The Triton


Don’t get stuck when guest is choking; act quickly and firmly


Consider for a moment what you would do if a guest suddenly stood up and looked directly at you. She is scared and does not speak. Would you recognize that as a choking incident?

Choking or foreign body airway obstruction (FBAO) is a condition caused by inhalation of a foreign object that partially or fully blocks the airway. If the airway is not cleared quickly, the victim will most likely die.

Choking with adults often happens in restaurants or at dinner parties where the victim is eating, laughing and having a good time. The combination of food, talking, laughter and a few cocktails can be deadly if food accidentally becomes lodged in the airway.

Here’s how to help someone you suspect is choking.

Step 1. Ask the person, “Are you choking?” Someone that is truly choking will not be able to answer but they should be able to nod their head.

Step 2. Ask the person, “May I help you?” Yes, in the United States you need permission to touch a conscious person.

Step 3. If they are choking and want your help, go behind them. If the person is sitting, ask them to stand. Wrap your arms around their waist as though hugging them from behind. Make a fist and place the thumb side of your stronger hand toward the victim, about 1 inch above their belly button. Place your other hand on top of your fist.

Step 4. Strongly squeeze in an upward manner, thrusting your fist into their abdomen. If you have ever been punched in the stomach and had the wind knocked out of you then you understand what we are trying to accomplish here. We are literally trying to knock the wind (and lodged food) out of our victim.

Continue doing this until the food is dislodged and the victim can breathe on their own, or until the victim passes out.

If the choking person passes out and still not breathing, you will most likely need to begin CPR.

Performing abdominal thrusts or the Heimlich maneuver on a pregnant woman is different. In this case, move your hands up higher, above the belly so as not to injure the unborn child. Your hands will be on the sternum, the flat bone in the center of the chest between the breasts. You are now trying to squeeze the lungs, which should hopefully push out whatever is caught in the victim’s airway.mike price heimlich

There’s also a different technique for men who have big beer bellies. Often, you can’t wrap your arms around their midsection. If the victim has more belly than you have arm span, move your hands up to the sternum and treat just as we did for the pregnant woman.

For patients younger than 1, we use what I like to refer to as the Heinz Ketchup technique. Place the baby on your arm, with its face in your hand, being careful not to cover the nose and mouth. Hold the head stable and lower than its bottom so gravity can assist you.  

With the opposite hand, smack the baby between the shoulder blades five times, just as if you were trying to get ketchup out of a bottle. Roll the baby onto your other arm, this time face up. Still holding the head, press down on the chest with two fingers five times to compress the lungs, which will hopefully force out whatever is caught in the airway. Repeat until the baby cries and is breathing on its own.

Often, people who are choking sense there is something stuck in their throat and they leave the dinner table thinking they might throw up. This is a big mistake. They need help and quick action must be taken, otherwise they could die. If you see someone who appears to be choking heading to the restroom, ask if they need assistance.  

Henry Heimlich, formerly a thoracic surgeon at Jewish Hospital in Cincinnati, was the inventor of the Heimlich maneuver described in this article.  For decades, the scientific community believed back slaps were the best treatment for choking. Heimlich condemned back slaps, calling them “death blows” that may actually force the obstruction deeper into the throat. Abdominal thrusts could only force the object out.

This information is for informational purposes only and is not a substitute for professional instruction by a qualified CPR and first-aid instructor.  All captains and crew should recertify every two years.

Trained as an emergency medical technician, Keith Murray now owns The CPR School, which provides onboard CPR, AED and first-aid training as well as AED sales and service. Contact him through


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