What to Do When Someone Is Choking: First Aid Steps Every Workplace Should Know
Choking is one of the few emergencies where the person helping has minutes — sometimes seconds — to act, and where the right response is almost entirely mechanical. No diagnosis, no equipment required to start, no waiting for professionals. Someone in the room either knows what to do, or they don't.
According to injury statistics compiled by the National Safety Council, choking remains one of the leading causes of preventable accidental death in the United States, and it disproportionately affects the very young and the elderly. It happens in break rooms, school cafeterias, restaurants, and care facilities — exactly the environments where organizations already invest in emergency readiness.
Here is what every trained (and untrained) responder should know.
First: Recognize the Difference Between Mild and Severe Choking
Not every choking event calls for physical intervention. The distinction matters:
- Mild airway obstruction — the person can cough forcefully, speak, or make noise. Encourage them to keep coughing. Do not slap their back or perform abdominal thrusts; a forceful cough is the most effective tool they have, and intervening can lodge the object deeper.
- Severe airway obstruction — the person cannot cough, speak, or breathe. They may clutch their throat (the universal choking sign), make high-pitched noises, or begin turning blue around the lips. This is the emergency. Act immediately.
Choking First Aid for a Responsive Adult or Child
Current American Red Cross guidance recommends alternating five back blows and five abdominal thrusts until the object is expelled or the person becomes unresponsive:
- Send someone to call 911. If you are alone, perform first aid first, then call.
- Give 5 back blows. Stand to the side and slightly behind the person. Support their chest with one hand, lean them forward, and deliver five firm blows between the shoulder blades with the heel of your hand.
- Give 5 abdominal thrusts (the Heimlich maneuver). Stand behind the person, wrap your arms around their waist, make a fist and place it thumb-side in, just above the navel and below the breastbone. Grasp your fist with the other hand and pull sharply inward and upward.
- Repeat — five back blows, five abdominal thrusts — until the object comes out or the person loses consciousness.
For a person who is pregnant or too large to reach around, use chest thrusts instead: place your fist against the center of the breastbone and pull straight back.
If the Person Becomes Unresponsive
Lower them carefully to the ground and begin CPR immediately, starting with chest compressions. Before each set of rescue breaths, look in the mouth — if you can see the object, remove it. Do not perform blind finger sweeps. If an AED is nearby, have someone retrieve it; an unresponsive choking victim can deteriorate into cardiac arrest, and the sequence becomes a cardiac emergency response. This is one of many reasons choking response is taught alongside CPR and AED operation in certified training — and why CPR training equipment belongs in every organization's readiness program.
Infant Choking Is Different
For a choking infant under one year old, never perform abdominal thrusts. Instead:
- Sit down and rest the infant face-down along your forearm, supported on your thigh, with the head lower than the chest.
- Deliver 5 back blows between the shoulder blades with the heel of your hand.
- Turn the infant face-up and give 5 chest thrusts — two fingers on the center of the breastbone, pressing about 1.5 inches deep.
- Alternate until the object is expelled or the infant becomes unresponsive — then begin infant CPR and call 911.
Where Anti-Choking Rescue Devices Fit
Suction-based anti-choking devices have become a common addition to workplace, school, and restaurant first aid stations. Placed over the mouth, they create negative pressure designed to dislodge an airway obstruction — and they can be used on oneself, which addresses the frightening scenario of choking alone.
The honest framing: these devices are a backup, not a replacement for back blows and abdominal thrusts, which remain the first-line response recommended by resuscitation guidelines. But for responders who are physically unable to perform thrusts, for victims who cannot be reached around, or when standard first aid fails, a rescue device on the wall is a meaningful second line of defense. Many organizations now mount a LifeVac choking rescue device alongside their AED cabinet for exactly that reason.
Build Choking Response Into Your Readiness Program
Choking response is a standard component of workplace CPR and first aid certification — the same training that prepares your team to use an AED. If your organization has invested in cardiac readiness, adding choking and airway response costs almost nothing and covers one of the most common emergencies your team will actually face. Round out the station with first aid kits sized for your facility.
Prepare your team for every emergency — not just cardiac arrest. AED Professionals provides CPR, AED, and first aid training support, anti-choking rescue devices, and complete first aid supplies. Call 888-541-2337 or explore the full catalog at aedprofessionals.com.
Frequently Asked Questions
Should I do the Heimlich maneuver on someone who is coughing?
No. If a person can cough forcefully, speak, or make noise, their airway is only partially blocked and coughing is the most effective way to clear it. Encourage them to keep coughing and stay with them. Intervene with back blows and abdominal thrusts only when they cannot cough, speak, or breathe.
What do I do if I'm choking and no one is around?
Call 911 if possible — even if you can't speak, an open line can bring help. You can perform abdominal thrusts on yourself with your fist, or thrust your upper abdomen sharply against a firm edge such as a chair back or countertop. A suction-based anti-choking rescue device can also be self-administered, which is one reason many people keep one at home or work.
Do anti-choking devices replace the Heimlich maneuver?
No. Back blows and abdominal thrusts remain the recommended first-line response for severe choking. Anti-choking suction devices serve as a backup when standard first aid fails or cannot be performed — for example, when the victim is alone, or when a responder cannot physically reach around the person.
Is choking response included in CPR training?
Yes. Certified CPR/AED and first aid courses cover choking response for adults, children, and infants as a standard part of the curriculum.
