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What to do if…
someone is choking and cannot breathe or speak

Produced and maintained by PanicStation.org Published: Last reviewed: Editorial policy USA guide

Short answer

Call 911 now, put the phone on speaker, and begin choking first aid. For a conscious adult or child over 1, alternate 5 back blows with 5 abdominal thrusts; for an infant under 1, alternate 5 back blows with 5 chest thrusts.

Do not do these things

  • Do not give the person food, water, medicine, or anything else to swallow.
  • Do not put your fingers into their mouth unless you can clearly see a loose object that is easy to remove.
  • Do not use abdominal thrusts on an infant under 1.
  • Do not shake an infant or hold a child upside down.
  • Do not leave the person alone or delay calling 911.
  • Do not delay standard choking first aid while looking for a suction device.
  • Do not continue back blows or thrusts after the person can breathe, speak, cry, or cough forcefully.

What to do now

  1. Call 911 immediately. Put the phone on speaker so you can keep helping, or point to a specific person and tell them to call. State that someone is choking and cannot breathe or speak, give the exact location, and follow the dispatcher’s instructions.

  2. For a conscious adult or child over 1, stand slightly behind and to one side. Support their upper body, lean them forward, and give 5 firm back blows between the shoulder blades with the heel of your hand.

  3. If the object does not come out, stand behind them. Make a fist and place its thumb side just above the navel and well below the breastbone. Grasp your fist with your other hand and give 5 quick inward and upward abdominal thrusts. Continue alternating 5 back blows with 5 abdominal thrusts until the object comes out or the person becomes unresponsive.

  4. For someone in the late stages of pregnancy, or anyone whose abdomen you cannot encircle, use chest thrusts instead of abdominal thrusts. Place your fist against the center of the breastbone, grasp it with your other hand, and give 5 quick inward thrusts. Continue alternating 5 back blows with 5 chest thrusts.

  5. For an infant under 1, support the head and neck and hold the infant face down along your forearm or thigh, with the head lower than the chest. Give 5 firm back blows between the shoulder blades. Turn the infant face up while supporting the head, then give 5 quick chest thrusts with the heel of one hand on the center of the breastbone. Continue alternating the two sets until the object comes out or the infant becomes unresponsive.

  6. If the person begins breathing, speaking, crying, or coughing forcefully, stop the blows and thrusts. Encourage coughing, stay with them, and keep watching for renewed breathing difficulty.

  7. If the person becomes unresponsive, carefully lower them onto a firm, flat surface and start CPR beginning with chest compressions. Send someone for an automated external defibrillator if one is nearby. Before giving breaths, look in the mouth and remove an object only if it is clearly visible. Continue CPR and follow the 911 dispatcher until emergency responders take over or the person begins breathing normally.

  8. If the object comes out, tell the 911 dispatcher and continue monitoring the person until emergency help arrives. Let emergency responders assess them because choking and the first-aid maneuvers can cause complications.

What can wait

You do not need to identify the exact object, clean up, contact everyone, assign blame, complete paperwork, or decide how the choking could have been prevented. Those things can wait until the person is breathing and emergency responders have taken over.

Important reassurance

Acting promptly matters more than remembering every detail perfectly. Keep 911 on speaker when possible and follow any instructions the dispatcher gives you.

Scope note

This guide covers immediate first steps for a person with a severely blocked airway. Medical assessment, recovery decisions, and hands-on first-aid training may require qualified healthcare or emergency professionals.

Important note

This is general first-aid information, not medical advice or a substitute for calling 911, following emergency instructions, or receiving hands-on training.

Additional Resources

Closely connected guides that may be useful during the same situation or its immediate aftermath.

About this guide

This guide was produced and is maintained by PanicStation.org using its published editorial process. Official and specialist sources are checked where relevant, and AI-assisted tools may be used for drafting, organisation, and consistency checks. The site operator remains responsible for publication, revision, and removal decisions.

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