Almost choking: don't hit on the back!

I've read a few threads that have reminded me of something that I learned during my recent Red Cross first aid training:

Apparently if a child or adult is struggling with something in their mouth and seem to be choking it is NOT safe to thump them on the back. They said that this could actually make them choke on it. Save the thumping on the back until their breathing has been completely blocked and they are doing a silent kind of struggle.
The first thing to do is tilt them forward... if a child: then over your knee. Then if this fails to dislodge it then thump firm and hard between the shoulder blades so as to use any air in the lungs to push the obstruction upwards.

My instructor said that if a child can still get air in, even just a little bit to just leave them alone to cough it up. He gave the example of when he had to help a child choking on a small toy... he said that it came out when he tilted the child forward but if he had thumped then the piece could have actually been shaken down deeper into the throat.

I was surprised to hear that I had been doing the wrong thing all these years. It's such a reflex thing to thump a child's back if they are starting to choke on anything isn't it? But this is current official first aid training... hard to argue with I guess. :dunno:

THis is correct, i have always tilted head down before a tap between the shoulder blades.
i am super speed now... i bet the kids dont even realise why they are hanging this way lol!

Thanks for the reminder.. Its always good to know what to when things like this happen

Yeah I think thats part of the reason they tell people not to do the hymlick manouver anymore either, and I think that's what everyones first instinct is I guess. But it all changes.. CPR has TOTALLY changed since I did it.

Oh dear. I thinks I need to do a first aid refresher course...

I really enjoyed doing my course. It was the Senior Level 2 course. Our private health insurance company paid for it. It was done in the evenings for a month.

:D I just completed my L2 Senior First Aid cert only yesterday. I did 2 full days. I learnt a lot. It was for work, so they paid for it. I'm sure it'll come in handy at home too.

Good reminder Bath.

Also never put your fingers in their mouth to try and remove whatever is caught. My GF did this recently when her 2 yo DD was choking on a piece of sausage. Her DD wasn't breathing and she thought she could get it out, but when she put her fingers in, her DD clamped her jaw shut (which is common apparently). My GF's fingers were stuck in her mouth, getting very badly squashed. In the panic, my GF pulled her fingers out and pulled alot of skin off them. Ambulance arrived, her DD started breathing again, sausage must have moved down. DD went to hospital and thankfully had only very mild injuries. My poor GF ended up in hospital for 4 days and had microsurgery on the nerves in her fingers which were very badly damaged. She still had limited sensation in one of her fingers.

Good reminder Bath! Thanks.

And Mel - OUCHIES. That is something I would not have thought of...

Geeze Mel! Yep, I read too that you should only sweep a mouth of a child if you can see the object... and I think it did say to do this for babies. But if a 2yo could do that! :o I'll think twice before putting my fingers in a child's mouth next time too!

My daughter had a very serious choking incident. She wasn't breathing, was unconscious and blue/purple turning white/grey and blotchy. I flogged her many times on her back (I don't remember how many) as I found her like this not actually struggling she was past that. Fortunately with the repeat flogging it unblocked slightly for some air to go down and she had a massive vomit then which cleared the melted, gooey, chunky chocolate out. It took her 30mins to actually breath normally. She had chest recession, wheezing and tracheal tug. I felt so mean as her back actually bruised but at least she is alive.

Lordy that's scary about the fingers. The one and only time my DD1 choked (ironically on a piece of soft pear) I was able to hook it out with a finger. Not sure I really wanted to wait until she stopped breathing to test the other stuff out...!

ETA right Emmy after that I'm properly scared now. All power to you, you did the right thing and thankfully it worked. Not going to read any more of this thread cos it's bringing out all the choking stories!!

My GF and her DH were both trying to prize open her mouth but it was locked shut and tight! She said she has never felt pain like it (and she has had 5 kids!!!) and there was nothing they could do to open it. Apparently it was an involuntary reflex, like lock jaw. But my fingers won't be going into my kids mouths after her telling me that!!!

DD1 had a choking incident with a piece of rockmelon at a 1st birthday party and my first instinct was to turn her upside down (like we do puppies to get them breathing) and swing her upside down and gave her a little thump in between the shoulders. It came out and then she had a huge vomit as well.... it was scary but I was glad my first instinct was to do what you are supposed to do.

Bumpity bump :)

I keep trying to tell DF this but he still does it everytime DS starts choking on something :wall:

I learnt the same when I did my first aid course about 12 years ago. I was 14 when I did it. Both times my DS choked on something were different & both times I had to do different things.
The first time it was a water bottle lid. It lodged in his throat & I tipped him almost upside down & thumped him & it came straight out. The second time was on a red frog lolly. First instinct told me to thump, but I knew not too. Not only was he just breathing, but it was sticky lolly. It wouldn't have helped. So this time I just held forwards him over my lap & called an ambulance, coz I had no idea how to get it out.
If they are coughing, don't thump.

ETA - a friend of mine told me about the fingers too. The muscles can go into spasm or something, making things worse.

Great, thanks for posting! Ill remember that:)

Sorry I didn't see this earlier.

tilting the individual upside down as a first response is a good idea. However, I understand the reason they are not educating people to instantly give the 4 blows to the back, is that it must be done in a particular way to prevent the person swallowing the item they are choking on.

It is also important to keep in mind that there are other things you can do to encourage the object to move. My FIRST port of call is to always ask the person to do a big cough for me. Often that pressure is enough to dislodge the item.

If the person is able to cry or talk, they are getting air in and the situation is much less catastrophic than if the person can't.


If you do find yourself needing to administer back blows to assist in dislodging an item from someone's airway you should;

Put them over your knee (size permitting ;)) face down with their head lower than the remainder of the body
Administer 4 firm strikes to the back between the shoulder blades
The blows should be administered with an open hand and in the direction the person is tilting (so towards their head).


Re putting your fingers in their mouth... NO WAY! NEVER do this. You could push the object further down the airway and/or get your fingers bitten off ;) Never put your fingers into an unconscious persons mouth either unless it is really really really necessary!

It is always scary when we find ourselves with someone choking but it is important to remain calm. If you are calm, the person is less likely to panic. If they panic, everything constricts and they may go into further respiratory distress.

Great comment MG.

I'd like to remind people that keeping your first aid up-to-date is a small investment for a lot of gain. We had a story of one of the first aid blokes at work performed CPR (successfully) on the grandfather of a bride who's wedding he was attending when he had a heart attack. Such a simple thing as a day a year saved this gent's life, and gave the bride a happy wedding memory.

First aid techniques are constantly refined to make it easier and to take advantage of new technology - don't put it off, sign up for a course today.

Thanks Bath, also thanks to everyone about the ice to the head (NOT to put ice on head injuries) thread, I think from yesterday....I love BB, the things I learn....and :( for all the choking stories, it sure is scary....

Laurin xxx

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Yeah I think thats part of the reason they tell people not to do the hymlick manouver anymore either, and I think that's what everyones first instinct is I guess.

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Thank Hollywood for that. I don't know if it's ever actually been taught in Australia, I could be wrong, but I thought I heard that somewhere. I have been Senior First Aid certified since 1993, and it has never been included in a course.

I have been present at two choking incidents - one at a Mothers' Group where a 1 year old was walking around with a rice cake :shakehead: and everyone, including an RN, just started to panic and scream. The other was a two year old eating popcorn, and both happened in the same week, so I am SO wary of kids eating these foods now!

my ds chokes most days he is 20 months old. He does the silent chokes so i first do the lean forward then fingers down throat then hit back.

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Thank Hollywood for that. I don't know if it's ever actually been taught in Australia, I could be wrong, but I thought I heard that somewhere. I have been Senior First Aid certified since 1993, and it has never been included in a course.

I have been present at two choking incidents - one at a Mothers' Group where a 1 year old was walking around with a rice cake :shakehead: and everyone, including an RN, just started to panic and scream. The other was a two year old eating popcorn, and both happened in the same week, so I am SO wary of kids eating these foods now!

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The Heimlich manouevre has never been a standard part of first aid in Australia, I think, but it certainly isn't now. People know it from the movies... but there isn't actually clinical evidence that it works better than the methods mentioned above, and there is plenty of evidence that it can do more harm than good.

Time for a :bump:

Didnt know this thread existed but definately should be stickied atleast! We had a choking incident (ds1 with an ice cube) a few weeks back that terrified me. Dh put him upside down and out coughed the ice cube (although I guess it would eventually melt and not be an obstruction anymore but ds1 was turning blue from being unable to breathe, pretty big ice cube and he was panicking).