Simple steps save someone from choking

Jul 15, 2013 by Keith Murray

Over the past few years, previous students have called with successful save stories, thanking me for teaching them how to save a life. Here are a few of those stories.

A female accountant was eating lunch in the employee cafeteria when a coworker stood up and placed his hands on his throat, the universal choking sign. The man looked scared. He was unable to cough, talk or breath.

Remembering her training, she asked if he was choking. He nodded. She asked if he needed help. Again, he nodded. She went behind him, wrapped her arms around his waist and squeezed.

After only a few attempts, a piece of food popped out of his mouth and he began breathing.

A new father called to tell me he had performed back smacks on his infant son who had an airway obstruction.

Another woman called after saving her new puppy. The puppy was choking and she performed back smacks, similar to those performed on a child, and saved the pup’s life.

These stories are true, and scenes like this happen every day. There were successful saves, yet many people die from choking, also called 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. When you are not breathing, you are in respiratory arrest. Respiratory arrest will ultimately lead to cardiac arrest, which means your heart stops.

Often, choking happens with adults in restaurants or at dinner parties where the victim is 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 who is choking.

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

Step 2. Ask the person, “May I help you?”  Believe it or not, in the United States you need permission to touch a conscious person.

Step 3. Go behind them. If the choking person is sitting, ask them to stand. Wrap your arms around their waist as if you were hugging them. 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 the first.

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 should 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, the victim can breath or the victim passes out. If they pass out and are still not breathing, you will most likely need to begin the steps of CPR. Contact 911 or emergency medical services immediately.

Performing abdominal thrusts or the Heimlich on a pregnant woman is different. You do not want to thrust on the mother’s stomach as you could injure the unborn child. On pregnant women, you will move your hands up higher, above the belly and on the sternum, the flat bone in the center of the chest. You are now squeezing the lungs, which should hopefully push out whatever is caught in the victim’s airway.

Treatment for men who look pregnant is different, too. Although this sounds funny, a lot of men have big bellies. Often, you can’t wrap your arms around their midsection. If the victim has more belly that you have arm span, move your hands up to the victim’s sternum and treat as you would a pregnant woman.

We do not perform abdominal thrusts on infants because of possible damage to their internal organs. Instead, we do what I like to refer to as the Heinz ketchup technique.

If the infant is not breathing, place it on your arm with the baby’s face in your hand (be sure not to cover the baby’s nose and mouth). Hold the head stable, a little 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.

Now, roll the baby onto your other arm, face up. Still holding the head, press down on the chest with two fingers five times. This compresses the lungs and will hopefully force out whatever is caught in the airway. Repeat this process until they baby cries.

Beware of the bathroom, as this is the worst place for a choking person. Often, the choking victim senses there is something stuck in their throat and they leave the dinner table, thinking they might throw up. Big mistake. Action must be taken quickly or they could die. If you see someone who appears to be choking heading to the restroom, ask if they need assistance.


Keith Murray, a former firefighter EMT, owns The CPR School, a first-aid training company. He provides onboard training for yacht captains and crew and sells and services AEDs. Contact him at 877-6-AED-CPR, 877-623-3277 or Comments on this column are welcome at