This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.
First Aid for Choking in Adults
Choking occurs when a foreign object blocks the airway, preventing oxygen from reaching the lungs and brain. Recognizing the signs of severe airway obstruction and delivering immediate back blows and abdominal thrusts can save a person's life. This guide outlines standard emergency protocols for conscious and unconscious choking adults.
Quick Summary
Quickly identify severe choking, call 911, and alternate between 5 firm back blows and 5 abdominal thrusts until the airway is clear or the person becomes unresponsive.
Important Medical Disclaimer
This guide is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult with qualified healthcare providers for medical concerns.
Step-by-Step Guide
Assess the Situation and Confirm Choking
Quickly determine whether the airway obstruction is partial or severe. Ask the person loudly, 'Are you choking?' If they can speak, cry, or cough forcefully, encourage them to keep coughing to clear the obstruction on their own. If they cannot speak, make high-pitched wheezing sounds, clutch their throat, or turn pale or blue, immediate intervention is required.
Important: Do not deliver back blows or thrusts if the person is coughing forcefully, as this can dislodge the object into a worse position.
Direct Someone to Call 911
Point directly at a specific bystander and tell them to call 911 or your local emergency number and locate an automated external defibrillator (AED). If you are alone with the conscious victim, initiate rescue physical maneuvers immediately before stopping to call. Ensuring professional emergency medical services are en route is critical in case the obstruction cannot be relieved.
Deliver 5 Firm Back Blows
Position yourself slightly behind and to the side of the choking adult. Support their chest with one hand and bend them forward at the waist so their upper airway is parallel to the ground. Using the heel of your other hand, deliver five distinct, forceful blows between the shoulder blades to dislodge the object via vibration and gravity.
Important: Ensure the victim is bent forward sufficiently so the object exits the mouth rather than sliding further down the trachea.
Perform 5 Abdominal Thrusts (Heimlich Maneuver)
Stand directly behind the person and wrap both arms around their waist. Make a fist with one hand and place the thumb side against the middle of the abdomen, just above the navel and well below the lower breastbone. Grasp your fist with your other hand and pull sharply inward and upward in five quick, distinct thrusts.
Important: Never place your hands on the xiphoid process (the bottom tip of the breastbone) or over the lower ribs, as this can cause bone fractures or internal organ lacerations.
Modify Hand Placement for Pregnancy or Obesity
If the choking individual is in the late stages of pregnancy or has a body size that prevents you from wrapping your arms around their abdomen, deliver chest thrusts instead. Position your hands around their chest from behind, placing the thumb side of your fist on the center of the breastbone between the nipples. Pull straight back with quick, firm thrusts.
Alternate Cycles Until the Airway Clears
Continue alternating cycles of five back blows and five abdominal (or chest) thrusts without stopping. Pause briefly between individual thrusts or blows to observe if the object has been expelled. Stop the cycle as soon as the person can breathe, cough forcefully, or speak normally.
Transition to CPR if the Person Becomes Unresponsive
If the adult loses consciousness, gently lower them to the floor onto their back and call 911 if not already done. Begin CPR immediately, starting with 30 chest compressions at a rate of 100 to 120 per minute. Each time you open the airway to give rescue breaths, look inside the mouth; if you see the obstructing object loose, remove it, but resume compressions without delay if nothing is visible.
Important: Do not perform a blind finger sweep under any circumstances, as this can push a foreign object deeper into the larynx.
Frequently Asked Questions
What should I do if I am choking and alone?
Does someone need medical evaluation after the choking object is cleared?
Why is a blind finger sweep dangerous?
What is the universal sign for choking?
Sources & References
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Click any link to access the full source. PubMed Central (PMC) links provide free full-text access.
This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.
If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.
Medically reviewed by WellAlly Editorial Team Last reviewed October 19, 2026. · Read our editorial policy