What to do

1. 

   If you think a child is choking, ask them ‘Are you choking?'.

   If they can breathe, speak, or cough then they might be able to clear their own throat. If they cannot breathe, cough, or make any noise, then they need your help straight away.

2. 

   Cough it out. Encourage them to cough and remove any obvious obstruction from their mouth.

3. 

   If coughing fails to work, you need to give five sharp back blows. To do this, help them to lean forwards, supporting their upper body with one hand. With the heel of your other hand give them five sharp back blows between their shoulder blades.

   After each back blow, check their mouth and pick out any obvious obstruction.

   • Do not sweep the mouth as this could push the object further down the throat.
4. 

   Squeeze it out. If back blows fail to clear the obstruction, give five abdominal thrusts. To do this, stand behind them and put your arms around the child's waist. Place one hand in a clenched fist between their belly button and the bottom of their chest. With your other hand, grasp your fist and pull sharply inwards and upwards up to five times.

   Check their mouth again, after every thrust.

5. 

   If the blockage has not cleared, call 999 or 112 for emergency help straight away. Repeat five back blows and five abdominal thrusts until help arrives, rechecking their mouth between every blow or thrust.

   • If they become unresponsive at any point assess using Primary Survey DRABC and start child CPR if required.
   • All children who have received abdominal thrusts should be seen in hospital, even if the obstruction has cleared.