• Lucy Adie

OsteoBlog: First Aid Series 3: Choking

16,000 people are treated for choking each year in UK hospitals. Over 5,000 of these incidents are fatal, half of whom are over 74 years of age.

Choking still remains a leading cause of death in children and the 4th leading cause of unintentional death in adults.

(Stats according to the National Safety Council

So, with these frightening statistics in mind, it is vitally important that as many people as possible know how to manage the person who is choking.

It will be fairly obvious when someone is choking. They will probably clutch their throat, go a little red in the face and be in a flat panic. They may be breathing noisily, which indicates that some air is getting through to the lungs, a good thing. The silent choker is not good and has far less time before they go unconscious and die. They may be blue round the lips and nose (a late moribund sign).

You must have a high index of suspicion of choking when someone is eating, children are playing with toys or there are medical conditions present which may affect a persons ability to maintain a patent airway (dementia, previous stroke, motor neurones disease, and many more).

Act quickly and effectively and remember that gravity is your friend, especially when dealing with the choking infant or child.

What do you do:

The choking adult and child down to 1 year of age.....

First, keep calm......... Early 999 (you can cancel if they recover)

Establish whether the patient is choking simply by asking them, "Are you choking?"

They may look at you like you have gone mad, but it is essential to work out what is wrong before you go slapping backs and thrusting stomachs!

Encourage them to cough.

Have a look in the mouth for any obvious obstruction and remove, but do not go digging around blindly for fear of pushing something deeper into the airway.

Lean them forward and slap them hard between the shoulder blades 5 times.

If the child is quite small then put them over your knee to slap, or hold them upside down along your leg for support.

Check the airway again.

You must now perform abdominal thrusts (formerly the Heimlich Manoeuvre).

In an adult, stand behind them and put the thumb edge of your hand into their abdomen just below the sternum in the centre and at the first soft point you can feel. Put your other hand over the top and then pull inwards and upwards to drive the obstruction up and out. Do this 5 times too, if necessary.

Check the airway again.

Repeat the 5 back slaps and 5 thrusts until the obstruction is dislodged or the patient becomes unconscious.

If the obstruction has not resolved, you should prepare to resuscitate the patient with CPR.

In infants age 1 year or less you must not do abdominal thrusts, we do chest thrusts instead.

Remember gravity is your friend and turn the child upside down to slap the back 5 times.

Then turn them over, still head down, and perform a 2- finger chest compression between the nipples, pressing down firmly on the sternum to about half the depth of the chest.

Repeat the back slaps and thrusts until the child becomes unresponsive or the obstruction is gone and they recover.

Please see the previous blog posts for in-depth instructions on CPR for adults and infants.

This instruction does not replace a first aid course, where you can practice on real people and dummies with instructors.

Thank you for reading this article, it could save someones life.

Lucy is a qualified Paramedic with 22 years experience and is committed to making sure as many people as possible know what to do in an emergency.

For osteopathy in High Wycombe and beyond, call Lucy from OsteoFusion on

07833 321604 or visit

#choking #abdominalthrust #chestthrust #backslaps #airwayobstruction



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