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First Aid: Heimlich Maneuver for Choking (Adult or Child)

Follow these first aid steps when someone is choking. You may hear these steps called the Heimlich maneuver.

Call 911

Call 911 if the person loses consciousness.

Step 1. Identify choking

  • Ask the person if they are choking. If they can't cough or speak, say that you will help.

Woman holding hands to throat, looking distressed.

Step 2. Grasp from behind

  • If the person is an adult or child over 1 year old, move behind them. Slide your palms under their arms, bringing your hands together in front of their body.

  • Make a fist with 1 hand, placing the flat surface of the thumb and first finger slightly above the bellybutton.

  • Note: If pregnancy or extreme overweight makes this impossible, give thrusts inward against the middle of the victim's breastbone.

Man standing behind woman with arms around her waist. Inset shows his fist next to her upper abdomen and his other hand flattened and ready to cover his fist.

Step 3. Thrust in and up

  • Cover your fist with the other hand, keeping your elbows away from your body.

  • Pull in and up quickly, using hard thrusts to force air from the person's lungs. This pops out the blockage.

  • Repeat thrusts until the person coughs or speaks. or they become unresponsive.

Man standing behind woman with arms around her waist and fist at her upper abdomen, with other hand flat on fist. Arrow shows him pressing in and up with his fist. Blockage is being expelled from woman's mouth.

Woman bending over the back of a chair to perform choking self-rescue.
If you are alone and choking, perform thrusts on yourself, or thrust your abdomen against a chair back, sink edge, or railing.

Step 4. Proceed to CPR

  • If the person becomes unresponsive, call for help and activate the emergency response system.

  • Do CPR if you are trained.

Online Medical Reviewer: Eric Perez MD
Online Medical Reviewer: Rita Sather RN
Online Medical Reviewer: Tara Novick
Date Last Reviewed: 2/1/2022
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