If you or your child inhales a foreign object, see your doctor. If an inhaled foreign object causes choking, the American Red Cross recommends the "five-and-five" approach to delivering first aid:
- Give 5 back blows. First, deliver five back blows between the choking person's shoulder blades with the heel of your hand.
- Give 5 abdominal thrusts. Perform five abdominal thrusts (also known as the Heimlich maneuver).
- Alternate between 5 blows and 5 thrusts until the blockage is dislodged.
If you're the only rescuer, perform back blows and abdominal thrusts before calling 911 or your local emergency number for help. If another person is available, have that person call for help while you perform first aid.
The American Heart Association does not teach the back-blow technique, only the abdominal thrust procedures. It's OK not to use back blows if you have not learned the back-blow technique. Both approaches are acceptable.
To perform the Heimlich maneuver on someone else
- Stand behind the person. Wrap your arms around the waist. Tip the person forward slightly.
- Make a fist with one hand. Position it slightly above the person's navel.
- Grasp the fist with the other hand. Press hard into the abdomen with a quick, upward thrust — as if trying to lift the person up.
- Perform a total of 5 abdominal thrusts, if needed. If the blockage still isn't dislodged, repeat the five-and-five cycle.
A modified version of the technique is sometimes taught for use with pregnant or obese people. The rescuer places his or her hand in the center of the chest to compress, rather than in the abdomen.
To perform the Heimlich maneuver on yourself
If you're alone and choking and you have a landline phone, call 911 or your local emergency number immediately. Then, although you'll be unable to effectively deliver back blows to yourself, you can still perform abdominal thrusts to dislodge the item.
- Place a fist slightly above your navel.
- Grasp your fist with the other hand and bend over a hard surface — a countertop or chair.
- Shove your fist inward and upward.
- First Aid/CPR/AED Participant's Manual. American Red Cross. http://editiondigital.net/publication/?i=64159. Accessed Aug. 19, 2011.
- What to do in a medical emergency: Choking (Heimlich maneuver). American College of Emergency Physicians. http://www.emergencycareforyou.org/EmergencyManual/WhatToDoInMedicalEmergency/Default.aspx?id=224. Accessed Aug. 19, 2011.
- Bachman J (expert opinion). Mayo Clinic, Rochester, Minn. Sept. 9, 2011.