Choking in children (first aid)
Choking can be a medical emergency. If a child or infant is choking, the first aid steps to take depend on how old they are and whether they are unconscious or not.
Research by UK first aid charities in 2014 found that more than a third of parents reported having been in a situation where their child was choking. However, half of those questioned didn't know the official first aid course of action to take for a choking child.
The goal is to release the object blocking the airway to help them breath again.
First assess the severity of the child's choking. If they can cough, encourage them to 'cough it up' until the obstruction or blockage is relieved.
If not, remove any obvious blockage in the child's mouth. Do not poke blindly with your fingers as this can force the object in further and cause injury.
If the child is not able to speak, or stops coughing or breathing, but they are conscious:
For children over a year old
For children over a year old, give up to five back blows then up to five abdominal thrusts, also known as the Heimlich manoeuvre.
The British Red Cross advises performing back blows by standing the child up, leaning them forwards and hitting them firmly on their back between the shoulder blades to dislodge the object.
If the blockage is still there, give up to five abdominal thrusts. Stand behind the child and put your arms around them. Make a fist with one hand, thumb side inwards, and cover it with the other hand. Pull sharply inwards and upwards just above the child's belly button.
If abdominal thrusts do not dislodge the object, try back blows again before repeating the abdominal thrusts.
For babies and infants under a year old
For babies and infants under a year old, the guidance was updated in February/March 2014 advising parents to lay a choking baby along their thigh rather than their arm. The leg is felt to be more secure and gives better support.
A choking infant should be laid face down along your thigh supported by your arm. Give them five back blows between the shoulder blades with the heel of your hand. Check the baby's mouth for any obstruction. If there is still a blockage then turn the infant onto their back and give up to 5 chest thrusts. Use two fingers, push inwards and upwards against their breastbone. If the obstruction does not clear after three cycles of back blows and chest thrusts, call for an ambulance and continue until help arrives.
Illustration: St John Ambulance
If a baby or child of any age stops breathing or becomes unconscious, shout for help if possible and get someone to call 999 immediately. If you are on your own, attempt to resuscitate the child for one minute before calling 999. Do not leave the child alone at any stage - if necessary take them with you while you call for help.