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Municipality of the District of Chester
Fire & Emergency Response

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Quick action can prevent choking deaths.......


There are some clear signs of choking as follows:

Mild obstruction

  • Able to speak
  • Signs of fear and distress
  • Forceful coughing
  • Reddish face
  • Grapping at the throat

Severe obstruction

  • Not able to speak
  • Signs of fear and distress
  • Weak or no coughing
  • High pitched noise or no noise when trying to breathe
  • Greyish face and bluish lips and ears
  • Grabbing at the throat


Check first by asking " Are you choking? "

If the victim can cough forcefully, speak, or breathe do not touch them. Tell them to try and cough up the object. If the mild obstruction lasts for a few minutes, have someone immediately call 911.

If the victim cannot cough, speak, or breathe at all, have someone immediately call 911.

Begin abdominal thrusts as follows:

  • Stand behind the patient ready to support them if they become unconscious and wrap your arms around their waist.
  • Keep your elbows out, away from the patient's ribs.
  • Find the top of the hip bones. Place a foot between the casualty's feet for a solid position.
  • Make a fist with one hand. Place the thumb side of the fist in the middle of their abdomen, just above their navel.
  • Grasp your fist with your other hand, thumbs toward the patient. Press your fist into the patient's abdomen with a quick inward and upward thrust.
  • If you need to repeat the movement, make each new thrust separate and distinct.
  • Repeat the thrusts until the object is expelled or the patient becomes unconscious.
  • If the casualty becomes unconscious, have someone immediately call 911.


  • Have someone immediately call 911.
  • Position the victim on their back.
  • Open the mouth and look for any foreign matter. Perform a finger sweep to draw the tongue from the back of the throat and dislodge any obstruction that may be in the mouth or throat. Remove it if you can.
  • Open their airway using the head-tilt/chin-lift method and assess for normal breathing for no longer than 10 seconds.
  • Attempt to give breaths. If unsuccessful, reattempt the head-tilt/chin-lift procedure and blow more forcefully.
  • If air won't go in, begin a cycle of 30 chest compressions.
  • Repeat looking in the mouth, attempting to ventilate and giving chest compressions until advanced medical care arrives.

CHILD (1 - 8 years of age)

If the child is conscious and sitting or standing, then perform abdominal thrusts as you would for an adult in the same position. Make sure you position your hands properly, keeping in mind the smaller size of the child. Follow the same procedures as you would on an adult for a child who is unconscious. It is not recommended that you perform blind finger sweeps in a child because of the danger of pushing the object further into the throat. Restrict your finger sweep to the mouth and the visible part of the throat.

INFANTS (less than 1 year of age)

Compared to an adult, an infant has a proportionally larger tongue. Suspect an infant is choking if they suddenly start to experience respiratory distress for no obvious reason and watch for the following:

  • A high-pitched, noisy sound during breathing
  • Coughing, becoming gradually weaker and punctuated by wheezing sounds
  • Gagging
  • Bluish colored skin
  • Anxious or agitated behavior
  • Small objects or toys located nearby that could cause choking


  • Have someone immediately call 911
  • Straddle the infant over one of your arms, face down and head lower than the rest of the body. Rest your arm on your thigh for support. Support the infant's head by firmly holding the jaw with your hand.
  • With the heel of your other hand, deliver as many as five blows between the infant's shoulder blades within three to five seconds. (The blows need to be forceful, but remember that you are dealing with an infant.)
  • If the foreign body is not expelled, then sandwich the infant's body between your hands. Turn the infant onto the back. One of your hands should support the infant's head, neck, jaw, and chest, while the other hand supports the infant's back. Lay the infant on your thigh or over your lap. The head should be lower than the rest of the body, supported by your hand.
  • Deliver as many as five quick downward chest thrusts within three to five seconds in the same location as you would to provide chest compressions for CPR.


  • Have someone immediately call 911
  • Open the infant's airway by tilting the head back and attempt to give breaths.
  • If you are initially unable to ventilate, reposition the head to make sure you have an open airway. Attempt to give breaths again.
  • Perform back blows and chest thrusts as you would for a conscious infant.
  • Look in the infant's mouth. If you see a foreign object, attempt to remove it by performing a finger sweep with your little finger. Do not perform a finger sweep if no object is visible.
  • Attempt to give breaths.
  • Repeat back blows and chest thrusts, look in the airway, and attempt to give breaths. Continue until the object is expelled or the paramedics arrive.