What to do if someone is choking - first aid advice from St John Ambulance

Choking in the UK - what the figures show

There are several reasons why we might choke, leaving us unable to breathe. It could happen while we’re eating too quickly, when food becomes lodged in our throat, or when a small object gets stuck and restricts our airways.

Around 300 people die from choking each year in England - a figure that includes both adults and children.

It’s concerning, then, that research from St John Ambulance found that fewer than half of people in the UK know how to help someone who is choking. Even more strikingly, one in three say they have experienced a choking episode where they were unable to breathe and feared they might die.

Yet many people are still unfamiliar with the simple techniques that can help someone who is choking, such as the Heimlich manoeuvre - now commonly known as abdominal thrusts. Others mistakenly believe that certain techniques will help when they actually won’t, which could delay the right response.

There is also a misconception among some people that it is the responsibility of restaurant staff, rather than bystanders, to step in during a choking emergency. This highlights just how important it is for everyone to know what to do and feel confident acting quickly.

That’s why St John Ambulance has spent the past month encouraging 500,000 people to take action. The charity wants people to learn how to recognise when someone is choking, understand the correct first aid response, and potentially save a life.

What should you do if someone is choking?

Since the 2024 relaunch of its Save a Life September campaign, St John Ambulance has delivered vital first aid training to more than 800,000 people. If you would like to get involved or find out more, you can visit their Save a Life September page.

In the meantime, St John Ambulance has shared some helpful advice on what to do and what to avoid when someone is choking. This can help you feel more prepared to respond in an emergency while you wait to receive formal first aid training.

What to do if an adult is choking

• Encourage them to cough - ask the person to cough to try to clear the obstruction themselves. If this doesn’t work, support their upper body with one hand and help them lean forwards.

• Give up to five back blows - if they can’t clear the obstruction by coughing, give up to five sharp blows between their shoulder blades using the heel of your hand.

• Try abdominal thrusts - if the back blows don’t work, give up to five abdominal thrusts. Stand behind the person and place both arms around their upper abdomen, making sure they are still leaning forwards. Clench one fist and place it between their belly button and the bottom of their ribs. Grasp your fist with your other hand and pull sharply inwards and upwards, up to five times.

• Check their mouth - if the obstruction still hasn’t cleared, call 999 or 112 for emergency help.

• Keep going - continue alternating between up to five back blows and up to five abdominal thrusts until the obstruction is dislodged or help arrives.

• If they become unresponsive - carefully lower them to the floor and start CPR.

What to do if a baby is choking

• Give back blows - lay the baby face down along your thigh, supporting their head and neck. Give up to five sharp back blows between their shoulder blades. After each blow, turn the baby over and check their mouth to see if the obstruction has cleared.

• Try chest thrusts - if the back blows don’t work, give up to five chest thrusts. Turn the baby onto their back and lay them along your knees. Using the two-thumb encircling technique, as you would for chest compressions, give sharper compressions to the breastbone (sternum). Repeat up to five times, or until the obstruction is cleared.

• Call 999 or 112 - if the obstruction still hasn’t cleared, call 999 or 112 for emergency help. Continue alternating between back blows and chest thrusts until help arrives, taking the baby with you if you need to make the call.

What not to do if someone is choking

• Don’t try to remove the blockage with your fingers - 1 in 5 people wrongly believe you should use your fingers to pull the obstruction out. Unless you can clearly see the object and it is easy to remove, avoid putting your fingers into the person’s mouth, as this could push the blockage further down.

• Don’t give them water - more than 1 in 10 people wrongly believe you should tell someone who is choking to drink water. This won’t clear the obstruction and could make the situation worse.

• Don’t wait for restaurant staff to step in - nearly 6 in 10 people said they would expect restaurant staff to help first if someone was choking. In an emergency, it’s important to act quickly rather than waiting for someone else to intervene.