What Is the Proper First Aid for Choking?
Choking happens when an object blocks the airway. Children are more vulnerable to choking since they put random things into their mouth.
Choking is dangerous, as it cuts off oxygen to the brain.
Last reviewed: September 2026 — checked against Resuscitation Council UK Guidelines 2025.
The universal sign indicating someone is choking is the hands clasping their throat.
Other warning signs include difficulty breathing, a persistent cough and pale skin; if the blockage is not cleared, the person may eventually lose consciousness.
Current UK guidance (Resuscitation Council UK Guidelines 2025) uses an escalating “five-and-five” approach: encourage the person to cough first, then give up to five back blows, then up to five abdominal thrusts, alternating between the two until the blockage clears.
To give a back blow, slap their back using the heel of one hand in between the shoulder blades — up to five times, checking between each blow to see if the object has come out.
What Are the 4 Actions in Order When Dealing With a Choking Victim?
These are four simplified actions, in line with the guidance taught by St. John Ambulance and the Resuscitation Council UK, when responding to a choking victim:
- Ask them if they are choking: If they can cough or talk, they may still clear the blockage themselves.
- Encourage them to cough: An effective cough is the best way to remove the obstruction.
- Give up to five back blows: If they cannot cough, or their cough becomes ineffective, give up to five sharp back blows between the shoulder blades with the heel of your hand.
- Give up to five abdominal thrusts: Wrap your arms around their waist and put your clenched fist between their belly button and the bottom of their breastbone. With your other hand, clutch your fist and pull sharply inwards and upwards, up to five times.
If the blockage still hasn’t cleared after five back blows and five abdominal thrusts, call 999 — put the phone on speaker if you’re on your own — and keep alternating five back blows with five abdominal thrusts until the object comes out, help arrives, or the person becomes unresponsive.
Check the mouth between attempts and remove the object only if you can clearly see it and easily grasp it. Never perform a blind finger sweep, as this can push the object deeper into the airway.
What Is the Proper First Aid for Choking Adults?
If there’s a partial (mild) airway obstruction, the choking adult can still breathe, though there may be noisy breathing.
They can often clear small objects by coughing, so while their cough is still effective, encourage them to keep coughing rather than intervening — only start back blows if the cough becomes ineffective or they cannot cough at all.
Ask the choking adult first: “Are you choking?” If they cannot answer, cough or breathe properly, act quickly using the steps below.
1: Give Up to Five Back Blows
Follow the steps:
- Stand behind and slightly to one side of the person. Support their chest with one hand and lean them well forward, so that when the object is dislodged it comes out of the mouth rather than moving further down.
- Give up to five sharp blows between their shoulder blades with the heel of your hand.
- Check between each blow to see whether the object has come out.
2: Give Up to Five Abdominal Thrusts (the Heimlich Manoeuvre)
If back blows don’t clear the blockage:
- Stand behind the person, wrap your arms around their waist, and lean them forward.
- Place your clenched fist on the abdomen, between the belly button and the bottom of the breastbone.
- Use your other hand to clutch your fist and pull sharply inwards and upwards.
- Do this up to five times, checking between each thrust.
- Only remove the blockage with your finger if you can clearly see it and grasp it easily; never perform a blind finger sweep, as this can push the object deeper.
- If the person is pregnant, do not give abdominal thrusts — give sharp thrusts against the centre of the breastbone (chest thrusts) instead.
3: Call 999 and Keep Alternating
TAKE NOTE: If the blockage has not cleared after five back blows and five abdominal thrusts, call 999 straight away (use the speaker function if you are alone). Then keep alternating five back blows with five abdominal thrusts until the obstruction is relieved, help arrives, or the person becomes unresponsive.
Even if the object comes out, anyone who has been given abdominal thrusts (or chest compressions) should be checked by a healthcare professional afterwards, as these techniques can cause internal injury.
4: CPR — If the Person Becomes Unresponsive
If the person becomes unresponsive, make sure 999 has been called, then start cardiopulmonary resuscitation:
- Lay the person on their back on a firm surface.
- Kneel beside them and put the heel of your hand in the centre of their chest, place your other hand on top, and interlock your fingers.
- Give chest compressions: press straight down by 5 to 6 cm at a rate of 100 to 120 compressions per minute, letting the chest come fully back up between compressions.
- If you’re trained and confident, give 2 rescue breaths after every 30 compressions. If not, give continuous hands-only compressions.
- If a defibrillator (AED) is available, switch it on and follow its voice prompts.
- Continue until emergency help arrives and takes over, the person shows signs of life (speaks, opens their eyes, moves purposefully or breathes normally), or you’re too exhausted to carry on.
What Is the Proper First Aid for a Choking Infant?
Children are prone to choking as they tend to swallow random things.
When this happens, check the mouth. Only remove the object if you can clearly see it and grasp it easily — never poke blindly or repeatedly with your fingers, as you might push the blockage further in and make it harder to remove.
The British Red Cross, the NHS and the Resuscitation Council UK all recommend the following steps for a choking baby.
1: Give Up to Five Back Blows
Sit down and hold the baby face down along your thigh or forearm, supporting their head and neck with your hand, with their head lower than their bottom.
Then, give up to five sharp back blows with the heel of your hand in the middle of the back, between the shoulder blades. Check between each blow to see if the object has come out — you may not need all five.
If the back blows don’t work, proceed to step 2.
2: Give Up to Five Chest Thrusts
Turn the baby over so they are face up along your thighs, with their head lower than their feet. Make sure you support their head.
Put two fingers in the centre of the chest, just below the nipple line, and push sharply downwards up to five times, checking between each thrust.
3: Call 999 and Keep Going
If the blockage has not come out after the back blows and chest thrusts, call 999 — put the phone on speakerphone so your hands are free — and do not leave the baby at any stage.
Keep alternating five back blows and five chest thrusts until the airway clears or help arrives.
If the baby becomes unconscious, call 999 immediately (if you haven’t already), place them on a firm, flat surface and start CPR.
Even if the object comes out, get the baby checked by a medical professional — part of the object may have been left behind, or they may have been injured by the procedure.
NOTE: Never give abdominal thrusts (the Heimlich manoeuvre) to a baby under one year old. For a choking baby, use back blows and chest thrusts only, as described above. For children over one year old, use back blows and abdominal thrusts.
How Many Are Back Blows for Choking Needed?
When someone is choking, give up to 5 back blows and up to 5 abdominal thrusts.
Provide up to five separate back blows in the middle of the person’s shoulder blades using the heel of your hand, checking between each one.
If that fails, give up to five abdominal thrusts (the Heimlich manoeuvre).
If the first cycle of five back blows and five abdominal thrusts doesn’t clear the obstruction, call 999, then keep alternating 5 back blows with 5 abdominal thrusts until the obstruction is cleared, help arrives, or the person becomes unresponsive.
What Are the Different Types of Choking?
If someone is choking mildly, encourage them to cough. For severe choking, give back blows and abdominal thrusts.
Mild Choking
When the airway is partly blocked, the person can still cough and breathe, so they may be able to remove the blockage themselves.
You can help with mild choking by encouraging them to cough until they clear the blockage.
You can also tell them to spit out the object if it’s in their mouth.
Remember, DON’T place your fingers in their mouth to feel for a blockage, as they might bite you — and never sweep the mouth blindly.
If coughing and spitting don’t work, or the cough becomes ineffective, begin the back blows.
Severe Choking
When a person’s airway is completely blocked, they cannot speak, cough or breathe, so they will need your help to prevent them losing consciousness.
Give back blows and abdominal thrusts. Stand behind the person and support their chest with one hand. Bend them forward so that if the object is dislodged it comes out of their mouth rather than moving farther down.
Give up to 5 sharp blows in the middle of their shoulder blades with the heel of your hand.
If there’s still an object blocking the airway, give up to 5 abdominal thrusts.
If the obstruction still hasn’t cleared, call 999 and keep alternating five back blows with five abdominal thrusts. If the person becomes unresponsive, make sure 999 has been called and start CPR straight away.
Frequently Asked Questions
Here are some additional facts that you must remember:
Can You Get Complications From Choking?
You may experience throat irritation, throat damage, or worse, death from asphyxiation.
When the airway is closed, insufficient oxygen reaches the lungs, and brain damage can develop within a few minutes.
The Resuscitation Council UK also advises that anyone successfully treated for choking with abdominal thrusts or chest compressions should be checked by a healthcare professional afterwards, since these techniques can cause complications and injuries.
What Should I Do if the Person Becomes Unresponsive?
Call 999 immediately if this hasn’t been done already — use the speaker function so your hands are free.
Then start CPR: 30 chest compressions (5–6 cm deep, at 100–120 per minute) followed by 2 rescue breaths, or hands-only compressions if you’re not trained.
Continue until emergency help arrives and takes over, or the person shows signs of life.
How Can I Prevent Choking?
Prevent your child from choking by keeping choking hazards out of reach. This includes coins, erasers, buttons, marbles, beads and button batteries — any small object that could get stuck in a child’s airway. As a rule of thumb, if an object is small enough to fit inside a young child’s mouth, treat it as a choking hazard and keep it out of reach.
Cut their food into smaller pieces, making it easier for them to swallow.
Save yourself from choking by thoroughly chewing your food and avoiding talking while eating.
Conclusion
Consider enrolling in first aid courses and learn how to give back blows and abdominal thrusts correctly, and when to call 999.
You could be the one to save children, your family, or anyone else by acting quickly and preventing complications from choking.
As they say, prevention is better than cure.
Our FAIB-accredited First Aid Training Courses are designed to make it easy to train your company’s first aiders, with both the 1-day emergency course and the 3-day first aid course can be delivered on your business premises or at one of our UK locations.
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