Adult Choking Relief Techniques for Emergency Response

Choking is a potentially life-threatening situation that can occur when an object becomes lodged in the throat, blocking the airway and making it difficult for the person to breathe. Swift and effective action is crucial to preventing severe injury or death. This comprehensive guide outlines the steps to take when responding to choking incidents involving adults.

According to the National Safety Council, choking is the fourth leading cause of unintentional injury death for adults over the age of 65. Choking in adults occurs when a foreign object obstructs the airway, preventing airflow into the lungs. This can happen while eating, drinking, or even when inhaling small objects or substances. Knowing how to respond to a choking adult can mean the difference between life and death. Here are the steps on how to relieve choking on adult victims:


  1. Assess the Situation: Quickly assess the choking adult's ability to breathe, speak, or cough. Determine if the obstruction is partial or complete.
  2. Encourage Coughing: If the choking adult is able to cough forcefully, encourage them to do so. Coughing can help expel the lodged object from the airway.
  3. Stand Ready to Assist: Stand by and be prepared to intervene if the choking adult's condition worsens. Maintain a reassuring and calm demeanor to avoid escalating their anxiety.
  4. Ask Permission to Help: If the choking adult cannot cough, speak, or breathe, and you suspect a complete airway obstruction, ask for permission to intervene.
  5. Perform Abdominal Thrusts (Heimlich Maneuver): Act promptly and effectively to clear the airway obstruction.
  6. Continue Abdominal Thrusts: Repeat the abdominal thrusts up to 5 times if necessary, checking after each thrust if the obstruction has been cleared. Avoid excessive force that could cause injury.
  7. Call for Professional Help: If the choking adult's condition does not improve after several thrusts or if they become unconscious, call emergency services immediately.
  8. Consider CPR for Unresponsive Adults: If the choking adult becomes unresponsive, begin CPR by performing chest compressions and rescue breaths as per standard guidelines.
  9. Stay with the Choking Adult: Stay with the choking adult and provide support until the situation is resolved.

Step 1: Assess the Situation

During a choking emergency, it's crucial to swiftly evaluate the choking adult's ability to breathe, speak, or cough. This initial assessment helps determine the severity of the situation and guides your next steps.

A significant portion of choking incidents occur in the home. For instance, a study published in the "Journal of the American Medical Association" reported that approximately 60% of fatal choking incidents in adults occurred in a home setting.


Step 2: Encourage Coughing

If the choking adult is still able to cough forcefully, encourage them to do so. Coughing is a natural response that may help dislodge the obstructing object from the airway, offering a chance for the person to clear the blockage on their own.


Step 3: Stand Ready to Assist

While the choking adult is coughing or experiencing distress, remain close by and ready to intervene if their condition worsens. Maintain a reassuring and calm demeanor to prevent escalating their anxiety, as your presence alone can provide comfort in this stressful situation.


Step 4: Ask Permission to Help

If the choking adult is unable to cough, speak, or breathe, and you suspect a complete airway obstruction, it's essential to ask for permission before intervening. Approach them calmly, communicate clearly, and be prepared to provide immediate assistance.


Step 5: Perform Abdominal Thrusts (Heimlich Maneuver):

When you receive permission to intervene and assist a choking adult, it's essential to act promptly and effectively to clear the airway obstruction. Follow these steps closely to perform the abdominal thrusts, commonly known as the Heimlich maneuver:


  1. Position yourself directly behind the choking person, ensuring that you're stable and balanced.
  2. Reach around the choking person's waist with your arms. Make sure you have a secure and stable grip on them.
  3. With one hand, form a fist while ensuring that your thumb is tucked inside your fingers. The thumb side of your fist will be used to apply pressure to the abdomen.
  4. Place the thumb side of your fist slightly above the navel (belly button) and below the ribcage. Make sure your fist is positioned in the middle of the abdomen.
  5. Hold your fist with your other hand to ensure a controlled and stable grip. Your hands should be positioned right above the navel.
  6. Deliver quick and upward thrusts to the abdomen. Each thrust should be forceful enough to create a sudden increase in pressure within the abdomen.


Step 6: Continue Abdominal Thrusts

If the initial abdominal thrusts do not succeed in clearing the airway obstruction, continue the technique for up to five repetitions. After each thrust, assess the choking adult's condition to determine if the obstruction has been dislodged. It's important to strike a balance between effectiveness and avoiding excessive force to prevent injury.


Step 7: Call for Professional Help

If the choking adult's condition does not improve despite your efforts or if they lose consciousness, immediately call emergency services. Professional medical intervention may be required to address the situation adequately.


Step 8: Consider CPR for Unresponsive Adults

If the choking adult becomes unresponsive, gently lay them on the ground and initiate Cardiopulmonary Resuscitation. Begin with chest compressions and rescue breaths according to established guidelines. CPR can help maintain blood circulation and oxygen supply to vital organs, increasing the person's chances of survival.


Step 9: Stay with the Choking Adult

Whether the obstruction is successfully relieved or professional help arrives, remain with the choking adult. Continue providing support and reassurance until the situation is fully resolved. Your presence and care can make a significant difference in their well-being during this critical time.

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How Does CPR Differ in an Unresponsive Adult Choking Victim?

When it comes to performing CPR on an unresponsive adult choking victim, there are some important differences to consider due to the potential presence of an airway obstruction. Here's how CPR differs in this scenario:

  • Airway Check: In a typical CPR scenario, you would start by tilting the person's head back slightly and lifting their chin to open the airway. However, if the person is known to be choking, it's essential to quickly check for any visible obstruction in the throat. If you can see an object blocking the airway, try to remove it with a finger sweep only if it's easily visible and can be easily reached.
  • Chest Compressions: In traditional CPR, after assessing the airway and starting compressions, you would perform a cycle of 30 chest compressions followed by 2 rescue breaths. However, in the case of an unresponsive adult choking victim, you should modify the technique. Focus primarily on performing uninterrupted chest compressions without the rescue breaths if you cannot easily see and remove the object causing the obstruction.
  • Monitoring Airway: While performing chest compressions, periodically reassess the airway for any visible objects. If you see the object and can easily remove it, do so, but prioritize chest compressions over rescue breaths.
  • Professional Help: Continue performing CPR and periodically checking the airway until emergency medical services arrive. If you're not able to remove the obstruction and the person's condition deteriorates further, emergency responders may attempt advanced techniques to clear the airway, such as using specialized tools or intubation.


The main goal of CPR in an unresponsive choking victim is to provide circulation and oxygenation to the body's vital organs. The presence of an airway obstruction may limit the effectiveness of rescue breaths, which is why chest compressions take precedence in these situations. While this modified approach focuses on maintaining blood flow and oxygen delivery, the best outcome is achieved when the airway is promptly cleared through effective interventions like abdominal thrusts (Heimlich maneuver) or by professional medical responders.


Understanding Choking Risks

In the United States, choking is a leading cause of visits to emergency rooms, with more than 160,000 visits annually due to choking on food alone. Choking incidents in adults can occur due to various factors, often resulting from a momentary lapse in chewing or swallowing properly. Some common causes and situations that lead to choking incidents in adults include:

  • Eating Too Quickly or Not Chewing Thoroughly: Adults who eat too quickly or fail to chew their food adequately increase the risk of larger food particles becoming lodged in their throats.
  • Consuming Tough or Dry Foods: Foods that are tough, dry, or sticky, such as meat, bread, or peanut butter, can pose a choking hazard, especially if they are not chewed thoroughly.
  • Eating While Distracted: Engaging in conversation, laughing, watching TV, or using electronic devices while eating can lead to distracted swallowing and increase the risk of choking.
  • Alcohol and Drug Use: Intoxication or drug use can impair coordination and increase the likelihood of choking incidents during eating or consuming substances.
  • Elderly Population: Older adults often face increased risks due to factors such as weakened muscles, dental issues, and medical conditions that affect swallowing.
  • Medical Conditions: Certain medical conditions, such as dysphagia (difficulty swallowing), neurological disorders, and GERD (gastroesophageal reflux disease), can contribute to choking incidents.


Recognizing Signs of Choking

Identifying the physical signs and behaviors that indicate a person is choking is crucial for ensuring prompt intervention and potentially saving a life. Some common signs that suggest a person is choking include:


  1. Inability to speak
  2. Clutching the throat
  3. Fear or panic in their facial expressions
  4. Ineffective coughing accompanied by a wheezing or high-pitched noise while inhaling.
  5. Cyanosis
  6. Inability to breathe
  7. Agitation or aggressive gestures


How to Prevent Choking in Adults

Choking incidents can often be prevented through awareness, proper food preparation, mindful eating habits, and safe behaviors. Here are some practical tips and precautions to reduce the risk of choking:


  • Cut food into small, bite-sized pieces, especially for foods like meat, fruits, and vegetables.
  • Be cautious with foods that are round and have the potential to block the airway, such as whole grapes, cherries, and nuts.
  • Ensure that foods are properly cooked, avoiding overly tough or undercooked items.
  • Take your time while eating. Chew your food thoroughly before swallowing.
  • Focus on chewing and swallowing before engaging in conversation or laughter.
  • Take small bites and avoid stuffing your mouth with too much food at once.
  • Maintain an upright posture while eating to aid in proper swallowing.
  • Avoid eating while walking or in a moving vehicle: These situations can increase the risk of choking due to jostling or lack of focus.
  • Be cautious with dental devices. Dentures or dental appliances can affect chewing and swallowing. Ensure they fit properly.


By following these practical tips and precautions, you can significantly reduce the risk of choking incidents and create a safer eating environment for yourself and those around you.


What is LifeVac?

LifeVac is a device designed to assist in removing airway obstructions when traditional methods like abdominal thrusts (Heimlich maneuver) are not effective or safe to use. It creates suction to dislodge objects from the airway, providing an alternative option for choking first aid. LifeVac is designed for use when a person is choking, and other interventions have failed. It's important to note that while LifeVac can be a valuable tool, it's not a replacement for proper training in first aid techniques and should only be used by individuals who have been properly trained.


Are there any risks associated with performing abdominal thrusts on a choking adult?

Yes. While abdominal thrusts are effective in relieving choking, there is a potential risk of causing injury, especially in the elderly or those with certain medical conditions. It's important to use controlled force and avoid excessive pressure that could lead to rib fractures or other injuries.


Can I perform abdominal thrusts on myself if I am choking and alone?

Yes, you can perform abdominal thrusts on yourself by using a chair back, railing, or countertop to apply pressure to your abdomen. However, it's recommended to take preventive measures to avoid choking incidents whenever possible.


Are there differences in performing choking first aid on an adult vs. an infant?

Yes, the techniques for choking first aid differ between adults and infants. For infants, back blows and chest thrusts are used instead of abdominal thrusts. It's important to familiarize yourself with both sets of techniques to be prepared for various scenarios.


Is it necessary to take a BLS training course to be prepared for choking emergencies?

While it's not mandatory, taking a BLS training course can greatly enhance your ability to respond effectively in choking emergencies and other life-threatening situations. BLS courses provide hands-on training, simulations, and certification that can give you the confidence and skills needed to save lives.