Choking First Aid (Child, Age 1 Year and Up)

Signs of choking

These are signs of choking:

• Violent coughing

• A high-pitched sound when breathing in

• Your child can’t cough, breathe, cry, or speak

• Face that turns pale and bluish

• Your child clutches at their throat

What to do

The steps to take when a child is choking will vary. The instructions for each situation are below.

If a child has trouble breathing but can talk and has a strong cough:

1. Do NOT put your finger into the child’s mouth to remove the object. Your finger could push the object deeper into the child’s throat.

2. Call 911. This is because the airway can become fully blocked.

3. Encourage the child to cough until the object comes out. Don't do the Heimlich maneuver. The child's cough is better than the Heimlich maneuver.

4. Watch the child closely to make sure the object comes out and doesn’t shift to fully block the throat.

If a child has trouble breathing but can’t talk or make sounds and is conscious:

1. Do NOT put your finger into the child’s mouth to remove the object. Your finger could push the object deeper into the child’s throat.

2. Tell someone nearby to call 911.

3. Do the Heimlich maneuver. First, stand or kneel behind the child and wrap your arms around their waist.

4. Make a fist with one hand. Place the thumb-side of your fist into the child's belly just above the belly button (navel). Then grab that fist with your free hand.

5. Use fast, short motions to thrust inward and upward. Don’t lift the child off the floor while doing this.

6. Continue abdominal thrusts until the object comes out, the child can cough and breathe, the child becomes unconscious, or help arrives.

If a child stops breathing or becomes unconscious:

1. Shout for help and call 911.

2. Lay the child down on their back on a hard, flat surface such as a table, floor, or the ground.

3. Start CPR. Use the heel of your hand to push down on the lower part of the child’s breastbone, just below the nipple line. Press down to at least 1/3 depth of the child's chest, or about 2 inches. You can use two hands if you need to. Do this 30 times really fast. This should take about 20 seconds. This is a rate of at least 100 to 120 compressions per minute. After each compression, allow the chest to return to its normal position.

4. Look in the child's mouth for the object before you give 2 rescue breaths. Gently lift the child's chin up with one hand and tilt the head back. Place your mouth over their mouth, pinch the nose shut, and puff 2 breaths into the child's mouth. Each breath should last 1 second. Watch to see if the child's chest rises.

5. If the chest does not rise, give 30 chest compressions. Look in the child's mouth for an object. Remove the object, being careful not to push it back into the throat. If you can't see an object, don't put your finger in the child's mouth.

6. If the child does not start breathing, continue cycles of 30 chest compressions followed by 2 quick breaths. Do this until breathing starts, help arrives, you become too exhausted to continue, or the scene becomes unsafe.

Prevention

• Watch your child during meals. Children should sit down to eat. They should cut food into small, bite-sized pieces.

• Teach your child to take small bites and to chew and swallow food before talking and laughing. Make sure that children sit down while they are eating.

• Teach your child to not put pencils, crayons, or erasers in their mouth.

• Teach children to not run with gum, food, or other objects in their mouth.

• Be aware of older children’s actions. Many choking incidents are caused when an older child gives a dangerous toy or food to a younger child.

• Check each room in the house every day for small objects like buttons, coins, and toy parts.

• Try to find the cause of the choking and avoid future problems.

• For younger children, choose large, sturdy toys that don’t have sharp edges. Safe toys are those that won’t fit into a toilet tissue roll.

• For younger children, avoid toys with small, removable parts. Check toys often for loose or broken parts.

• For younger children, remove drawstrings from clothing. Avoid tying balloons, long strings, or ribbons near the crib.

Follow-up care

Follow up with your child’s health care provider as advised.

Special note to parents

Anyone caring for children should learn child CPR and abdominal thrusts. Ask your child’s health care provider about classes in your area.

Call 911

Call 911 if any of these occur:

• Continued choking or trouble breathing

• Wheezing or any abnormal breathing noises after a choking incident. An airway that is partially blocked can become completely blocked.

• Skin, lips, and nails look blue or pale (dusky)

• Your child is lightheaded, disoriented, or unresponsive