If an adult is choking and conscious, give 5 back blows followed by 5 abdominal thrusts until the object is expelled or the person becomes unconscious.
What happens when someone is choking
A blocked airway is what makes choking so dangerous. In adults, it usually happens when food isn’t chewed enough or when someone tries to swallow something too big. The American Red Cross points out that conscious choking victims often grab their throat—a clear sign they need help fast. (That universal throat-clutching gesture? It’s the body’s way of screaming, “Help, I’m choking!”)
As of 2026, the American Heart Association (AHA) still recommends rescuers alternate between back blows and abdominal thrusts instead of relying only on the classic Heimlich maneuver. That’s especially true if the rescuer isn’t 100% confident they’re doing it right.
How to help a conscious adult who’s choking
- First, assess the situation. Shout, “Are you choking?” If the person nods or can’t talk, move fast—every second counts.
- Stand behind them. Place one foot slightly in front for better balance. (Think of it like a dance move—just without the music.)
- Give 5 firm back blows. Lean them forward a bit. Use the heel of your hand to strike between their shoulder blades. Don’t be gentle—aim for enough force to dislodge the blockage.
- Next, do 5 abdominal thrusts. Wrap your arms around their waist. Make a fist, place it just above their belly button, then grab that fist with your other hand. Thrust inward and upward sharply—like you’re trying to pop a cork out of a bottle.
- Keep alternating: 5 back blows, then 5 thrusts. Repeat until the object comes out or they stop responding.
What if the object doesn’t come out
- Try a finger sweep—but only if you can see the object clearly. Never poke around blindly; you might push it deeper. (Yes, this really does happen more often than you’d think.)
- If they become unresponsive, call emergency services right away. Start CPR immediately, beginning with chest compressions. According to the American Heart Association, those compressions can help force the object out.
- For obese or pregnant people, abdominal thrusts might not work—or could cause harm. In those cases, use chest thrusts instead. Place your fist in the center of their chest and push inward sharply.
How to prevent choking in the first place
- Chew thoroughly. No talking with a mouth full of food. The CDC reports that choking is a top injury-related killer in adults over 65—so slow down at meals.
- Supervise kids and elderly loved ones closely. Cut their food into tiny pieces. The American Academy of Pediatrics says to skip hard foods like whole nuts, popcorn, and hard candies for kids under 4.
- Take a certified first aid course. Organizations like the American Red Cross offer updated training as of 2026, complete with hands-on practice for thrusts and CPR.
- Avoid multitasking while eating. Put the phone down, stop laughing so hard—just focus on chewing. The NIH warns that distracted eating skyrockets choking risk.
One last thing: Never do abdominal thrusts on someone who’s still coughing or talking. They’re clearing their airway on their own. But if they stop coughing, stop speaking, or turn bluish—act fast. (Seriously, seconds matter here.)
