Choking: equip yourself to deal with this common life-threatening situation

Vital information for parents, childcare workers, and the general public

Sunday, February 15 2015

What do American singer and actress Cher, former United States President Ronald Regan and American actress Ellen Barkin have in common? They were the lucky ones who lived to tell the tale because someone knew what to do when they almost choked to death.

“Theirs are well documented success stories. However, the outcome of choking incidents is not always favourable. At some point in our lives, we are all likely to witness someone choking. This can be a frightening experience. However, if you familiarise yourself with what to do when someone is choking, you could make the difference between life and death.

David Stanton, Gauteng campus manager of Netcare Education’s Faculty of Emergency and Critical Care, says choking is one of the most common life-threatening hazards. He actively encourages everyone to learn how to help someone in this life-threatening situation.

“Choking occurs either because of the total obstruction of a person’s airway by a swallowed object, or when something blocks the windpipe instead of going down the food passage,” Stanton explains.

The blockage in the airway limits or completely cuts off the flow of air into the lungs, which can result in the person losing consciousness. “If the airway is not cleared in time, the person could die of suffocation. Choking is, therefore, a medical emergency.”

Stanton notes that suffocation can occur within minutes, as one cannot survive without sufficient air to the lungs, which supply the brain with vital oxygen. “This means that when faced with someone who is choking, time is of the essence and you have to take the correct action immediately to keep the individual alive until professional help arrives.”

“As emergency medical practitioners, we see it as our duty to inform the public of the techniques that can help save a person’s life when a trained healthcare practitioner is not immediately on hand to assist,” says Stanton. 

  • How can you tell if someone is choking?

Establish whether the person is choking. A person with a blocked airway will be unable to cough, talk or breathe and will most probably be clutching at his or her throat. “Ask loudly and clearly, whether they are choking – in most cases, the person will be able to signal yes or no. This will help rule out other possibilities, such as an allergic reaction, which requires different treatment.”

“Assess the situation and, if necessary, have someone phone for emergency medical assistance. If you are alone with the choking person, phone for assistance but put your phone on speaker-mode so that you can begin helping them while calling for help. It is imperative that the caller explains the nature of the emergency and the precise directions to the location.”

“If the person is coughing forcefully, do not interfere with their spontaneous coughing which may help expel the blockage. If the obstruction becomes severe, a silent cough or laboured breathing will become evident.  Worse still, the person may become unresponsive.”

  • Heimlich Manoeuvre

Try to dislodge the obstruction by administering a series of forceful abdominal thrusts. This is also called the Heimlich Manoeuvre, and it should only be attempted if the choking patient is an adult or a child over the age of one year.

“The Heimlich Manoeuvre involves an abdominal thrust that creates an artificial cough, which may be forceful enough to clear the airway. Quick, upward abdominal thrusts force a rush of air out of the lungs, similar to a cough, and this can force whatever is causing the person to choke out of the airway,” explains Stanton.

Step by step guide to the Heimlich Manoeuvre

  1. Lean the person forward slightly and stand or kneel behind them.
  2. Make a fist with one hand. Put your arms around the person and grasp your fist with your other hand above the choking person’s navel and just below the ribcage.
  3. Make a quick, forceful movement, angled inward and upward, in an attempt to assist the person to cough up the object.
  4. This manoeuvre should be repeated at least five times. Keep checking to see if the object has been dislodged from the patient’s airway.
  5. If the Heimlich Manoeuvre does not work initially, hit the person firmly between their shoulder blades several times using the heel of your hand, then repeat the Heimlich Manoeuvre.

“Remember that while the Heimlich Manoeuvre can save lives, it can also cause injury. It is therefore important that the person sees a doctor after having this technique performed on them to rule out potential injuries.”

“Abdominal thrusts should however not be used on women in an advanced stage of pregnancy or people who are obese. Instead, it is advisable to use a technique known as chest thrusts for such patients,” notes Stanton.

  • Chest thrusts

If the person becomes unresponsive, or is pregnant or obese, then it is advisable to use chest thrusts in an attempt to clear the obstruction.

  1. Stand behind the patient, as with the Heimlich Manoeuvre.
  2. Put your arms around the patient’s chest.
  3. Give sharp, forceful squeezes against the chest, with the aim of squeezing air out of the chest.
  • Small children (younger than a year old)

If a child younger than one year is choking, you have to be extremely careful when trying to remove a foreign object in order to avoid injury.

  1. Sit down and place the child facedown on your forearm, which rests on your thigh for stability.
  2. Angle the child so that their head and neck are lower than the torso.
  3. Thump the middle of the child’s back firmly with your other hand several times.
  4. This motion and gravity should together help to clear the blockage from the airway.
  5. Keep checking the mouth to see whether the object has been dislodged.
  6. If this doesn’t work, you can turn the infant onto their back, and give five sharp chest compressions, in the middle of the chest.

Should a person of any age lose consciousness, you need to start performing cardiopulmonary resuscitation (CPR).  Continue CPR until the object is visible and can be removed, or the paramedics arrive.

“It can be a frightening experience to deal with a person who is choking, but it is essential to keep calm and follow the steps detailed above, as they represent the best chance of helping someone who is choking,” Stanton says.

“It is a good idea to sit down with your family and anyone who regularly looks after your children, and talk through the steps of helping a choking patient. You never know when this vital information might save the life of one of your loved ones, or even your own.”

“Remember, it is essential that emergency medical services are summoned as soon as possible when someone is choking because, if these steps do not work, choking can very quickly result in the person losing consciousness and suffocating. The sooner paramedics are called, the sooner they will arrive on scene and the greater the chance of a positive outcome.”



Issued by:           Martina Nicholson Associates (MNA) on behalf of Netcare 911

Contact:              Martina Nicholson, Graeme Swinney, Meggan Saville or Devereaux Morkel

Telephone:         (011) 469 3016

Email:                   mar[email protected], [email protected], [email protected], or [email protected]