Choking refers to any obstruction of the upper airway. It can be classified either as partial obstruction or complete obstruction. Choking may occur in both conscious and unconscious 
individuals. Some of the common causes of choking include:
- Complete relaxation of airway muscles that lead to unconsciousness
- Inhalation of any foreign body that has lodged in the upper airway
- Trauma to the upper airway leading to inflammation of airway
- Anaphylactic reaction or severe allergic reaction to an allergen (such as bee venom, peanuts, ant venom, soy, tree nuts, dairy, eggs or sesame)
- Strangulation or forceful impact of the airways
Disclaimer: the material and instructions posted on this page on managing choking victims is for learning purposes only. To learn to effectively recognize, manage and help choking victims of all ages enrol in first aid and CPR classes with St Mark James.
First Aid for Partial Obstruction of Airway
Partial obstruction of airway occurs when the upper airway is partially blocked but there is still some air flow. Victims are able to breathe but insufficient. The patient may display symptoms that include:
- Coughing and wheezing, or a ‘raspy’ type of breathing
- Difficult or strained breathing
- Sonorous or snoring type of breathing
- Rapid, laboured breathing
- Bluish or grey skin due to lack of oxygen (asphyxia)
What to do:
- Stay calm and provide reassurance.
- While the victim is still able to breathe, instruct them to lean forward and encourage them to cough or clear the airways in a forceful manner. This may help expel the foreign object out of the windpipe and alleviate the problem.
- If possible, gather information about what the individual may have ingested, or whether it is anaphylactic reaction to certain substances. If victim is unable to respond, ask witnesses who may have seen what happened.
Back blows should NOT be performed as it can only worsen the problem. If the victim is unable to clear the airway, it may progress into a complete obstruction. Call emergency help immediately.
First Aid for Complete Obstruction of Airway
Complete obstruction of airway occurs when the airway is completely blocked and there is no airflow. The patient may display symptoms that include:
- Agitation and distress
- Inability to breath, talk, cough or cry
- Clutching around the throat – universal sign of choking or airway obstruction
- Sudden loss of consciousness due to absence of airflow
- Blushing or reddish face because of labored breathing
- Bluish coloring of the lips, fingernails and skin due to lack of oxygen
What to do:
- Dial 911 or instruct a bystander to dial 911 or local emergency service.
- Stay calm and provide reassurance.
- Open airway to check if obstruction is within finger reach. If possible, clear airway using your finger but DO NOT attempt to blindly sweep airway as it may push the object deeper into the windpipe.
- Tell the victim that you are performing back blows. Administer up to 5 back blows. Check after each blow if the foreign object has been cleared. If possible, have the victim lean forward. Using the heel of your hand, deliver forceful ‘back slaps’ or blows between the shoulder blades.
- Instruct the victim to cough as you deliver each back blow to increase the pressure and effectively expel the obstruction.
- Use infant back blow technique for choking infant. Place the infant head-down while deliver gentle back slaps.
- If after 5 back blows the airway is not yet clear, let the victim know that you are to perform 5 chest thrusts or Heimlich maneuver. Check after each thrust if the obstruction has been cleared.
- Continue providing the cycle of 5 Back Blows and 5 Chest Thrusts until the obstruction is cleared or emergency services arrive or the victim becomes unconscious.
- If the victim becomes unconscious, place them in side-lying position (recovery position); and check airway and breathing. Be ready to administer CPR if the patient is not breathing.
If the victim expels the foreign object or resumes normal breathing, STOP back blows and/or chest thrusts. Place the victim in recovery position if unconscious or assist them to be calm while waiting for emergency services.
Learn More
To learn more about providing effective help to victims of partial and full obstructions sign up for first aid and CPR training with St Mark James.