Choking First Aid: What to Do When Someone Can't Breathe

Choking kills quickly and quietly — a blocked airway can cause unconsciousness in about a minute, and the person often can't call out for help. The response taught in Australia is simple, but the order matters, and it's different from the "Heimlich manoeuvre" you may have seen in American films — abdominal thrusts are not recommended here.

First: is the blockage partial or complete?

If the person is coughing forcefully or can speak, the airway is only partly blocked. Don't slap their back — a hard thump at the wrong moment can move the object deeper. Encourage them to keep coughing and stay with them.

If they can't cough, speak or breathe — silent effort, gripping the throat, lips turning blue — the blockage is severe. Act now and have someone call 000.

Up to 5 back blows

Lean them well forward (a small child face-down across your lap; an adult over the back of a chair works too). With the heel of your hand, give a firm blow between the shoulder blades. Check after each blow — the goal is to dislodge the object, not to deliver all five.

Then up to 5 chest thrusts

If back blows fail: place one hand in the centre of the chest (the same spot as CPR compressions) and give a sharp inward thrust — slower and sharper than a compression — again checking between each. Keep alternating 5 back blows with 5 chest thrusts until the object shifts or help arrives.

Babies are the same pattern, gentler

Lay the infant face-down along your forearm, head lower than chest, and use two fingers for chest thrusts with the baby face-up along your thigh. Never hold a choking baby upside down by the legs, and never put fingers blindly down any casualty's throat.

If they become unconscious

Lower them to the ground, tilt the head, and start CPR immediately — chest compressions themselves often shift the blockage. This is exactly the scenario where hands-on practice pays off: our 90-minute CPR course ($45) and First Aid course ($95) at Dandenong drill choking response on adult, child and infant manikins until the sequence is automatic.