A guide about
choking and what to do if it happens
Choking is when your airway gets blocked and you can’t breathe properly.
Everyone has a small risk of choking, but this may be higher if you have a swallowing difficulty – known as dysphagia. It happens rarely but can be very frightening for the person and anyone with them if it does happen.
When someone chokes, the airway can either be partly or fully blocked. If it’s a mild blockage, they should be able to clear it themselves by coughing. If it’s a severe blockage, they won’t be able to cough so without anyone’s help they will lose consciousness.
The risk of choking can be higher if: the swallowing problem is more severe there are dental problems which make chewing difficult you eat too fast, overfill your mouth or find it hard to concentrate you are not sitting in a good upright position to eat you are feeling drowsy speech and language swallowing recommendations are not followed, for example, you are given a soft diet when a pureed diet has been advised.
If there is a choking risk, it is important that you have someone with you at meal/snack times and that you do not eat alone.
What to do if you think an adult is choking Check - ask ‘Are you choking?’
Mild choking - if the person speaks and answers yes, and can cough and breathe. Encourage them to cough until they can clear the obstruction. In most cases, this will resolve the blockage.
Watch them closely in case the choking becomes severe and they need more help.
Severe choking If they cannot speak (but usually are able to) and respond by nodding, if they are unable to breathe and/or sound wheezy, if their cough is silent but they are still conscious.
Give up to five back blows: Stand to the side and slightly behind the person. Support the chest with one hand and lean the person well forward so that when the obstructing object is dislodged it comes out of the mouth rather than goes further down the airway. Give up to five sharp blows between the shoulder blades with the heel of your other hand. Check after each one to see if it has been successful.
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If the obstruction is still not cleared, continue alternating five back blows with five abdominal thrusts. If the blockage does not clear after three attempts of back blows and abdominal thrusts call an ambulance immediately.
If the blockage is cleared, get the person checked over by a doctor in case of later complications.
If the person is or becomes unconscious: Support the person carefully down to the ground. Call an ambulance immediately. Begin CPR if you have been trained to do it.
Summary
How severe is the choking?
Severe choking Mild choking (ineffective cough) (effective cough)
Conscious: Encourage Five back the cough. blows followed Watch for any Unconscious: by five deterioration Start CPR abdominal or until thrusts blockage is cleared.
References: Resuscitation Council (UK) 2010 Guidelines: Adult Basic Life Support; Adult Choking Algorithm NHS Choices webpage ‘What should I do if someone is choking?’ 2015
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