Take a Class Resources Learn First Aid Adult/Child Choking
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  • Adult/Child Choking

    Choking is especially common in young children, but a person of any age can choke. Choking occurs when the airway becomes either partially or completely blocked by a foreign object, such as a piece of food or a small toy; by swelling in the mouth or throat; or by fluids, such as vomit or blood. A person who is choking can quickly become unresponsive and die, so it is important to act quickly.

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    Risk Factors for Choking

    Certain behaviors can put a person at risk for choking, such as talking or laughing with the mouth full or eating too fast. Medical conditions (such as a neurological or muscular condition that affects the person’s ability to chew, swallow or both) can increase risk for choking. So can dental problems or poorly fitting dentures that affect the person’s ability to chew food properly.

    Signs and Symptoms of Choking

    A person who is choking typically has a panicked, confused or surprised facial expression. Some people may place one or both hands on their throat. The person may cough (either forcefully or weakly), or he or she may not be able to cough at all. You may hear high-pitched squeaking noises as the person tries to breathe, or nothing at all. If the airway is totally blocked, the person will not be able to speak, cry or cough. The person’s skin may initially appear flushed (red), but will become pale or bluish in color as the body is deprived of oxygen.

    Emergency Steps

    1

    Check the scene safety, form an initial impression, obtain consent and put on PPE, as appropriate.

    2

    Check for signs and symptoms.

    • Weak or no cough*
    • High-pitched squeaking noises or no sound*
    • Pale or blue skin color*
    • Unable to cough, speak or cry*
    • Panicked, confused or surprised appearance*
    • Holding throat with hand(s)*

    *Note: Signs and symptoms with a * require immediate emergency medical treatment.

    3

    Call 9-1-1 and get equipment if the person requires immediate emergency medical treatment.

    4

    Give Care.

    General Care: Choking (Adult/Child)

    1. Position self to the side and slightly behind the choking person.
      1. For a small child, you may need to kneel behind them rather than stand.
    2. Give 5 back blows.
      1. Use the heel of the hand to strike between the shoulder blades.
    3. If no improvement, have the person stand up straight.
    4. Move behind the person; bend your knees slightly for balance and support.
    5. Give 5 abdominal thrusts.
      1. Pull inward and upward each time.
    6. Continue giving 5 back blows and 5 abdominal thrusts.
      1. Continue until the person can cough, cry or speak or becomes unresponsive.
    7. If the person becomes unresponsive, lower them to a firm, flat surface and begin CPR (starting with compressions) according to your level of training.
      1. Trained responders: After each set of compressions and before attempting breaths:
      2. Open the person's mouth.
      3. Look for an object.
      4. If seen, remove it using your finger. NEVER do a finger sweep unless you actually see an object.

    Choking Adult/Child FAQs

    How do I give back blows?

    To give back blows:

    • Position yourself to the side and slightly behind the person. For a small child, you may need to kneel behind them.
    • Place one arm diagonally across their chest.
    • Bend them forward at the waist so the upper body is parallel to the ground.
    • Firmly strike them between the shoulder blades 5 times with the heel of the hand.
    • Have each back blow be separate from the others.

    How do I give abdominal thrusts?

    • Have the person stand up straight.
    • Find their navel with two fingers.
    • Move behind them; place your front foot in between their feet, bending your knees slightly. For a small child, you may need to kneel behind them.
    • Make a fist with your other hand.
    • Place the thumb side against their stomach, above your fingers.
    • Take your first hand and cover your fist with it.
    • Pull inward and upward 5 times.
    • Make each abdominal thrust forceful and separate from the other.

    What should I do if the person is able to cough, cry or speak?

    Encourage the person to keep coughing, but continue to observe them. Do not leave them alone and be prepared to act if their condition changes.

    Do I always do the same steps for any person who is choking?

    There are special situations that may require you to give care for choking a little differently.

    • If a person is too large to wrap your arms around to give abdominal thrusts, give chest thrusts instead of abdominal thrusts.
    • If a person is obviously pregnant or known to be pregnant, give chest thrusts instead of abdominal thrusts.
    • If a person is in a wheelchair, give abdominal thrusts as usual but you may need to kneel behind the wheelchair. If abdominal thrusts are difficult, give chest thrusts.
      • Remove the armrests, if necessary, to give abdominal or chest thrusts.
      • As a last resort, remove the person from the wheelchair.

    What if I’m alone and start choking?

    If you are choking and alone, call 9-1-1 using a landline or a GPS-enabled mobile phone. Even if you are not able to speak, the open line will cause the dispatcher to send help.

    Give yourself abdominal thrusts, using your hands, just as if you were giving abdominal thrusts to another person. Alternatively, bend over and press your abdomen against any firm object, such as the back of a chair or a railing. Do not bend over anything with a sharp edge or corner that might hurt you, and be careful when leaning on a railing that is elevated.

    Do I treat a child who is choking the same as an adult?

    Yes, but with one possible change: if the child is small, you may need to kneel behind them instead of standing behind them. Use the same combination of 5 back blows followed by 5 abdominal thrusts to clear the airway obstruction. Do not hang a child upside down by their feet to dislodge the object. This is not effective and may cause further injury if you happen to drop them.

    Help Save Lives with an American Red Cross Class

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    Information Provided the Scientific Advisory Council (SAC)

    Behind every American Red Cross training program stands the Scientific Advisory Council - a team of experts dedicated to ensuring that what you learn is based on the latest and best emergency science. Visit redcross.org/take-a-class/scientific-advisory-council to see how we work, members, sub councils, scientific reviews, and recent research.

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