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This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.

Medically reviewed by WellAlly Editorial TeamLast reviewed October 19, 2026Editorial policy
First Aid15 min read

Adult Choking Rescue: How to Perform the Heimlich Maneuver and Back Blows

Published: October 19, 2026Updated: October 19, 2026

Learn how to rapidly identify and respond to severe foreign-body airway obstruction in an adult. This guide details the recommended combination of back blows and abdominal thrusts, as well as critical modifications if the person becomes unconscious or requires special positioning.

Quick Summary

Call 911 and alternate between 5 firm back blows and 5 rapid abdominal thrusts until the airway clears or the person loses consciousness.

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

1

Assess for Severe Airway Obstruction

Look for the universal choking sign—hands clutched to the throat—along with an inability to speak, cough forcefully, or breathe. If the person can speak or cough loudly, encourage them to keep coughing to clear the obstruction naturally. Only intervene physically if they cannot breathe, make high-pitched wheezing sounds, or begin turning blue.

Important: Do not interfere with a person who has a strong, effective cough, as physical maneuvers can push the object deeper.

2

Call 911 and Alert Bystanders

Direct a specific bystander to call 911 or your local emergency number immediately and locate an Automated External Defibrillator (AED). If you are alone with the victim, begin rescue maneuvers immediately for roughly two minutes or until the object clears before pausing to call emergency services. Clear the immediate area to ensure you have adequate room to maneuver.

3

Deliver 5 Firm Back Blows

Stand slightly behind the victim and place one arm across their upper chest for support. Lean them forward at the waist so that if the object dislodges, it falls out of the mouth rather than back down the airway. Using the heel of your dominant hand, deliver five distinct, forceful blows between the shoulder blades.

4

Perform 5 Abdominal Thrusts (Heimlich Maneuver)

Stand behind the victim and wrap your arms around their waist. Make a fist with one hand and place the thumb side against the middle of their abdomen, slightly above the navel and well below the lower tip of the breastbone. Grasp your fist firmly with your other hand and deliver five quick, upward and inward thrusts.

Important: For individuals in late pregnancy or who are severely obese, perform chest thrusts instead of abdominal thrusts by placing your fist on the center of the breastbone.

5

Alternate Cycles Until the Airway Is Clear

Continue alternating between 5 back blows and 5 abdominal thrusts without stopping. Monitor closely for the ejection of the foreign object or signs that air passage has resumed, such as coughing, speaking, or crying out. Stop physical thrusts immediately once normal breathing is restored.

6

Transition to CPR if the Person Loses Consciousness

If the person becomes unresponsive, gently ease them to the floor onto their back and call 911 if not already done. Begin cardiopulmonary resuscitation (CPR) starting with 30 chest compressions. Each time you open the airway to give rescue breaths, look inside the mouth; only remove an object if you can clearly see and grasp it.

Important: Never perform a blind finger sweep, as this can push the obstructing object deeper into the pharynx or damage the soft tissues.

Frequently Asked Questions

What should I do if I start choking and I am completely alone?
Dial 911 immediately and leave the line open so dispatchers can trace your location. You can perform abdominal thrusts on yourself by placing a fist above your navel, grasping it with your other hand, and pulling inward and upward, or by bending over a hard horizontal surface such as the back of a chair or edge of a table and pressing into your abdomen.
Does a choking victim need to go to the hospital if the object comes out?
Yes. Even if the object is successfully dislodged and normal breathing resumes, abdominal and chest thrusts can cause internal complications such as bruised ribs, abdominal wall injury, or lacerations to internal organs. A medical evaluation is necessary to rule out trauma or remaining foreign matter in the lungs.
Why are blind finger sweeps no longer recommended?
Blind finger sweeps can push a partially obstructing object deeper into the larynx or trachea, converting a partial blockage into a complete, fatal airway occlusion. You should only attempt manual removal if the object is clearly visible and easily grasped.
How do I modify rescue techniques for someone who is pregnant?
Do not deliver abdominal thrusts to someone who is visibly pregnant. Instead, position your arms higher, encircling the chest, and place the thumb side of your fist against the lower half of the sternum (breastbone) to deliver rapid, backward chest thrusts.
  1. 1
    Mayo Clinic: Choking First AidSource
  2. 2
    MedlinePlus: Choking - Adult or Child Over 1 YearSource
  3. 3
    NHS: What Should You Do if Someone Is Choking?Source

Click any link to access the full source. PubMed Central (PMC) links provide free full-text access.

Medical Disclaimer

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