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First Aid for a Choking Adult or Child

Follow these first aid steps when someone is choking. You may hear these steps called the abdominal (belly) thrust maneuver or sometimes by the older name, Heimlich maneuver.

Call 911

Call 911 if the person loses consciousness.

Step 1. Identify choking

  • Ask the person if they are choking. If they can't cough or speak, say that you will help.
Woman holding hands to throat, looking distressed.

Step 2. Grasp from behind

  • If the person is an adult or a child age 1 year or older, move behind them. Slide your palms under their arms, bringing your hands together in front of their body.
  • Make a fist with one hand, placing the flat surface of the thumb and first finger slightly above the bellybutton.
  • Note: If pregnancy or extreme overweight makes this impossible, give thrusts inward against the middle of the person's breastbone.
Man behind woman with arms around her waist and detail of his fist and other hand ready to cover fist.

Step 3. Thrust in and up

  • Cover your fist with the other hand, keeping your elbows away from your body.
  • Pull in and up quickly, using hard thrusts to force air from the person's lungs. This pops out the blockage.
  • Repeat thrusts 5 times. If the object is still stuck, have the person bend over so they are looking at the floor. With the heel of your hand, give 5 firm back blows between their shoulder blades.
  • If they are still choking, continue with 5 abdominal thrusts and 5 back blows until the object comes out or the person faints.
Man giving back blows to woman, with detail of hand placement between shoulder blades.Man giving abdominal thrusts to woman, showing object coming out of mouth.

Step 4. Proceed to CPR

  • If the person becomes unresponsive, call for help and activate the emergency response system.
  • Do CPR if you are trained.
Online Medical Reviewer: Dan Brennan MD
Online Medical Reviewer: Liora C Adler MD
Online Medical Reviewer: Marianne Fraser MSN RN
Date Last Reviewed: 1/1/2025
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