Choking: When Every Second Counts

The joy of a family meal, the casual conversation at a workplace lunch, or the lively chatter at a community gathering can quickly turn into a terrifying emergency if someone begins to choke. Choking is a silent, life-threatening event where an object obstructs the airway, preventing air from reaching the lungs. Unlike coughing, which can be noisy, complete choking often presents without sound, making rapid recognition and immediate action absolutely critical.

At Ready 4 Everything Training and Supplies, we teach that knowing how to respond to a choking emergency is one of the most vital first aid skills. Every second truly counts, as lack of oxygen can lead to brain damage or death within minutes.

Understanding Choking: Partial vs. Complete Obstruction

The first step in responding to choking is to differentiate between a partial and complete airway obstruction:

• Partial Airway Obstruction: The person can still move some air. They may be able to cough, speak, or make wheezing sounds.

• What to Do: Encourage the person to cough forcefully. A strong cough is the most effective way to dislodge the object. Do NOT intervene with back blows or abdominal thrusts if they are coughing effectively, as you could worsen the obstruction.

• Complete Airway Obstruction: The person cannot move any air. They will:

• Be unable to cough, speak, or breathe.

• Clutch their throat (the universal sign of choking).

• Have a panicked expression.

• Their skin may turn blue or grey (cyanosis) due to lack of oxygen.

• Become unresponsive quickly.

• What to Do: Immediate first aid is required.

Immediate Care for Responsive Choking (Adults and Children):

For a conscious adult or child who is experiencing a complete airway obstruction:

1. Confirm Choking: Ask, "Are you choking?" If they nod or cannot speak, assume they are choking.

2. Call for Help: If others are present, immediately direct someone to call 911/EMS.

3. Five Back Blows: Stand slightly to the side and behind the person. Support their chest with one hand and lean them slightly forward. Deliver 5 firm blows with the heel of your hand between their shoulder blades.

4. Five Abdominal Thrusts (Heimlich Maneuver): If back blows don't work, stand behind the person. Place one foot slightly in front of the other for balance. Place your fist (thumb side against the abdomen) just above their navel and well below the breastbone. Grasp your fist with your other hand. Deliver 5 quick, upward thrusts into the abdomen.

5. Repeat: Continue alternating 5 back blows and 5 abdominal thrusts until the object is dislodged, or the person becomes unresponsive.

Immediate Care for Responsive Choking (Babies - under 1 year):

For a conscious baby who is experiencing a complete airway obstruction:

1. Position the Baby: Support the baby's head and neck with one hand, resting them face down on your forearm, with their head lower than their chest. Rest your forearm on your thigh.

2. Five Back Blows: Deliver 5 forceful back blows between the baby's shoulder blades using the heel of your hand.

3. Five Chest Thrusts: Turn the baby over onto their back, supporting their head and neck. Place two fingers on the breastbone, just below the nipple line. Deliver 5 quick, downward chest thrusts, similar to CPR compressions but sharper.

4. Repeat: Continue alternating 5 back blows and 5 chest thrusts until the object is dislodged or the baby becomes unresponsive.

5. Never Blind Finger Sweep: Never try to sweep an object out of a baby's mouth with your finger unless you can clearly see it and easily retrieve it, as you might push it further down.

When the Person Becomes Unresponsive (All Ages):

If the person becomes unresponsive while you are providing choking first aid:

1. Call 911 (if not already done).

2. Lower them gently to the ground.

3. Begin CPR. When you perform rescue breaths during CPR, look into the mouth before each breath. If you see the object, attempt to remove it carefully. Continue CPR until EMS arrives or the person recovers.

Special Circumstances:

• Pregnant or Larger Adults: Perform chest thrusts instead of abdominal thrusts. Position your hands in the middle of the breastbone, similar to CPR hand placement.

• If You Are Alone: If you are choking and alone, try to perform abdominal thrusts on yourself by pushing your fist into your abdomen, or by leaning over a firm object like a chair back.

Why This Training is Vital: Preventable Tragedies

Choking incidents can happen to anyone, anywhere – at home, in restaurants, at school, or in the workplace. They are often preventable tragedies. Knowing the specific steps for different age groups empowers you to act quickly and confidently, turning a critical situation into a positive outcome. The Canadian Red Cross and other organizations continually update their guidelines based on the latest research, and our courses reflect these best practices.

Ready 4 Everything: Confidence in Crisis

At Ready 4 Everything Training and Supplies, our comprehensive first aid courses include extensive hands-on training for choking emergencies across all age groups. Our certified instructors create a supportive learning environment where you can practice these life-saving techniques on manikins, building the muscle memory and confidence required to act decisively when every second counts.

Don't let the fear of not knowing prevent you from saving a life. Be ready for this common, yet terrifying, emergency.

Your Action Item: Are you prepared to act when someone is choking? Sign up for first aid courses for your organization today and master the critical, time-sensitive skills that can dislodge an obstruction and save a life.