Title: How to help someone who is choking
Course: Non-Communicable Diseases, Emergency Care and Mental Health Part 1 - Ethiopia (Full)

How to help someone who is choking

In your village you may have seen someone choking before – perhaps a child or an adult. Were you able to help them? This is what you should do:

- If the person is breathing, encourage him/her to continue breathing and coughing.
- Slap the person vigorously on the upper back with your palms, while bending the person forwards. Do this several times (see Figure 8.5a).
- If back slapping does not remove the obstruction, try giving abdominal thrusts (see Figure 8.5b and Box 8.1).

Figure 8.5 Techniques to help someone who is choking: (a) back slapping, (b) abdominal thrust to force the obstruction up and out of the airway.

Box 8.1 Abdominal thrust technique to remove an airway obstruction

1. Position yourself behind the person and put both of your arms around the upper part of the abdomen. Make sure that he/she is bending forwards.
2. Make a fist with one hand over the person's upper abdomen (between the bellybutton and the breastbone), then grasp the wrist of the fisted hand with the other hand (Figure 8.5b).
3. Pull both your hands sharply inwards and upwards. Do this up to five times. This helps you to increase the pressure in the blocked airway in order to dislodge the obstruction.
4. Usually, this will have removed the obstruction: however, if not, repeat the back slapping and abdominal thrust procedures two to three times more.
5. If the person becomes unconscious, lay them on their back, open their mouth and try to remove any obstruction with your fingers or forceps if you have them. Begin 'rescue breathing' as described in Section 8.4.1.

A child is choking and comes to you coughing and screaming. Which technique would you use first and why?

Show answer

You should first try backslaps and encourage coughing (Figure 8.6). This is the first step for someone who is choking but who can breath, speak and cough. In this case, the child's coughing and screaming indicates that the blockage is partial because they can still breathe.

Figure 8.6 This poster is displayed in many Health Posts in Ethiopia to teach parents how to help a child who is choking. (Photo: Basiro Davey)