Caring for an Adult or Child Who Is Choking

When an adult or child is choking, give a combination of 5 back blows (blows between the shoulder blades) followed by 5 abdominal thrusts (inward and upward thrusts just above the navel) The goal of giving back blows and abdominal thrusts is to force the object out of the airway, allowing the person to breathe.

Back blows. To give back blows, position yourself to the side and slightly behind the person. For a child, you may need to kneel. Place one arm diagonally across the person’s chest (to provide support) and bend the person forward at the waist so that the person’s upper body is as close to parallel to the ground as possible. Firmly strike the person between the shoulder blades with the heel of your other hand. Each back blow should be separate from the others.

Abdominal thrusts. To give abdominal thrusts, stand behind the person, with one foot in front of the other for balance and stability. If possible, place your front foot between the person’s feet. Wrap your arms around the person’s waist. Alternatively, if the person is a child, you can kneel behind the child, wrapping your arms around the child’s waist. Find the person’s navel by placing one finger on the person’s navel, and the adjacent finger above the first. Make a fist with your other hand and place the thumb side just above your fingers. Cover your fist with your other hand and give quick, inward and upward thrusts into the person’s abdomen. Each abdominal thrust should be separate from the others.

Back blows. First, get the infant into position for back blows. Place your forearm along the infant’s back, cradling the back of the infant’s head with your hand. Place your other forearm along the infant’s front, supporting the infant’s jaw with your thumb and fingers. (Be careful not to cover the infant’s mouth with your hand while you are supporting the infant’s jaw.) Turn the infant over so that he or she is face-down along your forearm. Lower your arm onto your thigh so that the infant’s head is lower than his or her chest. Continue to support the infant’s jaw with the thumb and fingers of one hand while you firmly strike the infant between the shoulder blades with the heel of your other hand. Keep your fingers up to avoid hitting the infant’s head or neck. Each back blow should be separate from the others. ■ Chest thrusts. Next, place one hand along the infant’s back, cradling the back of the infant’s head with your hand. While continuing to support the infant’s jaw with the thumb and fingers of your other hand, support the infant between your forearms and turn the infant over so that he or she is face-up along your forearm. Lower your arm onto your thigh so that the infant’s head is lower than his or her chest. Place the pads of two fingers in the center of the infant’s chest, on the breastbone just below the nipple line. Press down about 1½ inches and then let the chest return to its normal position, keeping your fingers in contact with the breastbone. Each chest thrust should be separate from the others. Continue sets of 5 back blows and 5 chest thrusts until the infant can cough forcefully, cry or breathe, or the infant becomes unresponsive. After the choking incident is over, even if the infant seems fine, he or she should still be evaluated by a healthcare provider to make sure there is no damage to the airway or other internal injuries. For step-by-step instructions on