Practical Answers for Everyday Independence

What to Do When Someone Is Choking

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Category: Health & Safety

What to Do When Someone Is Choking

Choking occurs when food or another object becomes lodged in the throat or windpipe and prevents air from reaching the lungs. A complete airway blockage can cause unconsciousness, brain damage, cardiac arrest, or death within minutes.

Someone who can cough forcefully, speak, or cry is still moving air. Encourage them to keep coughing and watch closely.

Someone who cannot speak, breathe, cough effectively, or make normal sounds needs immediate help. Call 911 and begin choking first aid.

Choking techniques differ for adults, children, infants, pregnant people, and people whose body size makes abdominal thrusts difficult. Hands-on CPR and first aid training is the best way to learn and practice these lifesaving skills.

Recognize the Signs of Choking

A person who is choking may:

  • Clutch their throat
  • Suddenly stop speaking
  • Be unable to cough effectively
  • Make a weak or high-pitched sound
  • Have noisy or difficult breathing
  • Open their mouth without making sound
  • Appear frightened, confused, or panicked
  • Develop pale, blue, or gray skin
  • Lose consciousness

A child may suddenly become quiet, stop crying, or appear unable to breathe while eating or playing with a small object.

An infant may:

  • Be unable to cry
  • Have a weak or silent cough
  • Make a high-pitched sound
  • Struggle to breathe
  • Pull inward around the ribs
  • Become pale, blue, gray, limp, or unresponsive

Do not wait for the person to become unconscious before taking action.

Ask Whether the Person Is Choking

For an adult or older child, ask:

“Are you choking? Can you speak?”

If the person can answer clearly or cough forcefully, encourage continued coughing. Stay nearby and be ready to act if the cough becomes weak or the person can no longer speak.

If the person nods, cannot speak, or cannot breathe normally, treat it as a severe airway obstruction.

When the Person Can Cough Forcefully

A strong cough is one of the body’s best ways to remove an airway obstruction.

If the person can cough forcefully:

  • Encourage them to keep coughing.
  • Do not give back blows or abdominal thrusts yet.
  • Do not give food or drink.
  • Do not reach into their mouth.
  • Stay with them.
  • Call 911 if breathing becomes difficult or the cough becomes weak.

Do not slap someone on the back while they are standing upright and coughing effectively. Unnecessary intervention could move the object into a more dangerous position.

When the Person Cannot Speak, Breathe, or Cough Effectively

A severe airway obstruction is an emergency.

Have someone call 911 while you begin care. If you are alone, call 911 on speaker so the dispatcher can guide you while you help.

For a conscious adult or child older than one year, current American Heart Association guidance recommends alternating:

  • Five back blows
  • Five abdominal thrusts

Continue until:

  • The object comes out
  • The person begins coughing, speaking, or breathing
  • The person becomes unresponsive
  • Trained emergency responders take over

The American Heart Association updated its choking guidance in 2025 to recommend alternating five back blows with five abdominal thrusts for conscious adults and children. American Heart Association: Updated CPR and Choking Guidelines

Giving Back Blows to an Adult or Child

To give back blows:

  1. Stand to the side and slightly behind the person.
  2. Place one arm across the person’s chest for support.
  3. Bend the person forward at the waist so the object is more likely to come out of the mouth.
  4. Use the heel of your other hand to deliver a firm blow between the shoulder blades.
  5. Give up to five separate back blows.
  6. Check whether the obstruction has been relieved.

For a small child, kneel behind or beside them so you can provide support and control the amount of force used.

Do not strike the neck or lower back.

If the object does not come out, move to abdominal thrusts.

Giving Abdominal Thrusts

For an adult or child older than one year:

  1. Stand behind the person.
  2. Wrap your arms around their waist.
  3. Make a fist with one hand.
  4. Place the thumb side of the fist just above the navel and below the breastbone.
  5. Grasp the fist with your other hand.
  6. Pull sharply inward and upward.
  7. Give five separate abdominal thrusts.

Each thrust should be a separate attempt to remove the object.

Return to five back blows if the object remains lodged. Continue alternating the two techniques.

Do not place your fist directly over the ribs, the lower tip of the breastbone, or the navel.

Use less force for a small child while still providing firm, effective thrusts.

If the Person Is Pregnant or Abdominal Thrusts Are Not Possible

Use chest thrusts instead of abdominal thrusts when:

  • The person is visibly pregnant
  • You cannot reach around the person’s abdomen
  • The person’s body size makes abdominal thrusts ineffective
  • Abdominal thrusts cannot be delivered safely

Stand behind the person and place your arms beneath their armpits.

Position your hands over the center of the breastbone, above the lower tip of the sternum. Give firm backward thrusts.

Continue alternating back blows with chest thrusts until the object comes out or the person becomes unresponsive.

Follow the 911 dispatcher’s instructions if you are uncertain about hand placement.

Helping Someone in a Wheelchair

If the person uses a wheelchair:

  • Lock the wheels when possible.
  • Remove detachable armrests if doing so is quick and safe.
  • Position yourself behind the person when possible.
  • Use back blows and abdominal or chest thrusts as appropriate.
  • Do not delay care while attempting a complicated transfer.

If you cannot reach the abdomen safely, use chest thrusts.

The exact approach may depend on the chair, the person’s body position, and their physical needs. A 911 dispatcher can provide immediate guidance.

Choking in an Infant Younger Than One Year

Do not use abdominal thrusts on an infant.

If the infant cannot cough forcefully, cry, or breathe normally:

  1. Have someone call 911.
  2. Position the infant face-down along your forearm.
  3. Support the infant’s head and jaw.
  4. Keep the head lower than the chest.
  5. Brace your forearm against your thigh.
  6. Give five firm back blows between the shoulder blades.
  7. Turn the infant face-up while supporting the head and neck.
  8. Keep the head lower than the body.
  9. Give five chest thrusts over the lower half of the breastbone according to your current first aid training.
  10. Continue alternating five back blows and five chest thrusts.

Stop when:

  • The object comes out
  • The infant begins crying or coughing forcefully
  • The infant breathes normally
  • The infant becomes unresponsive
  • Emergency responders take over

Updated American Heart Association guidance recommends alternating five back blows and five chest thrusts for a conscious choking infant. Abdominal thrusts are not recommended because they can cause injury.

Technique and hand placement are easiest to learn in a certified infant CPR course. Follow the dispatcher’s instructions during an emergency.

What Not to Do for a Choking Infant

Do not:

  • Use abdominal thrusts.
  • Shake the infant.
  • Hold the infant upside down by the feet.
  • Put your fingers into the mouth unless you can clearly see the object.
  • Attempt to remove something you cannot grasp safely.
  • Give water or food.
  • Delay calling 911 during a severe obstruction.

Do not perform choking first aid when the infant has a strong cry or forceful cough. Continue watching closely and be prepared to act if the infant’s condition worsens.

If the Person Becomes Unresponsive

If an adult, child, or infant becomes unresponsive:

  1. Lower the person carefully onto a firm, flat surface.
  2. Call 911 if that has not already been done.
  3. Send someone to get an AED.
  4. Begin CPR, starting with chest compressions.
  5. Follow instructions from the dispatcher or your CPR training.
  6. Before attempting breaths, look inside the mouth.
  7. Remove the object only if you can clearly see it and reach it safely.
  8. Continue CPR until the person begins breathing normally or trained responders take over.

Do not continue standing abdominal thrusts after the person becomes unresponsive.

Do not delay compressions while repeatedly searching the mouth.

Never Perform a Blind Finger Sweep

Do not sweep a finger through the mouth when you cannot see the object.

A blind finger sweep may:

  • Push the object deeper
  • Damage the throat
  • Cause bleeding or swelling
  • Make the obstruction harder to remove

If an object is clearly visible and easy to grasp, remove it carefully. Do not poke, probe, or push it farther into the airway.

This rule applies to adults, children, and infants.

If the Object Comes Out

When the object is expelled:

  • Check whether the person is breathing normally.
  • Encourage them to remain still.
  • Do not immediately give food or drink.
  • Watch for continued coughing, wheezing, or breathing difficulty.
  • Keep the object for medical professionals when appropriate.
  • Tell responders what happened and which techniques were used.

Call 911 or seek emergency care if the person:

  • Does not resume normal breathing
  • Remains confused
  • Becomes unconscious
  • Has blue, gray, or pale skin
  • Has chest pain
  • Coughs up blood
  • Has severe throat, chest, or abdominal pain
  • Continues to feel that something is stuck

Medical Evaluation After Choking

Medical evaluation may be needed even after the person appears to recover.

A remaining piece of food or another object may have entered the airway. Choking first aid can also cause injuries to the ribs, chest, or abdomen.

Seek professional care after abdominal or chest thrusts, especially if the person develops:

  • Continued coughing
  • Wheezing
  • Shortness of breath
  • Chest pain
  • Abdominal pain
  • Difficulty swallowing
  • A hoarse voice
  • Vomiting
  • Blood in the saliva
  • Fever
  • New breathing symptoms
  • Rib tenderness
  • A feeling that something remains stuck

An infant or child who experienced a choking episode should be evaluated according to the child’s healthcare professional or emergency team’s instructions.

When Food Feels Stuck but the Person Can Breathe

Sometimes food becomes lodged in the esophagus, the tube that carries food to the stomach, rather than the airway.

The person may still be able to breathe and speak but may experience:

  • Pain when swallowing
  • Drooling
  • Inability to swallow liquids
  • A feeling that food is stuck in the chest or throat
  • Repeated gagging or vomiting

Do not perform abdominal thrusts when the person is breathing and the problem appears to involve swallowing rather than the airway.

Seek urgent medical care, especially if the person cannot swallow saliva, has chest pain, has a sharp object stuck, or is in significant distress.

If You Are Choking While Alone

If you can cough forcefully, keep coughing.

If you cannot speak, breathe, or cough effectively:

  1. Call 911 immediately.
  2. Leave the telephone line open if you cannot speak.
  3. Unlock the door if you can do so without delaying care.
  4. Give yourself abdominal thrusts.
  5. Continue until the object comes out or help arrives.

To perform abdominal thrusts on yourself:

  • Make a fist.
  • Place it above your navel and below your breastbone.
  • Grasp it with your other hand.
  • Pull sharply inward and upward.

You may also press your upper abdomen firmly against the back of a sturdy chair or another stable, blunt-edged surface.

Do not use a sharp edge, glass surface, unstable object, or high railing.

Choking Versus Gagging

Gagging and choking are not the same.

A person who is gagging may:

  • Make noise
  • Cough
  • Retake breaths
  • Become red in the face
  • Attempt to spit food out

A person with a complete airway obstruction may:

  • Be silent
  • Be unable to inhale
  • Be unable to cough effectively
  • Become pale, blue, or gray
  • Lose consciousness

Gagging can help move food forward or out of the mouth. Do not place your fingers into the mouth during ordinary gagging unless an object is clearly visible and easily removable.

Common Choking Hazards for Children

Young children may choke on:

  • Whole grapes
  • Hot dog rounds
  • Popcorn
  • Nuts
  • Hard candy
  • Gum
  • Chunks of meat or cheese
  • Raw carrots
  • Spoonfuls of nut butter
  • Marshmallows
  • Gummy candy
  • Coins
  • Balloons
  • Button batteries
  • Magnets
  • Pen caps
  • Small toy parts
  • Jewelry
  • Marbles

Cut foods into developmentally appropriate sizes and shapes. Cook hard vegetables until soft when appropriate.

Keep small objects out of reach and follow age recommendations on toys.

Button batteries and high-powered magnets create additional medical emergencies if swallowed or placed in the nose or ears. Seek immediate professional help even when the child is breathing normally.

Choking Risks for Adults

Adults may have increased choking risk because of:

  • Eating too quickly
  • Taking large bites
  • Poorly fitting dentures
  • Alcohol or sedating medication
  • Stroke
  • Parkinson’s disease
  • Dementia
  • Multiple sclerosis
  • Muscle weakness
  • Dental problems
  • Dry mouth
  • Difficulty swallowing
  • Reduced alertness
  • Talking or laughing while chewing

Someone with repeated coughing, choking, a wet voice, or difficulty swallowing during meals should discuss it with a healthcare professional. A swallowing evaluation may be needed.

Preventing Choking During Meals

Helpful habits include:

  • Sit upright while eating.
  • Take small bites.
  • Chew thoroughly.
  • Avoid rushing.
  • Finish chewing before speaking.
  • Avoid laughing with food in the mouth.
  • Cut difficult foods into manageable pieces.
  • Avoid eating while walking, running, or lying down.
  • Limit alcohol when eating.
  • Maintain dentures and dental care.
  • Follow prescribed texture or thickened-liquid recommendations.
  • Supervise young children while they eat.
  • Keep distractions manageable.

Do not change someone to a thickened-liquid or texture-modified diet without professional guidance. These diets should be recommended and monitored by qualified healthcare professionals.

Preparing for a Choking Emergency

Reading the steps is helpful, but physical practice makes them easier to remember during an emergency.

Consider completing:

  • Adult CPR and first aid training
  • Child CPR training
  • Infant CPR training
  • AED training
  • Swallowing-safety education when caring for someone with dysphagia

Make sure family members, caregivers, teachers, and workplace staff understand the current choking-response sequence.

CPR recommendations are periodically updated. Refresh training so you are using current techniques.

Helpful Resources: Browse CPR & Emergency Response Supplies for products, equipment, services, or supplies related to this section.

Common Mistakes to Avoid

Try not to:

  • Interfere with a strong, effective cough.
  • Give food or water to a choking person.
  • Perform only abdominal thrusts without current training.
  • Use abdominal thrusts on an infant.
  • Perform a blind finger sweep.
  • Hold an infant upside down by the feet.
  • Shake an infant or child.
  • Delay calling 911 during a complete obstruction.
  • Continue standing thrusts after the person becomes unresponsive.
  • Allow someone to walk away immediately after a serious choking episode.
  • Assume everything is fine because the object came out.
  • Ignore continued coughing, wheezing, chest pain, or trouble swallowing.
  • Use choking techniques for someone who can breathe but has food stuck in the esophagus.

A Simple Choking Checklist

If someone appears to be choking:

  1. Ask whether they can speak.
  2. Encourage forceful coughing when they can still move air.
  3. Call 911 for a severe obstruction.
  4. For a conscious adult or child, alternate five back blows with five abdominal thrusts.
  5. Use chest thrusts when abdominal thrusts are not appropriate.
  6. For an infant, alternate five back blows with five chest thrusts.
  7. Never use abdominal thrusts on an infant.
  8. Never perform a blind finger sweep.
  9. If the person becomes unresponsive, lower them to a firm surface and begin CPR.
  10. Use an AED when available.
  11. Seek medical evaluation for continued symptoms or injuries after the event.

Choking is frightening, but a quick response can save a life. Recognize when the person can no longer cough effectively, call for emergency help, and continue appropriate care until the airway clears or trained responders arrive.

Suggested Guides

Important Health & Safety Notice

The information in this guide is provided for general educational purposes only. Independence Answers is not a medical provider, and this content is not a substitute for professional medical advice, diagnosis, treatment, or supervision. Always follow the instructions of your doctor, pharmacist, or other qualified healthcare professional, especially if you have a medical condition, take medication, or are unsure whether an action is safe for you.

Do not ignore or delay seeking professional care because of something you read here. If you believe someone may be experiencing a serious or life-threatening emergency, call 911 or your local emergency number immediately.