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How to help a child who is choking

Dr Roger Henderson
Reviewed by Roger HendersonReviewed on 29.04.2024 | 3 minutes read

Children have much narrower airways than adults and a delightful curiosity to put objects in places – their mouth, nose or ear, for example. This puts them at high risk for choking on things – even a grape can pose a threat.

While it’s awful to think about, it can feel empowering to learn what to do when an object blocks the airways, so you can help your child in an emergency. We’ll talk you through it.

Those aged less than 1 are treated slightly differently, and it’s best to learn this technique from a live or online demonstration.

This article may be a good starting block, but for added confidence, you could always find a local first aid course that covers choking and other emergencies – the British Red Cross is one provider, St. John's Ambulance is another.

How to I recognise choking?

Choking occurs when the airway to their lungs is blocked by food or a foreign object like a toy, peanut or a battery. It may be fully blocked, preventing them from breathing, or it may be partially blocked, and they may still be able to breathe, cough, cry and talk a little.

They will clutch at their neck, chest or stomach and look very distressed. They may suddenly start coughing, even though they are not ill. And you might see evidence of the culprit around, such as marbles or toy figurines.

Avoid the instinct to blindly put fingers down their throat – you may push an object further and you may cause a serious injury. If something is obviously seen in their mouth, you can take this out.

What do I do first?

First things first, assess the situation and try to remain calm, so they can stay calm. If they are coughing loudly, bend them slightly forward, sit with them and encourage them to cough. This means their airway is not obstructed.

If they are not able to speak or cry and they are finding it difficult to breathe in, start 5 back blows. Bend them slightly forwards and hit them fairly firmly with the heel of your hand between their shoulder blades. This should propel any blockage out by the pressure of the jolt. For a small child, it's best to lay them face down across your lap and give the back blows, making sure their face is unobstructed.

If they are unconscious, call for someone nearby to help or – if alone – call 999 for an ambulance, and start two breaths then 15 chest compressions in a repeated sequence, if you know CPR (cardiopulmonary resuscitation). If you don’t feel confident with this, the ambulance call handler will talk you through it.

What do I do next?

If 5 back blows have been unsuccessful, you should proceed to 5 abdominal thrusts, previously called the Heimlich manoeuvre. This is only for those over 1 – it’s a slightly different technique for babies.

Stand or kneel behind your child and hug your arms around them, with hands meeting just under their ribs. Avoid applying pressure to the ribs themselves. Claps one hand in a fist, with the other hand over it and pull inwards and upwards in one sharp movement.

This should create presure in the lungs to propel the blockage out of their mouth.

When should I call an ambulance?

If they are coughing at first, try these procedures, and if unsuccessful with 5 back blows and 5 abdominal thrusts, call 999 for an ambulance.

Keep repeating the sequence while you wait for help. Call back if anything changes in their condition in the meantime.

If your child is unconscious and has stopped breathing, call an ambulance immediately and start two breaths and 15 chest compressions if you feel confident to do so. Alternatively, stay on the phone with the call handler while they talk you through how to do CPR.

Keep going (or swap in with another bystander) until help arrives. It should come quickly.

Even if you dislodge an object, it’s best to get your child checked out, as damage may have been caused by the object and by the techniques used to dislodge it.

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Dr Roger Henderson
Reviewed by Roger Henderson
Reviewed on 29.04.2024
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