Foreign body in airways — choking in adults and children

Foreign body in airways — often food that 'has gone down the wrong way' — can block breathing completely in minutes. It happens suddenly, typically during meals, and the person cannot say what is wrong if the airway is completely closed. Quick, calm action can save a life before oxygen deprivation occurs.

§Partial or complete blockage

The first and most important thing is to assess how serious the blockage is. In a partial blockage, the person can still breathe, cough and perhaps talk — the air gets past. In a complete blockage, the person can neither cough effectively, talk nor breathe; they often grab their throat and quickly become panicky and blue. The two conditions are handled differently.

§Action in case of complete airway obstruction in adults

If the person stops being able to cough, talk or breathe, you must intervene with alternating back blows and abdominal thrusts. First back blows between the shoulder blades with the palm of your hand while the person is bent well forward so the foreign object can fall out forward rather than further down. If that doesn't work, give abdominal thrusts (Heimlich's grip): you stand behind the person, clasp your hands between the navel and breastbone and press inward and upward. You alternate between back blows and abdominal thrusts in the sequence and number you have learned in the course until the foreign object comes out or the person loses consciousness.

• 01Bend the person well forward
• 02Deliver powerful back slaps between the shoulder blades with the palm of your hand
• 03If it doesn't work: give abdominal thrusts (Heimlich) — inward and upward
• 04Alternate between back strokes and abdominal tension according to course instructions
• 05Call 1-1-2 if it doesn't work quickly

§If the person loses consciousness

If the person loses consciousness, they are gently laid down, you call (or get someone else to call) 112 and you begin CPR as you have been trained. Chest compressions can themselves help press the foreign body loose. Do not stop to grope blindly in the mouth — that can push the object further down.

§Children and infants — be more cautious

In children, the same principle is used with back blows and abdominal thrusts, but technique and force are adapted to the child's size. In infants, abdominal thrusts are not given in the same way as in adults — instead a special combination of back blows and chest thrusts is used with the infant in an adapted position. Because the body is small and delicate, it is especially important to have learned the technique practically in a course that covers first aid for children.

§After any brake work you must bleed the system, check that the pedal is firm, and test drive the car in a safe place with gentle braking before it is returned. Always use the manufacturer's wear limits and torque specs, and keep brake fluid away from paint — it etches. Brake work is never the place to take a shortcut.

Even if the foreign body comes out and the person seems unhurt they should see a doctor after abdominal thrusts because compression to the abdomen can cause internal injuries. If the person has been without breathing or unconscious medical follow-up is always required.

“If they can cough, let them cough. If they cannot, act immediately — alternating back blows and abdominal thrusts until the airway is clear.”

— Basic first aid rule