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Choking - adult or child over 1 year

Contents of this page:

Illustrations

Choking first aid - adult or child over 1 year - series
Choking first aid - adult or child over 1 year - series

Alternative Names    Return to top

Heimlich maneuver - adult or child over 1 year

Definition    Return to top

Choking is when someone can't breathe because food, a toy, or other object is blocking the airway (throat or windpipe).

Considerations    Return to top

A choking person's airway may be completely or partially blocked, so that not enough oxygen reaches the lungs. A complete blockage is a medical emergency. A partial blockage can quickly become life threatening if the person cannot properly breathe in and out.

Without oxygen, permanent brain damage can occur in as little as 4 - 6 minutes. Rapid first aid for choking can save a life.

Occasionally an object will enter the lung. While the person may appear to improve and breathe normally, in a few days symptoms may develop, such as:

Causes    Return to top

Symptoms    Return to top

The universal distress signal for choking is grabbing the throat with the hand.

Other danger signs include:

First Aid    Return to top

How to perform the Heimlich maneuver:

  1. First ask, "Are you choking? Can you speak?" DO NOT perform first aid if the person is coughing forcefully and able to speak -- a strong cough can dislodge the object.
  2. Stand behind the person and wrap your arms around the person's waist.
  3. Make a fist with one hand. Place the thumb side of your fist just above the person's navel, well below the breastbone.
  4. Grasp the fist with your other hand.
  5. Make quick, upward and inward thrusts with your fist.
  6. Continue these thrusts until the object is dislodged or the victim loses consciousness.

IF THE PERSON LOSES CONSCIOUSNESS

FOR PREGNANT OR OBESE PEOPLE

  1. Wrap your arms around the person's CHEST.
  2. Place your fist on the MIDDLE of the breastbone between the nipples.
  3. Make firm, backward thrusts.

After removing the object that caused the choking, keep the person still and get medical help. Anyone who is choking should have a medical examination. Complications can occur not only from the choking, but also from the first aid measures that were taken.

DO NOT    Return to top

When to Contact a Medical Professional    Return to top

Seek medical help right away if you find someone unconscious.

When the person is choking:

After the object is successfully dislodged, the person should see a doctor because complications can arise.

In the days following a choking episode, contact a doctor immediately if the person develops:

These could be signs that the object entered the lung instead of being expelled.

Prevention    Return to top

References    Return to top

Manno M. Pediatric respiatory emergencies: upper airway obstruction and infections. In: Marx J, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 6th ed. Philadelphia, Pa: Mosby Elsevier; 2006: chap 166.

Thomas SH, Brown DFM. Foreign bodies. In: Marx J, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 6th ed. Philadelphia, Pa: Mosby Elsevier; 2006: chap 57.

Update Date: 10/2/2008

Updated by: Jacob L. Heller, MD, Emergency Medicine, Virginia Mason Medical Center, Seattle, Washington, Clinic. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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