Choking

Choking occurs when a foreign object – such as a mouthful of food, a marble or false teeth – partly or completely blocks a person’s airway. Choking may be a life-threatening medical emergency because the brain can only survive a few minutes without oxygen. Another name for choking is foreign body airway obstruction.

First aid can save the life of a choking person if applied correctly and immediately. Procedures are different for adults and children. Always call triple zero (000) for an ambulance in a medical emergency.

The suggestions in this fact sheet are not a substitute for first aid training. Everyone should learn first aid skills. Refer to the Where to get help section below for organisations that offer first aid courses.

Signs of choking – partly blocked airway
The person can still breathe, speak or cough. Symptoms of a partially blocked airway include:

• Panicked and distressed behaviour
• Frantic coughing
• Unusual breathing sounds, such as wheezing or whistling
• Clutching at the throat
• Watery eyes
• Red face.

• Panicked and distressed behaviour, including vigorous attempts to breathe
• Clutching at the throat
• Watery eyes
• Red face at first, turning pale and then blue due to lack of oxygen (cyanosis)
• Unconsciousness and collapse.

• Get help if possible. For example, ask someone nearby to call triple zero (000) for an ambulance. You will also be given advice over the phone from emergency services.
• Stand behind the choking person.
• If you cannot put your arms around the person (because they are overweight, for example) ask them to lean forwards so that gravity will help you. Using the heel of your hand, give five sharp slaps between their shoulder blades.
• Keep checking to see if the object has been expelled. Please note that medical attention is still needed, even if the object is expelled, because the trachea (wind pipe) may be damaged.
• If the backslapping does not work, use your hands to give five chest thrusts. Place your hands on the person’s breastbone and compress sharply. This procedure can also provoke an artificial cough.
• If the object remains lodged and the person loses consciousness, lower them to the ground. Look inside their mouth. If you can see the foreign object, try to scoop it out with your little finger.
• If the person still isn’t breathing, commence mouth-to-mouth resuscitation.

• Roll the person onto their back.
• Open their airway by tilting back the person’s head and lifting their chin.
• Close their nostrils with your finger and thumb.
• Put your mouth over the person’s and blow into their mouth.
• Regularly check the person for a pulse. If their heart stops beating, commence cardiac compressions.

• Place the heel of one hand on the lower half of the person’s breastbone. Place the other hand on top of the first hand and interlock your fingers.
• Press down firmly and smoothly (compressing to one-third of chest depth) 30 times. Then administer two breaths.
• The combination of 30 cardiac compressions followed by two breaths is called cardiopulmonary resuscitation or CPR.
• Continue CPR until ambulance officers take over.

• If the child cannot breathe, get help if possible. For example, ask someone nearby to call 000 for an ambulance.
• Place the child face down over your knee so that their head is lower than the chest. A bigger child can be laid on their side on the floor.
• Give four sharp blows on the back between the shoulder blades to dislodge the object.
• If the child still isn’t breathing, call triple zero (000) for an ambulance. The operator will give you instructions while you wait for the ambulance to arrive. You will probably be asked to commence mouth-to-mouth resuscitation. Unless the operator tells you, do not use the abdominal thrust procedure as it can cause serious internal damage in children.

• Try to stay calm. Attract someone’s attention for help.
• Attempt forceful coughing. This may eject the foreign object.
• Don’t let anyone slap you on the back while you are upright. Gravity may allow the object to slip further down your trachea.
• Instead of using your hands, you can perform the abdominal thrust procedure with a chair. Stand behind the chair and lean your body over it so that you drive the chair back into your abdomen.

• Your doctor
• Always call for an ambulance in a medical emergency Tel. 000
• Emergency department of the nearest hospital

• St John Ambulance Australia Victoria Tel. 1300 360 455
• Australian Red Cross Tel. 1300 367 428

• Always call triple zero (000) for an ambulance in a medical emergency.
• Don’t slap a choking person on the back while they are upright – gravity may allow the object to slip further down the trachea.
• First aid for choking adults includes the abdominal thrust procedure, which uses pressure against the abdomen to compress the lungs and provoke an artificial cough.
• The procedure you would use for children is different to the one used for adults.

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