Adult Choking Relief Techniques for Emergency Response
Author:
CPR Select
Last updated:
8/19/2025
Choking is a potentially life-threatening situation that occurs 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.
Choking is the fourth leading cause of unintentional injury death overall, with the risk rising sharply in adults over the age of 70. Choking in adults occurs when a foreign object obstructs the airway, preventing airflow into the lungs. This can happen while eating, drinking, or inhaling small objects or substances. Knowing how to respond to a choking adult can mean the difference between life and death.
What to do if someone is choking?
Here are the steps on how to relieve choking on adult victims:
Assess the Situation: Quickly assess the choking adult's ability to breathe, speak, or cough. Determine if the obstruction is partial or complete.
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.
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.
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.
Perform Abdominal and Back Thrusts: Give up to 5 back blows; if ineffective, give up to 5 abdominal thrusts. Continue alternating 5 back blows and 5 abdominal thrusts until the obstruction is cleared or the person becomes unresponsive.
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.
Consider CPR for Unresponsive Adults: the adult becomes unresponsive, begin CPR. If trained, use 30 chest compressions followed by 2 rescue breaths, checking the mouth for a visible object each cycle. If untrained, compression-only CPR is acceptable.
Stay with the Choking Adult: Stay with the choking adult and provide support until the situation is resolved.
1. Assess the Situation
During a choking emergency, quickly evaluate the adult’s ability to breathe, speak, or cough. This initial assessment helps determine whether the airway obstruction is partial or complete, which guides your next steps.
Partial obstruction: The person may be able to cough, speak, or breathe, though it may be noisy or labored. Encourage coughing and monitor closely.
Complete obstruction: The person cannot speak, cough effectively, or breathe, and may exhibit cyanosis (bluish skin or lips) or panic. Immediate intervention is required.
According to ILCOR and ERC guidelines, early recognition of obstruction severity is critical to prevent hypoxia and potential death. If in doubt, treat as severe to prevent delays.
2. Encourage Coughing
If the adult can cough, encourage them to do so, as coughing is the body’s natural mechanism to expel a foreign object. Effective coughing can often dislodge the obstruction without external intervention. Do not give back blows or thrusts while they are coughing forcefully.
Avoid interfering unless the person’s condition worsens, as unnecessary force may cause harm. ERC and AHA guidance note that allowing the person to attempt self-clearance first is an important step when obstruction is partial.
3. Stand Ready to Assist
Remain close to the choking adult, maintaining a calm and reassuring presence. This ensures you can act quickly if the obstruction worsens. Send someone to call emergency services and get an AED.
Stay within arm’s reach, and be prepared to perform back blows or abdominal thrusts if the airway becomes completely blocked.
Reassurance helps reduce anxiety, which can otherwise worsen airway compromise.
First-aid manuals from the American Red Cross emphasize that bystanders’ calm presence improves outcomes and facilitates cooperation during intervention.
4. Ask Permission to Help
If the adult cannot cough, speak, or breathe, and you suspect a complete airway obstruction, ask for consent before intervening.
Approach calmly and clearly: use short, direct instructions, e.g., “Can I help you?”
Be prepared to perform abdominal or chest thrusts immediately once consent is given.
If the person becomes unresponsive, implied consent applies, and you should begin CPR according to established guidelines.
ERC and ILCOR note that asking for permission when possible respects autonomy, but unresponsive victims should be treated without delay.
5. Perform Abdominal Thrusts (Heimlich Maneuver)
Once you have permission to assist a choking adult, act promptly to clear the airway obstruction. Follow these steps carefully:
Position yourself: Stand directly behind the person, feet shoulder-width apart for stability.
Secure your grip: Wrap your arms around their waist.
Form your fist: Make a fist with one hand. Place the thumb-side of your clenched fist slightly above the navel and below the ribcage; grasp with your other hand and pull inward-upward
Place your fist: Position it slightly above the navel and below the ribcage, in the middle of the abdomen.
Stabilize: Grasp your fist with the other hand for controlled force.
Deliver thrusts: Give quick, upward and inward thrusts. Each thrust should create a sudden increase in abdominal pressure to expel the object.
How to give back blows?
Stand to the side and slightly behind, support the chest, lean them forward, and deliver up to 5 back blows with the heel of your hand between the shoulder blades.
6. Continue Abdominal Thrusts
If the obstruction is not cleared:
Give up to 5 back blows, then up to 5 abdominal thrusts.
Alternate 5 back blows and 5 abdominal thrusts until the object is expelled or the person becomes unresponsive.
ERC/ILCOR guidelines emphasize alternating back blows and abdominal thrusts rather than limiting thrusts to only 5. AHA guidance does not cap abdominal thrusts if back blows are not performed.
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. AHA and Red Cross stress calling for help as soon as it is safe to do so, especially if the airway remains blocked.
8. Perform 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. Check the mouth for visible objects each cycle. CPR can help maintain blood circulation and oxygen supply to vital organs, increasing the person's chances of survival.
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 performing CPR on an unresponsive adult choking victim, some adjustments are necessary due to the potential airway obstruction.
Airway Check: Quickly check for any visible obstruction in the throat. Only attempt to remove an object with a finger sweep if it is clearly visible and easily reachable. Never perform a blind finger sweep.
Chest Compressions: Perform 30 chest compressions followed by 2 rescue breaths, checking the airway for a visible object each cycle.
Monitoring Airway: While performing compressions, periodically reassess the airway. Remove visible objects if safely possible, but prioritize chest compressions over rescue breaths if the object cannot be easily removed.
Professional Help: Continue CPR and airway checks until emergency responders arrive. Advanced medical personnel may use specialized tools or intubation to clear the airway if standard measures fail.
The primary goal of CPR in a choking victim is to maintain blood circulation and oxygenation to vital organs. Rescue breaths are important for trained rescuers, but chest compressions take precedence when the airway is obstructed. Effective early interventions, like abdominal and back thrusts, remain crucial for the best outcome.
What are the Risks of Choking?
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 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 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 while eating or consuming substances.
Elderly Population: Older adults often face increased risks due to weakened muscles, dental issues, and medical conditions that affect swallowing.
Medical Conditions: Certain conditions, such as dysphagia (difficulty swallowing), neurological disorders, and GERD (gastroesophageal reflux disease), can contribute to choking incidents.
What are the signs that someone is 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:
Inability to speak
Clutching the throat
Fear or panic in their facial expressions
Ineffective coughing accompanied by a wheezing or high-pitched noise while inhaling.
Cyanosis
Inability to breathe
Agitation or aggressive gestures
What Does CPR Select Suggest 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 back blows and abdominal thrusts, are ineffective. It creates suction to dislodge objects from the airway. Evidence for routine use is limited, and it should only be used after standard first-aid techniques and according to organizational or local policy. It is not a replacement for proper first-aid training.
Are there any risks associated with performing abdominal thrusts on a choking adult?
Yes. While abdominal thrusts are effective, they can cause injury, especially in elderly adults or those with medical conditions. Risks include rib fractures, internal injury, or soft tissue damage. Use controlled, firm pressure, and follow proper technique.
Can I perform abdominal thrusts on myself if I am choking and alone?
Yes. Self-administered abdominal thrusts can help if alone:
Place a fist just above your navel, grasp it with the other hand, and push inward and upward.
Alternatively, lean over a sturdy object (back of a chair or countertop) and press your upper abdomen firmly.
Are there differences in performing choking first aid on an adult vs. an infant?
Yes. Infants receive back blows and chest thrusts instead of abdominal thrusts. Familiarize yourself with both adult and infant techniques to be prepared for all scenarios.
How do I assist a choking pregnant or obese person?
For pregnant or obese adults, chest thrusts are preferred over abdominal thrusts. Stand behind the person, place your hands on the center of the chest (just above the sternum), and push inward and upward repeatedly until the obstruction is cleared or the person can breathe.
When should I call emergency services for a choking victim?
Call immediately if the person cannot clear the obstruction, cannot breathe, or loses consciousness. If trained, start CPR for unresponsive victims while waiting for help. Timely action is critical to prevent severe complications.
Are there legal protections for helping a choking person?
Many regions have Good Samaritan laws, protecting bystanders who provide reasonable emergency assistance in good faith, as long as aid is within their knowledge or training.
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.
