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Choking - unconscious adult or child over 1 year

Choking - unconscious adult or child over 1 year; First aid - choking - unconscious adult or child over 1 year; CPR - choking - unconscious adult or child over 1 year

Choking is when someone cannot breathe because food, a toy, or other object is blocking the throat or windpipe (airway).

A choking person's airway may be blocked so that not enough oxygen reaches the lungs. Without oxygen, brain damage can occur in as little as 4 to 6 minutes. Rapid first aid for choking can save a person's life.

This article discusses choking in adults or children over age 1 who have lost alertness (are unconscious).

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First Aid for Choking - unconscious adult or child over 1 year

I Would Like to Learn About:

Causes

Choking may be caused by:

Symptoms

Symptoms of choking when a person is unconscious include:

First Aid

Tell someone to call 911 or the local emergency number while you begin first aid and CPR.

If you are alone, shout for help and begin first aid and CPR.

  1. Roll the person onto their back on a hard surface, keeping the back in a straight line while firmly supporting the head and neck. Expose the person's chest.
  2. Open the person's mouth with your thumb and index finger, placing your thumb over the tongue and your index finger under the chin. If you can see an object and it is loose, remove it.
  3. If you do not see an object, open the person's airway by lifting the chin while tilting the head back.
  4. Place your ear close to the person's mouth and watch for chest movement. Look, listen, and feel for breathing for 5 seconds.
  5. If the person is breathing, give first aid for unconsciousness.
  6. If the person is not breathing, begin rescue breathing. Maintain the head position, close the person's nostrils by pinching them with your thumb and index finger, and cover the person's mouth tightly with your mouth. Give two slow, full breaths with a pause in between.
  7. If the person's chest does not rise, reposition the head and give two more breaths.
  8. If the chest still does not rise, the airway is likely blocked, and you need to start CPR with chest compressions. The compressions may help relieve the blockage.
  9. Do 30 chest compressions, open the person's mouth to look for an object. If you see the object and it is loose, remove it.
  10. If the object is removed, but the person has no pulse, begin CPR with chest compressions.
  11. If you do not see an object, give two more rescue breaths. If the person's chest still does not rise, keep going with cycles of chest compressions, checking for an object, and rescue breaths until medical help arrives or the person starts breathing on their own.

If the person starts having seizures (convulsions), give first aid for this problem.

After removing the object that caused the choking, keep the person still and get medical help. Anyone who is choking should have a medical examination. This is because the person can have complications not only from the choking, but also from the first aid measures that were taken.

Do Not

DO NOT try to grasp an object that is lodged in the person's throat. This may push it farther down the airway. If you can see the object in the mouth, it may be removed.

When to Contact a Medical Professional

Seek medical help right away if someone is found unconscious.

In the days following a choking episode, contact a doctor right away if the person develops:

The above signs may indicate:

Prevention

To prevent choking:

Related Information

Abdominal thrusts
Wheezing
Cough
Community-acquired pneumonia in adults

References

American Red Cross. First Aid/CPR/AED Participant's Manual. 2nd ed. Dallas, TX: American Red Cross; 2016.

Atkins DL, de Caen AR, Berger S, et al. 2017 American Heart Association focused update on pediatric basic life support and cardiopulmonary resuscitation quality: an update to the American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2018;137(1):e1-e6. PMID: 29114009 pubmed.ncbi.nlm.nih.gov/29114009/.

Easter JS, Scott HF. Pediatric resuscitation. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 163.

Kleinman ME, Goldberger ZD, Rea T, et al. 2017 American Heart Association focused update on adult basic life support and cardiopulmonary resuscitation quality: an update to the American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2018;137(1):e7-e13. PMID: 29114008 pubmed.ncbi.nlm.nih.gov/29114008/.

Kurz MC, Neumar RW. Adult resuscitation. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 8.

Thomas SH, Goodloe JM. Foreign bodies. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 53.

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Review Date: 2/12/2021  

Reviewed By: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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