If someone is choking and cannot cough, speak, or breathe, call your local emergency number now (911 in the US) — then begin first aid.
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For ages 1 year and up

Adult & Child Choking: Step by Step

Use these steps for anyone over about 1 year old — the technique is the same for adults and children, with a lighter touch for smaller bodies. For babies under 1, use the infant technique instead.

First: confirm it's a full airway blockage.

If they can still cough forcefully, speak, or breathe, do not perform abdominal thrusts. Stay with them and encourage coughing. Only intervene if they cannot cough, speak, or breathe, or they nod when you ask "Are you choking?"

Eight-step illustrated guide: 1) Assess the situation by asking "Are you choking?" 2) Give 5 back blows between the shoulder blades. 3) Give 5 abdominal thrusts (Heimlich maneuver). 4) Repeat steps 1–3 until the object comes out or they become unconscious. 5) If unconscious, call 911 and lay them on their back. 6) Begin chest compressions, 2 inches deep. 7) Check the mouth and remove the object if visible. 8) Give 2 rescue breaths and repeat compression cycles until help arrives.
Quick-reference summary of the steps below. Full instructions, including for pregnant individuals and self-administered thrusts, are in the sections underneath.

  1. Confirm choking and call for help

    Ask "Are you choking?" If they can't answer, cough, or breathe, tell someone nearby to call your local emergency number immediately. If you're alone, call before you begin, or after the first round if it's faster.

  2. Position yourself and lean them forward

    Stand slightly behind and to the side of the person. Support their chest with one hand and bend them forward at the waist so the object can fall out of their mouth rather than go deeper.

  3. Give 5 back blows

    Using the heel of your hand, strike firmly between the shoulder blades 5 times. Each blow should be a distinct, sharp motion aimed at dislodging the object — not a gentle pat.

  4. Give 5 abdominal thrusts (Heimlich maneuver)

    Stand behind the person. Make a fist and place the thumb side just above the navel, well below the breastbone. Grasp your fist with your other hand and pull sharply inward and upward, 5 times.

    For a pregnant person or someone with a large abdomen, place your hands higher, at the base of the breastbone, and use chest thrusts instead.

  5. Alternate 5 back blows and 5 abdominal thrusts

    Keep repeating the cycle — 5 back blows, then 5 abdominal thrusts — until the object is forced out, the person can breathe or cough forcefully on their own, or they lose consciousness.

  6. After the object comes out

    Encourage them to cough anything else up. Even if they seem fine, recommend they see a doctor — abdominal thrusts can occasionally cause internal injury, and airway swelling can develop later.

Make sure emergency services are already on the way.

If no one has called yet, call now — put the phone on speaker if you're alone so you can keep working.

  1. Lower them to the ground carefully

    Support their head and body as they go down. Lay them on their back on a firm, flat surface.

  2. Begin CPR, starting with chest compressions

    Kneel beside them and give 30 chest compressions in the center of the chest, about 2 inches deep, at a fast, steady pace (about 100–120 per minute).

  3. Open the airway and look before breaths

    Tilt the head back, lift the chin, and open the mouth. If you can see the object, remove it with a finger sweep. Never do a blind finger sweep if you can't see the object — you may push it deeper.

  4. Give 2 rescue breaths, then continue CPR

    If trained, give 2 rescue breaths. If the chest doesn't rise, reposition the head and try again. Continue cycles of 30 compressions and 2 breaths, checking the mouth periodically, until the object is expelled, they respond, or paramedics take over.

This is a simplified overview. CPR technique and hand placement differ slightly for children versus adults. An accredited CPR course is the best way to learn this safely and confidently — see our resources page.

  1. Call emergency services immediately

    Call or have a smart device call your local emergency number. Stay on the line if you can — many dispatchers can guide you through the next steps live.

  2. Give yourself abdominal thrusts

    Make a fist and place the thumb side just above your navel. Grasp your fist with your other hand and thrust inward and upward, sharply, repeatedly.

  3. Use a firm surface if needed

    If self-thrusts aren't working, lean over a firm edge — the back of a chair, a countertop, or a railing — and thrust your upper abdomen down and onto it.

  4. Keep trying

    Continue until the object dislodges or help arrives. Try to stay near a door or somewhere you can be found and unlock it if possible before starting, in case you lose consciousness.

Do & Don't

Do

  • Act quickly once you've confirmed a full blockage
  • Alternate back blows and abdominal thrusts
  • Encourage forceful coughing if they can still cough
  • Get medical follow-up after any choking episode

Don't

  • Don't interrupt someone who is coughing effectively
  • Don't do a blind finger sweep in the mouth
  • Don't perform abdominal thrusts on a pregnant person — use chest thrusts
  • Don't give up — continue cycles until help arrives

Choking baby or toddler under 1?

Infants need a different, gentler technique — never abdominal thrusts on a baby.

See infant choking steps