Choking in adults, children and babies: what first-aid guidance describes

How can mild and severe choking be told apart?

First-aid guidance describes mild choking as a person who can still speak, cough or breathe. Such a person can usually clear the blockage alone, and the advice is to encourage them to keep coughing. The Resuscitation Council UK advises against blind finger sweeps of the mouth, because they can push the object further back.

Severe choking is described as being unable to speak, cough or breathe. Without help, the person eventually becomes unconscious. First-aid guidance only moves to back blows when coughing is not possible or is not working.

What do first-aid sources describe for a choking adult?

NHS inform describes leaning the person well forward and giving up to five sharp blows between the shoulder blades with the heel of the hand. If the blockage remains, it describes abdominal thrusts, with a clenched fist placed between the navel and the bottom of the breastbone, gripped with the other hand and pulled sharply inwards and upwards. This is repeated up to five times.

The British Red Cross gives the same order of steps for an adult: encourage coughing, then up to five back blows, then up to five abdominal thrusts. The Resuscitation Council UK 2025 guidance describes alternating five back blows with five abdominal thrusts until the choking is relieved or the person becomes unresponsive. For a pregnant person, the Resuscitation Council UK says abdominal thrusts are not performed, and the hands are placed higher, over the lower end of the breastbone.

When is 999 called, and what if the person stops responding?

NHS inform describes calling 999 if the blockage has not cleared, then repeating the back blows and abdominal thrusts while waiting for help. The Resuscitation Council UK describes calling 999 once choking has not been relieved after the first five abdominal thrusts. The British Red Cross says to call 999 if the person is still choking. St John Ambulance describes calling 999 or 112 for a baby or child if the blockage has not cleared. The wording on timing differs a little between sources, but each links the call to a blockage that has not cleared.

If the person becomes unresponsive, the Resuscitation Council UK describes starting CPR and making sure 999 has been called. NHS inform describes opening the airway, checking breathing, and starting CPR if the person is not breathing.

How does choking in a baby under one differ?

The NHS describes up to five sharp back blows, with the baby lying face down along the thigh or forearm and the head kept low. If the blockage stays, the NHS describes up to five chest thrusts, with the baby face up and two fingers placed in the middle of the chest, just below the nipple line. The NHS describes checking the mouth between each blow or thrust.

Abdominal thrusts are not used on babies under one year old. The NHS says to call 999 if the object does not come out, and to keep alternating back blows and chest thrusts until help arrives. If the baby becomes unconscious, it describes calling 999 and starting CPR. The Resuscitation Council UK likewise describes back blows and chest thrusts rather than abdominal thrusts for infants. The NHS also advises against finger sweeps, which can push the object further back.

What changes for a child over one?

The NHS pairs back blows with abdominal thrusts for children over one. It describes a clenched fist placed between the navel and the ribs, pulled sharply inwards and upwards, repeated up to five times, checking after each whether the object has come out. If the blockage does not clear after back blows and abdominal thrusts, the NHS describes calling 999 and continuing the cycle until help arrives.

The British Red Cross describes continuing cycles of back blows and abdominal thrusts until the object comes out, help arrives or the child becomes unresponsive. St John Ambulance describes starting child CPR if the child becomes unresponsive. For children, the Resuscitation Council UK paediatric guidance describes up to five back blows if coughing is not possible or is becoming ineffective, followed by thrusts.

Is a medical check needed afterwards?

The NHS says that even when the object comes out, medical help is advised, because part of the object may remain or the child may have been hurt by the procedure. The Resuscitation Council UK gives a similar reason for adults, saying that complications and injuries can occur after abdominal thrusts or chest compressions, so a healthcare professional should see anyone treated this way.

St John Ambulance says that every baby who has had chest thrusts, and every child who has had abdominal thrusts, should be seen in hospital, even if the blockage has cleared.

The Resuscitation Council UK published new first-aid guidelines in October 2025, so its current pages are the reference if details change.