A step-by-step guide explaining what to do in a choking emergency.
Choking occurs when a foreign object becomes lodged in the throat or windpipe, obstructing air flow. A piece of food is frequently the culprit in adults. Small objects are frequently swallowed by young children. Because choking prevents oxygen from reaching the brain, provide first aid as soon as possible.
Hands clasped to the throat is the universal sign for choking. If the person does not give the signal, look for the following signs
Inability to talk
Difficulty breathing or noisy breathing
Squeaky sounds when trying to breathe
Cough, which may either be weak or forceful
Skin, lips and nails turning bluish
Skin that is flushed, then turns pale or bluish in color
Loss of consciousness
If the person is able to cough forcefully, he or she should do so. Singapore First Aid Training Centre recommends the basic approach to providing first aid if the person is choking and unable to talk, cry, or laugh forcefully.
Give 5 back blows. Stand to the side and just behind a choking adult. For a child, kneel down behind. Place one arm across the person's chest for support. Bend the person over at the waist so that the upper body is parallel with the ground. Deliver five separate back blows between the person's shoulder blades with the heel of your hand.
Give 5 abdominal thrusts. Perform five abdominal thrusts (also known as the Heimlich maneuver).
Alternate between 5 blows and 5 thrusts until the blockage is dislodged.
We do not emphasize the back blow technique at SGFIRSTAID, only the abdominal thrust procedures. If you haven't learned how to use back blows, it's fine not to use them. Both approaches are valid.
To perform the Heimlich maneuver (abdominal thrusts) on someone else:
Stand behind the person. Place one foot slightly in front of the other for balance. Wrap your arms around the waist. Tip the person forward slightly. If a child is choking, kneel down behind the child.
Make a fist with one hand. Position it slightly above the person's navel.
Grasp the fist with the other hand. Press hard into the abdomen with a quick, upward thrust — as if trying to lift the person up.
Perform between six and 10 abdominal thrusts until the blockage is dislodged.
If you're the only person on the scene, perform back blows and abdominal thrusts before dialing 995 or your local emergency number for assistance. If another person is nearby, have them call for assistance while you perform first aid.
Perform standard cardiopulmonary resuscitation (CPR) with chest compressions and rescue breaths if the person becomes unconscious.
To perform abdominal thrusts (Heimlich maneuver) on yourself, do the following:
First and foremost, if you are alone and choking, call 995 right away. Although you won't be able to deliver effective back blows to yourself, you can still use abdominal thrusts to dislodge the item.
Place a fist slightly above your navel.
Grasp your fist with the other hand and bend over a hard surface — a countertop or chair will do.
Shove your fist inward and upward.
To clear the airway of a pregnant woman or obese person:
Position your hands a little bit higher than with a normal Heimlich maneuver, at the base of the breastbone, just above the joining of the lowest ribs.
Proceed as with the Heimlich maneuver, pressing hard into the chest, with a quick thrust.
Repeat until the food or other blockage is dislodged. If the person becomes unconscious, follow the next steps.
To clear the airway of an unconscious person:
Lower the person on his or her back onto the floor, arms to the side.
Clear the airway. If a blockage is visible at the back of the throat or high in the throat, reach a finger into the mouth and sweep out the cause of the blockage. Don't try a finger sweep if you can't see the object. Be careful not to push the food or object deeper into the airway, which can happen easily in young children.
Begin CPR if the object remains lodged and the person doesn't respond after you take the above measures. The chest compressions used in CPR may dislodge the object. Remember to recheck the mouth periodically.
To prepare yourself for these situations, learn the Heimlich maneuver and CPR in a certified first-aid training course. Learning CPR is an important part of first aid training, and its rapid administration is critical, thus having a qualified first aider on hand who can remain calm under pressure is quite useful. When dealing with emergency circumstances, becoming trained in first aid procedures can make you feel more comfortable and confident since you will know the most efficient ways to deal with the problem.
An added benefit of this is that the people around you, be it children, adults and others around you, will also feel more reassured knowing that there are trained people on site.
If you’re interested in finding out more about the application of first aid principles and how they can help you, your organisation and those around you, we offer a comprehensive e-learning courses on first aid.
These are courses which can be accessed at any time to help train you and those around you at times which suit them, developed by experts to assist with practical first aid training.
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