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Normally when we swallow, a flap of cartilage, the epiglottis, moves downwards to stop food being taken into the trachea, or windpipe. Where this fails to happen, food becomes stuck in the airway and choking is said to have occurred. Sometimes the victim may vomit or cough up the foreign body, but occasionally this fails to happen and the casualty may be unable to breathe, either partially or completely. Where a choking victim is unable to breathe, action must be taken immediately, as brain damage will occur within three or four minutes of its being starved of oxygen. Choking is a common cause of accidental death amongst children.

How to recognize a choking attack

1. The victim will probably clutch at his or her throat and be unable to speak or breath without difficulty.

2. The victim will probably become acutely distressed and panicky.

3 Inability to breathe will probably result in fairly rapid loss of consciousness.

Emergency action for a choking attack in an adult

1. Initially, try to get the victim to cough in order to dislodge anything obstructing the airway.

2. If this is not successful, lean the victim forwards and give him or her five hard slaps on the back between the shoulder blades.

3. If this does not relieve the choking then abdominal thrusts can be performed from behind a casualty who is either standing or sitting. For this, pass your hands around the casualty and interlock your hands together just above the navel in the region of the diaphragm and pull sharply inwards and upwards a few times.

4. If the casualty is unconscious, open the airway and remove any visible obstruction. Check the breathing and be prepared to give artificial ventilation.

5. If the obstruction has not been dislodged, move the casualty on to his or her side and administer five firm slaps between the shoulder blades.

6. If this fails to dislodge the obstruction then place the casualty on their back, kneel astride him or her and perform abdominal thrusts with the heel of the hand (one hand on top of the other) just below the breastbone.

7. If this is not successful, telephone 999 for an ambulance and resume artificial ventilation.

Emergency action for a choking child

  • Lay the child across your lap with his or her head down. Slap firmly between the shoulder blades five times.
  • If this is unsuccessful, turn the child over so that he or she faces you on your lap. Support the back of the child and give him or her five firm upward thrusts with one hand above the navel.
  • Should this fail to dislodge the foreign body then try steps 1 and 2 again. If the child becomes unconscious then call an ambulance immediately and begin resuscitation.

Emergency action for a choking baby

Abdominal thrusts should never be used on a child younger than one year.

1. Straddle the baby face down along your arm supporting her head and give her five firm slaps, between the shoulders. Then check the mouth and remove any obvious and visible obstruction.

2 If choking continues, turn the baby over, still supporting the back of her head. Place two fingertips between the navel and the breastbone. Press forward and downward in quick movements and repeat the movement every three seconds up to four times if necessary.

3 If the infant loses consciousness, summon medical help immediately and begin resuscitation.

Never poke your fingers down a choking victim's throat in an attempt to find the obstructing object you will only push it in further and make it more difficult to dislodge. If the object appears in or at the victim's mouth then you may remove it gently.