Choking and the Heimlich Maneuver

Choking occurs when food or another foreign object becoming lodged in the airway. Choking prevents oxygen from getting to the lungs and the brain. Lack of oxygen to the brain for more than 4 minutes may result in brain damage or death. It is important for all people to recognize and know how to handle choking both in the home and in restaurants and other public places. The Heimlich maneuver, an emergency procedure used to treat choking victims, is responsible for saving thousands of lives each year.

How can choking be prevented?

In adults, choking can often be prevented if the following precautionary measures are taken:

  • Cut food into small pieces.

  • Chew food slowly and thoroughly, especially if wearing dentures.

  • Avoid laughing and talking while chewing and swallowing.

  • Avoid excessive intake of alcohol before and during meals.

In infants and children, choking can be often be prevented if the following precautionary measures are taken:

  • Keep marbles, beads, thumbtacks, latex balloons, coins, and other small toys and objects out of reach, particularly in children younger than 4 years old.

  • Prevent children from walking, running, or playing when they have food and toys in their mouth.

  • Youngsters under the age of 4 should not be fed foods that can easily become lodged in the throat, such as hot dogs, nuts, chunks of meat or cheese, grapes, hard or sticky candy, popcorn, chunks of peanut butter, or raw carrots.

  • Supervise mealtimes with young children.

  • Prevent older siblings from giving a dangerous food or toy to a young child.

What is the recommended first-aid technique for choking?

The Heimlich maneuver is a series of under-the-diaphragm abdominal compressions. It is recommended for a person who is choking on a piece of food or a foreign object.

According The Heimlich maneuver is used only when a person is choking due to something blocking the airway. Choking is when a person can't speak, cough, or breathe. An airway obstruction can lead to a loss of consciousness and death. When applying the Heimlich maneuver, be careful not to use too much force so you don't damage the ribs or internal organs. The Heimlich maneuver is the only method for clearing a blocked airway currently recommended for adults by the American Heart Association and the American Red Cross.

What is the Heimlich maneuver for adults?

The Heimlich maneuver lifts the diaphragm and forces enough air from the lungs to create an artificial cough. This cough is intended to move air through the windpipe, pushing, and expelling the obstruction out of the airway and mouth:

Illustration showing a woman choking, a man grabbing her around her stomach from behind, and using his fist and hand to perform the choking rescue technique.

  • To do the Heimlich maneuver, reach around the person's waist. Position one clenched fist above the navel and below the rib cage. Grasp your fist with your other hand. Pull the clenched fist sharply and directly backward and upward under the rib cage six to 10 times quickly.

  • In case of obesity or late pregnancy, give chest compressions.

  • Continue uninterrupted until the obstruction is relieved or advanced life support is available. In either case, the person should be examined by a health care provider as soon as possible. 

Illustration showing the choking woman bending over the back of a chair to perform choking self-rescue.

Although the Heimlich maneuver is simple and effective, it can be painful and even cause injury to the victim. It should be used only in actual emergencies, when it is fairly certain that the person is actually choking.

Note: In infants and small children, a different technique of the Heimlich maneuver is recommended. Discuss the proper first-aid choking technique for your child with his or her health care provider.

How can I learn the proper technique for administering the Heimlich maneuver?

The Heimlich maneuver is simple to learn and is often taught during first-aid and cardiopulmonary resuscitation (CPR) classes. Contact your local chapter of the American Red Cross or American Heart Association or contact your local hospital or health care facility for a class schedule and more information.