Choking Child, How to Help

(Older than 1 year and has not yet reached puberty)

Choking is when food or an object gets stuck in the airway or the throat and stops air from getting to the lungs. Choking can be mild or severe.

Mild choking

The child can make sounds and can cough loudly. 

You should:

• Stay close by and let him cough.
• Call 9-1-1 if you are concerned about his breathing.

Severe choking

The child cannot breathe OR cannot make a sound OR his cough makes no sound OR he uses the choking sign, holding his neck with one or both hands.

You should:

• Act quickly to get the object out of the child’s airway so he can breathe.

Stops responding

The child is not breathing and does nothing when you tap him and ask if he is OK.

You should:

• Call 9-1-1

How to help a child with severe choking:

1. Ask: “Are you choking?” If he nods his head tell him you are going to help.
2. If the child is coughing and can talk, stand by to help as needed.
3. If the child is unable to make a sound or talk, perform abdominal thrusts (the Heimlich Maneuver).
   • Kneel behind and at shoulder level with the child.
   • Place one fist slightly above the belly button and below the breastbone with thumb side next to abdomen. If you cannot get your hands in position because the child is obese, place your fist on the center of his chest.
   • Grasp your fist with your other hand and give quick upward thrusts into the belly.
4. Repeat giving thrusts until the object comes out and the child can breathe, cough or talk or until he stops responding.

How to help a choking child who stops responding:

1. Lower the child to a firm, flat surface.
2. Tap and shout. If no response:
3. Yell for help. If someone arrives tell him to call 9-1-1 and to get an AED.
4. Check breathing.
5. Give CPR. 1 set of CPR = 30 chest pushes & 2 breaths. Push on the chest 30 times.
6. Open the airway and look in the mouth. If you see an object in the child’s mouth remove it.
7. Give 2 breaths.
   • If the object is still blocking the airway, the chest will not rise. Continue CPR. Check the mouth for the object each time before you give breaths. Pushes or breaths may dislodge the object.
   • If the object is removed or dislodged, continue sets of 30 chest pushes and 2 breaths without stopping to open the mouth.

Phone 9-1-1 and get an AED:

1. After 5 sets of CPR, stop and call 9-1-1 if no one has called.
2. Get an AED if no one has done this. If you cannot quickly locate an AED, return to the child and continue
   CPR after you call 9-1-1.
3. Give sets of 30 pushes and 2 breaths until the child responds or someone with advanced training takes over. Check the mouth for an object before you give breaths. 

NOTE: If thrusts are needed to relieve choking, the child should be seen by a doctor as soon as possible.

What can I do to prevent my child from choking?

Serve food that is appropriate for your child’s age. Young children should not eat the following foods which may cause them to choke:

• hot dogs
• popcorn
• nuts or seeds • hard or raw fruits and vegetables
• round candies • grapes
• plain peanut butter sandwiches (adding jam or jelly decreases the risk of choking) 

Most doctors suggest that the foods in the list above should not be offered to children until they are at least three or four years of age.

Always watch young children while they eat. Insist that your children sit down to eat or drink.

Keep small objects out of reach of young children. Small household objects commonly cause choking.

Examples:

• Coins
• Safety pins
• Paper clips
• Marbles
• Beads
• Latex balloons
• Toys with small parts