It honestly surprises me how close people come to death every time they eat something. According to the National Safety Council, 2500 people died from choking in the USA in 2009! The most common cause of an obstruction? Hot dogs.
But really, any type of food or object in the mouth can cause a partial or full airway obstruction. As a paramedic, keeping the airway open is a top priority because an occlusion to the airway can be a life threatening condition.
How do you know if someone is choking? There are a few very obvious signs and symptoms that a person will have when they are have a full or partial airway obstruction.
Heavy coughing and gagging are signs of a partial airway obstruction. These cases are less severe, but very uncomfortably for the victim. In a partial obstruction, the victim is still able to pass air through their wind pipe and may even be able to speak.
In a full airway obstruction, the victim will not be able to pass air and likely will not be able to speak or cough. Their skin may start to turn blue from lack of oxygen and they will be very panicked. These are the life threatening obstructions that require intervention.
So what can you do if a family member or even a stranger near you appears to be choking? Follow the steps below. Note: these maneuvers are only for a choking adult. Relieving and obstruction in a child is very different.
Ask The Victim If They Are Choking And If They Need Help
This may sound obvious, but really what you are doing is getting consent to help this person.
If they are able to talk, they may tell you that they are choking. These victims will be able to cough and that is the best thing that they can do. You should not attempt any sort of rescue maneuver on them because you may make their partial obstruction a more life threatening full obstruction.
If the victim is not able to talk or cough, then it is time to intervene. A victim with a full obstruction may be holding their hands near their throat. This is the universal sign for choking. If the victim nods their head indicating that they are choking, ask them if they need help. If the victim indicates they need help or cannot respond, move on to the next step.
Call 911 And Perform The Heimlich Maneuver
The Heimlich Maneuver is meant to imitate a forceful cough for this conscious victim with a full airway obstruction. Since a person with a full obstruction cannot get air in for a cough, you need to force whatever air that is in their lungs out so that the obstruction can be relieved.
First you position yourself behind the patient. Place one of your legs between the victim’s legs to keep them stable. Next make a fist with your left hand and place the knuckle of your thumb just above the victim’s belly button. Wrap your right hand around your left so that your arms are now encircled around the victim.
Now you want to thrust your hands inward and upwards toward the victim’s chest. Do not be gentle when you are doing this! The thrust with your hands should be quick and hard imitating a cough. Do this until either the obstruction is relieved or the patient becomes unconscious. If they become unconscious, move onto the next step.
Note: If the victim is so large that you cannot wrap your arms around their abdomen, position your hands on the middle of their chest and perform chest thrusts until the obstruction is relieved or they are unconscious.
Lay The Victim On The Ground And Start CPR
You’ve completed the steps above, no object has come out of the victim’s mouth and now they are unconscious. If this happens, it will be very hard for you, the rescuer, to hold this person up and continue the Heimlich.
At this point you should lay the person on their back and perform modified CPR (see our article, “Emergency CPR” for greater detail). Once the victim is placed on the ground, position yourself on the side of them. Next place the heel of one of your hands between the victim’s nipples. Place your other hand on top of your first hand. Lean over the victim, lock your elbows and shoulders, and press down on the victim’s chest forcefully. The movement should come from your hips, not your arms and you may feel the victim’s breastbone break if you are doing this correctly.
Perform 30 chest compressions then look in the victim’s mouth. If you see an object, attempt to scoop it out by hooking your finger around the back of it and out the mouth. If you do not think you can scoop it out or it is too deep in their mouth for your finger to reach, do not put your fingers in the victim’s mouth.
Perform another 30 chest compressions and repeat this sequence until EMS arrives or the obstruction is relieved. If you are able to successfully relieve the obstruction from the victim’s mouth, lay them on their side until EMS arrives. This is so that if the victim vomits, they won’t create another obstruction.
So there you have it, the steps you need to help a choking victim. These maneuvers are very effective in most cases and can seriously save someone’s life. All CPR classes will go over these maneuvers and I highly recommend taking a class for practice.
Also if you want to see these maneuvers in action, YouTube has plenty of videos. The best part about helping a choking victim is that you do not need any equipment! Just having the knowledge is enough to save someone’s life.