7 Swift Rescue Steps for a Choking incident

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Last Updated on March 24, 2026 by Paul Clayton

7 Swift Rescue Steps for a Choking Incident

Key Takeaways

• • Printable Image below, JUST RIGHT CLICK AND SAVE TO PRINT 
  • Identify the Signs: * Mild Choking: The person can cough, speak, or make noise. Do not interfere; encourage them to keep coughing.
    • Severe Choking: The person is silent, cannot breathe, may turn red/blue, or uses the “universal sign” (hands clutching the throat). This requires immediate action.
  • The 5-and-5 Approach: * Start with 5 back blows: Lean the person forward and strike firmly between the shoulder blades with the heel of your hand.
    • Follow with 5 abdominal thrusts (Heimlich Maneuver): Stand behind them, wrap your arms around the waist, make a fist above the navel, and pull inward and upward.
  • Special Populations:
    • Infants: Use gentle back blows while the baby is face-down on your forearm, followed by chest thrusts (using two fingers) if needed.
    • Pregnant or Obese Individuals: Perform thrusts on the chest (breastbone) rather than the abdomen.
  • If the Victim Becomes Unconscious:
    • Lower them to the ground and begin CPR (30 compressions followed by rescue breaths).
    • Check the mouth for the object before giving breaths, but only remove it if it is visible and reachable.
  • Self-Rescue: If alone, use the back of a sturdy chair to thrust your abdomen against, or drop your weight from a push-up position to the floor to force air out of the lungs.
  • Post-Incident Care: Always seek medical evaluation after a choking incident, even if the object is cleared, to check for internal injuries or cracked ribs.

The odds of dying from choking on food in the US are approximately 1 in 2,659. To put this probability into perspective, the odds of dying from choking are much lower than dying from an accidental plane crash or gun discharge.

Pretty slim odds, right?

It is true, but not that far-fetched. The chances of you, your loved ones, or your kid choking on food or toys to death aren’t impossible. Choking is usually the leading cause of death in toddlers and the leading cause of death in people over 65.

Frequently Asked Questions

Q: What should I do if someone is choking but still coughing or talking?

You should not interfere. If a person can cough, cry, or speak, their airway is only partially obstructed. Encourage them to keep coughing forcefully, as the body can often expel the object on its own. Only step in with back blows or thrusts if they become silent or can no longer breathe.

Q: How do the rescue steps change for a pregnant or obese person?

If a person is in the late stages of pregnancy or is too large for you to wrap your arms around their waist, you should perform chest thrusts instead of abdominal thrusts. Place your fist against the center of their breastbone (rather than the belly button area) and thrust backward firmly.

Q: Is it possible to perform the Heimlich maneuver on myself if I am alone?

Yes. You can use the “Chair Method” by leaning over the back of a sturdy chair and thrusting your upper abdomen against the edge. Alternatively, drop into a push-up position and let your chest hit the floor forcefully; the sudden impact can help force air out of your lungs, dislodging the object.

Q: Why is it dangerous to perform the Heimlich maneuver on someone choking on water or saliva?

The Heimlich maneuver is designed to mechanically expel solid objects. Using it on someone who has “inhaled” liquid can actually be counterproductive, potentially causing them to inhale the fluid even deeper into the lungs. In these cases, coughing is the natural and most effective remedy.

Q: Should I go to the hospital if the object is successfully coughed up?

Yes. The article stresses that a medical evaluation is necessary after any significant choking incident. Abdominal thrusts and back blows are forceful and can cause internal damage or cracked ribs that may not be immediately apparent.

Knowing what to do when someone is choking is important to prevent injury or, worse, unavoidable death. Knowing you’re well-prepared for such an event also brings a sense of peace of mind. In this guide, I’ll teach you what to do if someone starts to choke.

Signs of Choking

Learning to tell when someone is choking is just as important as knowing what to do when someone starts choking.

The problem with choking is that it can sometimes be silent, which is particularly concerning for parents. Think about it: coughing usually equates to air movement, and gasping does. Kids usually don’t know how to come and tell you when they’re choking. You must supervise your kids while they eat, and don’t assume silence means everything is okay.

With that said, here are some important signs to look for to tell if someone is choking. Some of the signs are obvious, but it might be harder to tell if someone tries to hide what’s going on

• The universal sign of distress: The international sign of choking is when someone has both hands grasping the throat. If you see this, know that someone needs help.
• Gagging: If the other person appears to be gagging and retching, but nothing or drool is coming out, they might be choking.
• Coughing: Coughing uncontrollably is also a sign of mild choking. Typically, this occurs when the body attempts to expel foreign substances from the lungs.
• Wheezing: If someone appears to be struggling mightily to take a deep breath and is audibly wheezing, it indicates the airway is partly blocked.
• Panic: Generally, if someone exhibits signs of panic, such as a red face, watery eyes, or wide eyes, it might be a sign that they’re choking
• Silence and inability to talk:  Yes, silence can also indicate something is wrong. When someone is coughing and making noises, it means the obstruction is urgent, but they’re not in imminent danger. On the other hand, if they’re silent and can’t make a noise, it’s a sign of severe choking, and they’re not far from unconsciousness or death.

Steps to Take When Someone Starts Choking

Now that we know how to tell if someone is choking, let’s look at what to do if someone starts choking.

Step 1

If you suspect someone is choking, the first step is to ask them if they’re choking. In most cases, they’ll nod to say they’re choking. They might also display signs of distress or even hold their throat with both hands.

Also, try calling them and helping them relax. It’ll be easier to help them if they’re relaxed, and by calling them, they won’t pass out as fast.

Step 2

If they can talk, cough, or make noises, their airway is partially obstructed, and some airflow is still possible. In this case, please encourage them to cough it up and refrain from interfering. The obstruction may clear by itself.

Step 3

If the casualty cannot speak, cough, wheeze, or make high-pitched noises, it indicates severe choking, and you must act quickly.

Before reaching out, let them know you will assist them so they know what to expect.

Step 4 

Back blows are the first-aid technique you should employ to help a choking person. It requires you to provide five short, sharp blows between the shoulder blades.

Here’s a step-by-step method for performing the back blows:

• Stand behind the casualty and wrap one of your arms diagonally across their chest. Ideally, your fingers should be opposite your casualty’s arm, while your elbow should be slightly above their hip.
• Next, bend the casualty forward at the waist. The aim should be to have the airway parallel to the ground.
• With the heel of your free hand, deliver five firm back blows between the shoulder blades. Whack the casualty as hard but firmly on the back until the blockage comes flying off.

Hopefully, the back blows will be enough to clear the airway blockage and relieve the casualty from choking. If there’s still blockage and your casualty is choking, you must move to the next technique.

Step 5

If the back blows aren’t efficient at eliminating the blockage, you must switch to the abdominal thrusts, AKA the Heimlich maneuver.

The abdominal thrust maneuver is a first aid procedure used to treat upper airway obstructions caused by foreign objects or other obstructions. It is commonly taught during basic life support and cardiac life support classes. American doctor Heimlich is often credited with its creation.

Here’s a step-by-step guide to how to perform the abdominal thrust technique on a choking person:

• Go behind the casualty as you did with the back blow technique. However, instead of running your hand diagonally, wrap your hands all around.
• Next, make a fist and find the belly button with your pinky finger. Position the clenched hand pinky on the belly button, then roll it up so the knuckle of your thumb is right under the rib cage.
• Start thrusting upwards, once at a time. You pull your fist in and out until you dislodge whatever is in their mouth, and they can breathe again.

During thrusting, you shouldn’t do it 10 times in a row, as most films tend to portray. Instead, you need at least a second between each thrust. After every thrust, check whether the obstruction has been dislodged so as not to continue. In short, please don’t be crazy about it to avoid breaking ribs.

Of course, when someone is choking to death, worrying about a broken rib takes a backseat; getting the food dislodged from the airway is the most important thing. However, many people tend to overuse abdominal thrusts. Doing 5 thrusts in 2 seconds won’t increase your chances of dislodging a blocked airway more than doing one at a time.

You could still break a rib even if you do the thrusts correctly. You can minimize the risk. It won’t ever be zero, but having someone do it calmly is much better.

The Heimlich maneuver is an efficient technique, but unfortunately, you can’t perform it on an infant, pregnant woman, or obese person. There’s a higher risk of injury.

If the person choking falls in the above groups, your fist should be placed near the breastbone. Then, use the same thrusting techniques to perform the chest thrusts.

Step 6

If the Heimlich maneuver doesn’t help your casualty dislodge the blockage, and they pass

out, you need to perform CPR. CPR comes in handy when the casualty is unconscious and can’t breathe.

If your casualty is unresponsive and doesn’t breathe, you need to perform CPR. However, if they’re unconscious and still breathing, you need to put them in a recovery position.

Usually, if a blockage doesn’t clear, a person will pass out automatically. And when they do, their throat relaxes, and you can start CPR.

Here’s a general guide to how to perform CPR:

• Ensure the casualty is on a firm surface
• Remove any visible foreign objects from their mouth. Start by supporting and positioning their chin. Next, depress their tongue using your thumb while supporting their chin and lifting the jaw. Use the index finger of your other hand as a hook to clear and remove any foreign objects in the victim’s mouth.
• Open the victim’s airway by tilting their head back while raising their chin.
• Administer rescue breaths to see if the blockage clears.
• If the victim’s chest isn’t rising, begin compressions. Kneel next to them and find the center of their chest. Stack your hands by interlocking them and start your 30 compressions. Each compression should be at least 2 inches deep and performed at a rate of at least 100 per minute. That’s more than one every second. It’s fast, but remember that it’s a type of circulatory compression and may become exhausting over time.
• Alternate the compression with attempts to clear any blockage.
• Hopefully, this should clear the blockage. If not, continue with compressions and rescue breaths until an AED or EMS personnel arrive and take over.

Step 7

Even if everything is fine, you must always take the victim to a hospital for evaluation. They must get a checkover to see if there’s any internal damage. It’s particularly important for victims who have had the abdominal thrust done on them because their ribcage can easily break off.

What to do if a kid is choking?

Helping a baby or infant clear an obstruction from their airways isn’t much different from that of an adult.

Here’s a breakdown of the steps you should take:

• Lean the baby over your arm, ideally at about 25-30 degrees. Their airway should be approximately parallel to the ground.

Give them five gentle back blows, repeated as needed, to dislodge the obstruction. The baby should be facing down on the lower part of your arm. Remember, the key here is to watch if they spit out what they were choking on.

• If the back blows don’t seem to work, proceed to do chest compressions. Carefully roll the baby on their back so they face two. Place the index and middle finger at the center of their breastbone, and make gentle up and down thrusts. One chest thrust per second is enough.
• If the blockage doesn’t clear, switch to the back blows. Alternate these two techniques until the airways are free of obstructions.
• If the infant becomes unconscious or unresponsive, consider performing CPR.

How to Perform the Heimlich When You’re Alone

Choking when you’re alone happens more often than you would think. It’s one of my nightmares. The good thing is that you can use the Heimlich maneuver to help yourself in such a situation.

Here’s how to do it:

Chair Method

If you’re alone and choking, you could perform a Heimlich maneuver using the back of a chair or any other surface that allows for it. It’ll hurt like hell, but it’s efficient, much better than other alternatives, and, more importantly, will save your life.

• Find a chair, preferably with a rounded edge
• Make a fist across the front of your body, ideally just under the rib cage
• Fall forward on the chair, landing on the clenched fist first. Slam hard on the chair, trying to drive your fists upward.
• Repeat until the obstruction is cleared.

Alternative Self-Choking Technique

If you’re choking and alone, you could also get into a push-up position, ideally with your knees on the ground. Then slam yourself onto the ground, chest first. This is likely to knock the wind out of you.

Moving large amounts of air quickly will forcefully dislodge any object in your airways. This technique is a great alternative and can complement the Heimlich technique.

When Not to Use the Heimlich Technique

The Heimlich maneuver is an effective method for clearing an obstructed airway. However, it’s only as good as it can be up to a certain point. There are several circumstances in which the Heimlich maneuver isn’t ideal.

For example, if the victim is coughing or speaking, they don’t need the Heimlich maneuver. In such cases, you must encourage the casualty to cough and clear the obstruction. In short, give them time to breathe.

What To Do If Someone Chokes on Water, Own Saliva, or Liquids?

You don’t need to take any action if someone else is choking on liquids. After all, forming a full blockage with liquid is quite difficult.

When someone coughs or chokes on liquids, it’s not REAL choking. Instead, small amounts of liquid got down the wrong pipe, and coughing is simply a reflexive response to expel the unwelcome fluids.

You can’t use the Heimlich maneuver on someone choking on liquids. The technique mechanically expels a solid obstruction and won’t work for fluids. Performing the Heimlich maneuver on a person choking on water may cause them to inhale it completely.

*Tips Regarding Choking

• For the love of God, always let people know you’re choking. It’s a natural reaction to try to go to the bathroom and walk away to help yourself, but don’t do that.
• Based on most choking incidents, the best tip is to chew your steak thoroughly.
• Other major causes of choking are eating too quickly, swallowing bones & small objects, and inhaling small objects.

This video has been included to clarify the topic. Credit goes to News4JAX

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Final Thoughts

Assess and Ask: If you suspect choking, ask the casualty if they are choking (they will likely nod) and try to keep them calm.

Back Blows: If severe choking is confirmed (no sound/cough), deliver five short, sharp back blows between the shoulder blades while the person is bent forward.

Abdominal Thrusts (Heimlich Maneuver): If back blows fail, switch to the Heimlich maneuver:

• • Wrap arms around the casualty.
  • Make a fist, positioning the thumb side just below the rib cage and above the belly button.
  • Perform five upward thrusts, checking after each one to see if the obstruction has cleared.

Chest Thrusts Exception: If the casualty is an infant, pregnant, or obese, use chest thrusts (near the breastbone) instead of abdominal thrusts to minimize injury risk.

Infant Procedure: For infants, alternate five gentle back blows (with the baby face down on your arm) with five gentle chest compressions (using two fingers on the breastbone).

Unconsciousness/CPR: If the casualty becomes unresponsive or passes out, immediately begin CPR (30 compressions alternating with attempts to clear the airway and rescue breaths).

Medical Follow-up: Always take the victim to the hospital for a professional check-up, even if the blockage is successfully cleared, especially if the Heimlich maneuver was performed (due to the risk of broken ribs or internal damage).

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