CALL 911 FIRST if emergency services are available. This page is for backup/offline reference.
Choking (Conscious Adult)
Complete airway obstruction — person cannot speak, cough, or breathe.
Critical Warning
If the person is coughing forcefully, do NOT interfere. Effective coughing is clearing the airway.
Recognize the Signs
- Hands clutched to throat (universal choking sign)
- Cannot speak, cough, or breathe
- High-pitched wheezing or no sound
- Turning blue (cyanosis)
- Loss of consciousness
Action Steps
Confirm choking
Ask: 'Are you choking?' If they can't answer but nod yes, act immediately.
Give 5 back blows
Stand to side and slightly behind. Lean them forward. Deliver 5 firm blows between shoulder blades with heel of hand.
Give 5 abdominal thrusts (Heimlich)
Stand behind. Make a fist, place thumb-side above navel (below ribcage). Grab fist with other hand. Pull sharply inward and upward 5 times.
Alternate back blows and thrusts
Continue 5 back blows + 5 abdominal thrusts until object is expelled or person becomes unconscious.
If person becomes unconscious
Lower gently to ground. Call 911. Start CPR. Before rescue breaths, open mouth and check for visible object — remove only if you can see it. Do not blind-sweep.
Self-Heimlich
If alone: drive your abdomen (above navel) forcefully against the back of a sturdy chair or countertop edge.
Do NOT Do
- Do NOT slap the back of someone who is coughing effectively
- Do NOT do finger sweeps unless you can see the object
- Do NOT give water to try to wash it down
- Do NOT leave the victim alone even if the object clears — internal injury possible
Aftercare
Anyone who received abdominal thrusts should see a doctor — internal injuries can occur. Watch for continued breathing difficulty.
When to Get Professional Help
Call 911 if the object doesn't clear in 3-4 attempts, or if person loses consciousness at any point.