Chest pain, breathlessness, or severe symptoms? Seek urgent care — First Aid guides · Warning signs

Choking First Aid — Heimlich Manoeuvre Guide

Step-by-step choking first aid for adults, children, and infants.

Call 112 immediately if the person cannot breathe, speak, or cough, or if back blows and abdominal thrusts are not working.

Choking is a genuine medical emergency that can cause death within minutes. Knowing how to act calmly and correctly can save a life.

Recognising Choking

  • Clutching throat with hands (universal choking sign)
  • Unable to speak, cry, or make much sound
  • High-pitched wheezing when breathing
  • Turning blue or pale around the lips
  • Loss of consciousness if airway fully blocked
If the person can cough forcefully — encourage them to keep coughing. Only intervene if the cough becomes weak.

For Adults and Children Over 1 Year

5 back blows + 5 abdominal thrusts — repeat until clear
1
Stand behind and lean them forward
Support their chest and lean them slightly forward.
2
Give 5 firm back blows
Use the heel of your hand to strike firmly between the shoulder blades. Check after each blow.
3
Give 5 abdominal thrusts
Make a fist, place it just above the navel. Grasp with the other hand. Pull sharply inward and upward 5 times.
4
Alternate and repeat
Keep alternating until the object is dislodged, the person breathes normally, or emergency services arrive.
5
If unconscious — start CPR
Lower to floor, start CPR. Look in the mouth before each rescue breath and remove any visible object.

Clinical guidance from American Red Cross[1] stresses matching home care to symptom severity and seeking urgent review when red-flag signs appear.

For Infants Under 1 Year

Never perform abdominal thrusts on an infant.

Back blows and chest thrusts for infants
1
Hold face down on your forearm
Support the head, hold face down with head lower than chest.
2
Give 5 back blows
Use 2 fingers to deliver 5 firm back blows between the shoulder blades.
3
Turn face up
Turn the infant over, face up on your other forearm.
4
Give 5 chest thrusts
Place 2 fingers just below the nipple line. Give 5 quick downward chest thrusts.
5
Check and repeat
Check the mouth after each cycle. Repeat until clear or emergency services arrive.

After a Choking Episode

Always see a doctor after a serious choking episode. Abdominal thrusts can cause internal injuries that need assessment.

For verification and deeper reading, NHS[2] offers independent, evidence-based information you can cross-check with your own clinician.

References & further reading

Sources cited in this guide. DIMH links to independent medical institutions for verification — not as a substitute for personal medical advice.

  1. American Red Cross — First aidhttps://www.redcross.org/take-a-class/first-aid
  2. NHS — First aid advicehttps://www.nhs.uk/conditions/first-aid/
  3. Mayo Clinic — First aid guideshttps://www.mayoclinic.org/first-aid/first-aid-basics/art-20056685
  4. NIH — Complementary and integrative healthhttps://www.nccih.nih.gov/
  5. MedlinePlus — Herbal medicinehttps://medlineplus.gov/herbalmedicine.html
  6. NIMH — Mental health informationhttps://www.nimh.nih.gov/health

When home care is not enough: chest pain, trouble breathing, confusion, or symptoms that worsen quickly need urgent medical attention.

This article is for general educational purposes only and is not a substitute for professional medical advice. Always consult a qualified healthcare provider for your specific situation. Last reviewed: March 2026. Read our full Medical Disclaimer.

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