness in a matter of minutes (or less). 

Your main goal is to help them get the obstruction out of their airway. You will do this by performing a combination of back blows and abdominal thrusts. 

You will alternate between 5 back-blows and 5 abdominal thrusts, starting with back-blows. You will continue to alternate with these two methods until either the object comes out, or the person becomes unconscious. 

It should be mentioned that you do need consent from the person choking before you can touch them. So, make sure to ask them if they would like your help and look for them to indicate that they do, by nodding, for example. But, let’s be honest, if someone is experiencing a full airway obstruction, they will very likely want your help.

Performing Back Blows

As mentioned above, the first thing you should do when someone has a full airway obstruction is to perform 5 back-blows. 

To do this, follow these steps:

  1. Stand immediately next to the person choking with your knees bent in an athletic stance. This is important because if they do pass out, you need to be stable enough to lower them to the floor. 
  2. Place one arm under their closest arm, across their chest, with your hand on their far shoulder. 
  3. Have them bend forward at the waist so their upper body is as close to parallel with the floor as possible. 
  4. With the base of your palm, deliver five firm blows in the centre of their upper back, between their shoulder blades.

Then switch to abdominal thrusts.

Performing Abdominal Thrusts

If the object has not come out after giving the person five back blows, it’s time to perform abdominal thrusts.

  1. Stand behind them, again in an athletic stance, with one foot forward placed right between their two feet. 
  2. Wrap your arms around their waist.
  3. Make a fist with one hand and place the thumb side against the middle of the person’s abdomen, just above the belly button.
  4. Grasp your fist with the other hand and give five quick thrusts in and up, like the shape of the letter J.
If these five abdominal thrusts still don’t dislodge the object, you need to perform five more back blows, and continue the cycle until either the object comes out or the person becomes unconscious. 

Should I Do Abdominal Thrusts on a Pregnant Woman?

No, it is not safe to do abdominal thrusts on a pregnant woman. 

If you cannot perform abdominal thrusts for any reason, such as the person is pregnant, or too large to wrap your hands around their abdomen, or they are in a wheelchair and you can’t get to their abdomen, you can perform chest thrusts instead of abdominal thrusts. 

To perform chest thrusts, stand behind the person and wrap your hands around their chest, placing your arms right under their armpits. Place your fist in the middle of the person’s chest with your thumb facing inward, and place your other hand over your fist. Give five chest thrusts by pulling straight back. 

So, to be clear, in this case you will be alternating between five back blows and five chest thrusts until the object is dislodged or until the person becomes unconscious. 

What if it is a baby that's choking?

If a baby who is 1 year old or younger has a full airway obstruction, follow the following protocols. 

  1. Lay the baby face down across your forearm with its legs straddling your arm. Your hand should be on the baby’s face/jaw to support its head.
  2. Get down on your knees, placing the same forearm on one of your legs for support.
  3. Perform five firm back blows with the palm of your hand in the middle of the baby’s back, between the shoulder blades. 
  4. Turn the baby over by clamping the baby with your other arm, holding the cranium with your hand for support. Then turn the baby over so its legs are now straddling your other arm. Place that arm on your leg for support.
  5. Perform five chest compressions using your index and middle finger, placed in the middle of the baby’s chest just below the nipple line. The depth of the compressions should be roughly 1/3 the width of the baby’s torso. 

Continue performing five back blows and five chest compressions until the object is dislodged or the baby becomes unconscious. 

Should I call 911?

If someone has a full airway obstruction this is an extremely serious emergency, and it is important to call 911 to make sure paramedics are on the way to help. However, the person only has seconds for you to help them while they are conscious, so if you are the only one there to help you must provide back blows and abdominal thrusts before calling 911. You should not waste time calling 911 if someone has a full airway obstruction and there is nobody else there to help. If there are bystanders there with you, get someone else to call 911 right away while you are giving care. 

If you are the only one there to help and while providing back blows and abdominal thrusts the person goes unconscious, now it is time to call 911.

What to I do if they go unconscious?

If the person choking goes unconscious, you should ensure that 911 has been called by a bystander, and if you’re alone, you should now call 911 yourself. If you can access an AED, get one now. 

Begin CPR, starting with chest compressions. If you are not trained in CPR, you should definitely take a first aid course. Almost all first aid courses have CPR and AED training as a main component of the course, and these are life-saving skills. 

Aftercare

If someone has suffered a full airway obstruction, they should seek medical attention. Even if they managed to dislodge the object and they are feeling better, the object may have caused damage to their airway. Also, if back blows and abdominal thrusts were performed other injuries may have occurred. 

Choking Prevention Tips

Prevention is always better than cure, and the same goes for choking. Here are some tips to prevent choking incidents:

  1. Cut food into small pieces, especially for young children and elderly individuals.
  2. Avoid talking, laughing, or playing while eating, as it increases the risk of choking.
  3. Keep small objects, such as coins, small toys, and balloons, out of reach of young children.
  4. Educate yourself by taking a first aid course so that you’re prepared in case of an emergency.

Conclusion

A full airway obstruction is an extremely serious emergency and if you witness someone who is choking you need to provide assistance right away. Alternating between back blows and abdominal thrusts is the best way to help someone when they are suffering from a full airway obstruction. If someone goes unconscious from choking you need to call 911 and perform CPR. By far, the best way to prepare for a situation like this is to take a certified first aid course. At Fundamental First Aid, all of our WorkSafeBC and Canadian Red Cross first aid courses include Choking and CPR skills. After taking one of our courses, you will have the skills and confidence to stay calm and provide the proper care to somebody who is choking.

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