​Choking Tube

Choking occurs when a foreign object is lodged in the windpipe, cutting off oxygen to the brain - thus first aid needs to be administered as quickly as possible.

If the person doesn't give the signal, look for these indications:

Call for emergency medical assistance (Dial 997) and while waiting for help, follow the American Red Cross "five-and-five" approach: 

• First, deliver five back blows between the victim's shoulder blades with the heel of your hand.
• Next, perform five abdominal thrusts (also known as the Heimlich maneuver) hands positioned as in the photo above.
• Alternate between five back blows and five abdominal thrusts until the blockage is dislodged.

How to perform the Heimlich maneuver on someone else?

• From behind, tip the person slightly forward and wrap your arms around his or her waist.
• Make a fist and place the thumb side of your fist against the victim's upper abdomen, below the ribcage and above the navel.
• Grasp your fist with your other hand and press into their upper abdomen with a quick upward thrust. Do not squeeze the ribcage; confine the force of the thrust to your hands.
• Repeat until object is expelled.

How to perform the Heimlich maneuver on yourself?

• Set a fist a little above the navel.
• Grasp your fist with the other hand and bend over a hard surface — the back of a chair or against a railing or counter.
• Give yourself abdominal thrusts by shoving your fist inward and upward.
• If you cannot perform the thrust, position yourself against the surface and press forcefully enough into it so that the thrust dislodges the object.

How to clear the airway of a pregnant woman or obese person? 

• Hands need to be positioned a little bit higher than with a normal Heimlich maneuver, at the base of the breastbone, just above the joining of the lowest ribs.
• Perform the Heimlich maneuver.
• Repeat until blockage is dislodged or the person becomes unconscious start CPR

How to clear the airway of an unconscious person?

• Lower the person on his or her back onto the floor and straddle them with your knees.
• Clear the airway. If there's a visible blockage, carefully reach a finger into the mouth and sweep it out. Make sure not to push the object deeper into the airway especially if in young children.
• If the object remains lodged, begin CPR giving four inward and upward thrusts without givining air. Recheck the mouth periodically.

How to clear the airway of an infant younger than age 1?

• Gently place the infant facedown on your forearm, which is resting on your thigh or over your raised knees.
• With the heel of your hand, thump the infant gently but firmly five times on the middle of the back.
• If the above fails, turn the infant face up on your forearm with the head lower than the trunk. Place two fingers at the center of the breastbone, give five quick chest thrusts.
• Repeat if required.
• If one of these techniques opens the airway yet the infant doesn't resume breathing, begin infant CPR. It is necessary to assure that excessive force is not used as that can cause damage to the breast bone.

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This information is provided by the NGHA Content Advisory Board and is not intended to replace the medical advice of your health care provider.