What to do when an adult, child or baby is choking

Call 911. If the person cannot cough, speak or breathe, start back blows and thrusts at once. You do not need any equipment. This guide gives the steps by age and points out where the major sources differ.

By the HEAL IQ team. See how we write this site. Last updated 2026-11-04.

Step 1: Decide if the airway is partly or fully blocked

If it is a partial block, encourage the person to keep coughing and stay with them. This matters: FDA warns that back blows could turn a partial block into a complete one, and people usually clear a partial block themselves. A partial block can get worse quickly, so keep watching.

Step 2: Call 911

Call 911 or your local emergency number, or have someone else call. The American Heart Association lists this first. If you are by yourself, put the phone on speaker so your hands are free. Emergency crews have other ways to remove a blockage and can take the person to a hospital.

Step 3: Back blows and thrusts, by age

Adults and children over 1 year

1. Stand to the side and slightly behind the person. For a small child, kneel.
2. Put one arm across the chest and bend the person forward at the waist.
3. Give 5 separate, firm back blows between the shoulder blades with the heel of your hand.
4. If that does not work, stand behind the person. Find the navel. Put the thumb side of your fist just above it. Cover your fist with your other hand.
5. Give 5 separate abdominal thrusts, pulling inward and upward. This is the move also called the Heimlich maneuver.
6. Keep alternating 5 back blows and 5 thrusts until the object comes out, or the person can cough, speak or breathe, or the person becomes unresponsive.

Pregnant people, and people you cannot get your arms around

Use chest thrusts in place of abdominal thrusts. The 2025 adult guideline says this for the late stages of pregnancy and when you cannot encircle the abdomen. The American Red Cross says it for anyone obviously or known to be pregnant. Follow the more cautious wording: if you know the person is pregnant, use chest thrusts.

Babies under 1 year

1. Lay the baby face down along your forearm, with your thigh for support and the head lower than the body. Support the head and jaw.
2. Give 5 firm back blows between the shoulder blades with the heel of your hand.
3. Turn the baby face up, supporting the head and neck, with the head still lower than the body.
4. Give 5 quick chest thrusts in the center of the chest, just below the nipple line.
5. Keep alternating 5 back blows and 5 chest thrusts until the object comes out, or the baby can cough or cry, or the baby becomes unresponsive.

A difference between sources you should know about. For infant chest thrusts, the 2025 American Heart Association guideline now recommends the heel of one hand, because research suggests it gives greater compression depth than the older two-finger method. The American Red Cross, NHS and MedlinePlus pages we read still describe two fingers. Ask your class instructor which method they teach. Do not let this stop you from acting.

If the person becomes unresponsive

1. Lower them to a firm, flat surface.
2. Make sure emergency services have been called.
3. Start CPR, beginning with chest compressions.
4. Before giving a breath, look in the mouth. Remove an object only if you can see it.

Do not sweep with your fingers

Do not reach into the mouth to feel for something you cannot see. The 2025 guidelines for adults and children list blind finger sweeps as harmful. The NHS explains that you could push the object further in.

If you are alone and choking

The American Red Cross says to call 911 on a landline or a GPS-enabled mobile phone. Even if you cannot speak, the open line tells the dispatcher to send help. Give yourself abdominal thrusts with your hands, or bend over and press your abdomen against a firm object such as the back of a chair. Avoid anything with a sharp edge or corner.

After it comes out

Get medical care even if the person seems fine. The NHS says part of the object may still be there, or the person may have been hurt by the procedure. MedlinePlus says to always call a baby's provider after a choking episode.

How good is the evidence?

Honestly, limited. The 2025 adult guideline says no randomized trials compare these methods. Its back-blow advice relies partly on a cohort of 709 people, where back blows were linked to better relief and fewer injuries than abdominal thrusts. Serious injuries from abdominal thrusts are also on record in case reports. Even so, these are the steps that the American Heart Association, the Red Cross and FDA tell the public to use, and FDA says they have a high rate of success.

Where do anti-choking devices fit in?

After all of the above, if at all. FDA says a device may be used as a second option if the standard steps fail, and that using one first could delay them. We sell one such device, ResQVac, and we have no FDA clearance or authorization and no clinical study on file for it. You do not need one to follow this guide. Read how first aid, training and a device differ and what FDA says.

Take a class

Reading is not practice. The American Red Cross and the American Heart Association both offer classes. Parents and caregivers should choose one that covers children and infants. If you took a class before late 2025, the steps may have changed, and a refresher is worth it.

More from us: all guides or the ResQVac product page.