Dealing with someone choking at an event

One first aid skill that you may well have to use at work or at home is dealing with someone who is choking. Choking is a life-threatening condition. If you have an airway obstruction, then you can not breathe and you can only stay in that state for a very short space of time.

There are different types of choking, mild and severe.

Severe choking is where you have an obstruction that has totally blocked the airway so you cannot breathe at all.

A mild obstruction could be something like a small fishbone that has been lodged in your throat but not completely blocking. It is very uncomfortable, you will be coughing and getting fairly distressed.  If someone has a mild obstruction, encourage them to cough and monitor their condition.  As the airway is only partly blocked, the person will usually be able to speak, cry, cough or breathe. They will usually be able to clear the blockage themselves.

Do not put your fingers in their mouth to help them as they may bite you accidentally.  They may need to see a doctor or go to a hospital depending on if they can clear the obstruction.

A conscious adult or older child choking victim with severe airway obstruction, may not be able to talk, cough, speak, cry or breathe and may do the universal choking sign with hands around their throat. Without help, they will eventually become unconscious.

If you ask them “are you choking” and they cannot answer you, then you know they have severe airway obstruction.

Once you have established that the victim is choking, shout for help.

Stand behind them with one arm under their arm supporting against their stomach. Lean them forward and with your other hand perform up to 5 sharp back blows between the shoulder blades, check to see if the obstruction has come out.  If this is unsuccessful then separate the patient's feet, place one foot behind their feet and raise their elbows.

Place one hand with the thumb tucked in against the abdomen above the belly button and grab your fist with the other hand. Perform abdominal thrusts five times. Check to see if the obstruction is out on every thrust. If not repeat the same steps with five sharp back blows and five thrusts until the object comes out of the patient's airway or the patient becomes unconscious.

Call the EMS after no later than 5 cycles and if you have had to deliver abdominal thrusts to a patient, always get them checked out by a medical professional as severe damage can be done with this procedure.

Once you lay the person down on their back, activate EMS if you have not already and start CPR at the compression stage. By delivering compressions, hopefully, the obstruction will be cleared and they will start to breathe again.

If the patient is pregnant or markedly obese use chest thrusts instead of abdominal thrusts.

Finally, never attempt this unless someone actually needs it and it is recommended in all cases for them to get checked out by a medical professional after performing abdominal thrusts.