Choking
Maneuvers to relieve choking are frequently life saving. Adults most often choke on a piece of food, such as a large piece of meat. Infants do not have well-developed swallowing reflexes and may choke if given small, rounded foods such as peanuts or hard candies. Children, especially toddlers, also may choke on toys, coins, and other inedible objects that they place in their mouth.
Coughing may be the first symptom and is often so severe that the person cannot ask for help. The person may grasp both hands near the throat. Breathing and speaking can become weak or stop. There can be high-pitched or snoring sounds. The person can turn blue, have a seizure, or faint.
First-Aid Treatment
Treatment for a person who is choking takes precedence over calling for emergency medical care.
 See the figure Performing the Heimlich Maneuver.
A strong cough often expels the object from the airway. A person with a strong cough should be allowed to continue coughing. A person who can speak normally usually still has a strong cough. If a person who is choking cannot cough, the Heimlich maneuver should be performed. The Heimlich maneuver produces increased pressure in the abdomen and chest, which expels the object.
If the person is conscious, the rescuer approaches from behind, then circles his hands around the person's abdomen. The rescuer forms a fist, with the thumb pointing inward, and places it between the breastbone and navel, toward the person. The other hand is then placed firmly over the fisted hand. The hands are then thrust inward and upward forcefully, 5 times in succession. Less force should be used if the person is a child. Series of thrusts should be repeated until the object is expelled. If the person loses consciousness, the rescuer should stop the thrusts.
If the person loses consciousness, steps are taken to open the airway and provide artificial respiration (see Section 24, Chapter 299). Failure of the chest to rise indicates that the airway is still blocked. The rescuer checks the airway for, and removes, visible objects. If none are found, the rescuer inserts his finger into the person's mouth to find and remove any hidden objects present. Artificial respiration is then resumed.
 See the figure Clearing a Blocked Airway in an Infant.
For an infant, the Heimlich maneuver is not performed. Instead, the infant is turned face down, the chest resting on the rescuer's hand, with the head lower than the body. The rescuer then strikes the infant between the shoulder blades 5 times using the heel of the hand (back blows). The strikes should be firm but not hard enough to cause injury. The rescuer then checks the mouth, removing any visible objects. If the airway remains blocked, the rescuer turns the infant face up with the head down, thrusts his second and third fingers inward and upward on the breastbone 5 times (chest thrusts), then checks the mouth again.
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