Choking – St John Ambulance Cymru

First Aid advice for when an adult is choking

What causes choking?

When someone is choking, their airway is partly or completely blocked, which may prevent them from breathing properly. They might be able to clear the blockage by coughing, but if they cannot, you will need to help them straight away.

What are the signs of choking?

Watch for signs such as difficulty breathing, speaking, or coughing, a red, puffy face and visible distress, such as pointing to the throat or grasping the neck. To help an adult or older child when they are choking, you should follow the steps below:

First aid steps to follow when an adult is choking

Step 1 – Assess

If you think someone is choking, ask them, “Are you choking?” If they can breathe, speak, or cough, they may be able to clear their own throat. If they cannot breathe, cough, or make any noise, they need your help straight away.

Step 2 – Cough

Encourage them to cough and remove any obvious obstruction from their mouth.

Step 3 – Back blows

If coughing fails to work, you need to deliver five sharp back blows. To do this, help them to lean forwards, supporting their upper body with one hand. With the heel of your other hand, deliver five sharp back blows between their shoulder blades. After each back blow, check to see if there’s anything in their mouth.

Step 4 – Thrusts

If back blows fail to clear the obstruction, give five abdominal thrusts. To do this, stand behind them and put your arms around their waist. Place one hand in a clenched fist between their belly button and the bottom of their chest. With your other hand, grasp your fist and pull sharply inwards and upwards up to five times. Check their mouth again, each time.

Step 5 – Call 999

If the blockage has not cleared, call 999/112 for emergency help straight away. Repeat five back blows and five abdominal thrusts until help arrives, re-checking their mouth each time.