Choking occurs when an object blocks the airway, preventing normal breathing and potentially becoming life-threatening if not addressed quickly. Recognizing the signs, such as difficulty breathing, coughing, or the inability to speak, is critical. For mild choking, encourage the person to cough to dislodge the object. In severe cases, where the airway is fully blocked, performing the Heimlich maneuver or back blows (for infants) can save a life. Knowing basic first aid techniques and staying calm during an emergency can make all the difference. If the object cannot be removed, seek immediate medical assistance.
What Is Choking?
Choking occurs when an object, usually food or a toy, gets stuck in the trachea (airway). When this happens, air cannot flow properly in or out of the lungs, making it difficult for the child to breathe.
The trachea is normally protected by a small flap of tissue called the epiglottis. The trachea and the esophagus share an opening at the back of the throat. The epiglottis acts as a lid, closing over the trachea each time a person swallows, allowing food to pass down the esophagus while preventing it from entering the trachea.
Occasionally, the epiglottis may not close quickly enough, and an object can slip into the trachea—what we commonly refer to as something «going down the wrong pipe.»
In most cases, the object only partially blocks the trachea, is coughed up, and normal breathing resumes quickly. Kids who cough but can still breathe and talk usually recover without assistance. Though it can be uncomfortable and upsetting, they are generally fine after a few seconds.
When Is Choking an Emergency?
Choking becomes a life-threatening emergency when an object completely blocks the airway, preventing air from reaching the lungs. If the brain is deprived of oxygen, immediate action is required.
Signs That a Child Is Choking and Needs Help Immediately:
- Cannot breathe
- Is gasping or wheezing
- Cannot talk, cry, or make noise
- Turns blue
- Grasps at their throat or waves their arms
- Appears panicked
- Becomes limp or unconscious
In these situations, if you are trained, immediately start abdominal thrusts (the Heimlich maneuver), which is the standard procedure for choking.
What Are Abdominal Thrusts (the Heimlich Maneuver)?
If you have children, it’s crucial to be trained in both CPR and abdominal thrusts (the Heimlich maneuver). This technique forces a sudden burst of air through the trachea from the diaphragm, dislodging the object and potentially expelling it from the mouth.
Though the technique is simple, it must be performed with caution, especially on young children. Proper training is essential to avoid injury, particularly in infants. Special versions of abdominal thrusts for infants are designed to minimize the risk to their small bodies.
CPR and abdominal thrust techniques are taught in basic first-aid courses offered by organizations like the YMCA, local hospitals, the American Heart Association (AHA), and the American Red Cross.
What Should I Do if a Child Might Be Choking?
Call 911 for any serious choking situation.
Possible Situations and How to Handle Them:
- If the child is choking but can still breathe and talk:
- This means the airway is not completely blocked. It’s best to do nothing and let the child recover on their own.
- Do not reach into the child’s mouth or pat their back, as this can push the object further down.
- Stay calm and with the child until the episode passes.
- If the child is conscious but can’t breathe, talk, or make noise, or is turning blue:
- Call 911 immediately or have someone nearby do so.
- Start abdominal thrusts if you are trained.
- If untrained and no one else can help, wait for emergency personnel to arrive.
- If the child was choking and is now unconscious and not breathing:
- Shout for help and call 911 immediately.
- Start CPR if you are trained.
- If you are untrained, wait for help to arrive.
When Should I Call the Doctor or Go to the ER?
After any major choking incident, take the child to the ER. Seek emergency medical care if:
- The child has a persistent cough, drooling, gagging, wheezing, difficulty swallowing, or breathing problems.
- The child turned blue, became limp, or was unconscious during the episode, even if they seem to recover.
- You suspect the child swallowed an object like a toy or battery.
If the child had a choking episode but fully recovered after coughing, there is no need for emergency care, but you should still call your doctor.
How Can We Prevent Choking?
Children under 3 are particularly at risk for choking. To protect kids:
- Avoid foods that pose choking risks, such as hot dogs, grapes, raw carrots, nuts, raisins, hard or gummy candy, spoonfuls of peanut butter, chunks of meat or cheese, and popcorn.
- Serve food in small bites. Cut grapes into quarters, slice hot dogs lengthwise and into small pieces, and cook vegetables before serving.
- Ensure children sit down to eat and do not talk or laugh with food in their mouths.
- Be mindful of toys and household items that can pose choking hazards, like deflated balloons, coins, small toy parts, and batteries. Frequently check your home for objects that children might put in their mouths.
- Choose age-appropriate toys and follow the manufacturer’s age recommendations. A simple test is to see if a toy can pass through a cardboard toilet paper tube; if it does, it’s too small.
Preparation is Key
Take the time now to get prepared. CPR and first-aid courses are essential for parents, caregivers, and babysitters. Contact your local American Red Cross, YMCA, or American Heart Association chapter, or check with hospitals and health departments in your community for available courses.