Emergency First Aid Guidelines for California Schools 33
CHOKING
FOR CONSCIOUS VICTIMS
Call 9-1-1 or activate EMS after starting rescue efforts.
INFANTS UNDER ONE YEAR OF AGE
Begin the following if the infant is choking and is unable to
breathe. However, if the infant is coughing or crying, DO
NOT do any of the following, but call EMS 9-1-1, try to
calm the child and watch for worsening of symptoms. If
cough becomes ineffective (loss of sound), begin step 1
below.
1. Position the infant, with head
slightly lower than chest, face
down on your arm and support the
head (support jaw; do NOT
compress throat).
2. Give up to 5 back blows with the
heel of the hand between infant’s shoulder blades.
3. If object is not coughed up,
position infant face up on your
forearm with head slightly lower
than rest of body.
4. With 2 or 3 fingers, give up to 5
chest thrusts near center of breastbone, about one
finger width below the nipple
line.
5. Open mouth and look. If foreign
object is seen sweep it out with
finger.
6. Tilt head back and lift chin up
and out to open the airway. Try
to give 2 breaths.
7. Repeat steps 1-6 until object is coughed up, infant
starts to breathe or infant becomes unconscious.
IF INFANT BECOMES UNCONSCIOUS, LAY ON
BACK AND GO TO PAGE 32, RIGHT COLUMN,
STEP 6 OF CPR INSTRUCTIONS USING 2
FINGERS IN MIDDLE OF BREAST BONE FOR
COMPRESSIONS.
CHILDREN OVER ONE YEAR OF AGE & ADULTS
Begin the following if the child/adult is choking and is
unable to breathe. However, if the child/adult is coughing
or crying, DO NOT do any of the following, but call EMS 9-
1-1, try to calm the child/adult and watch for worsening of
symptoms. If cough becomes ineffective (loss of sound),
begin step 1.
1. Stand or kneel behind person and place your arms
under the armpits to encircle the chest.
2. Place thumb side of fist against
middle of abdomen just above
the navel. DO NOT place your
hand over the very bottom of
the breastbone. Grasp fist
with other hand. Press with
quick backward and upward
thrusts.
3. Give up to 5 quick inward and upward thrusts.
4. Repeat steps 1-2 until object is coughed up, or person
starts to breathe or becomes unconscious.
IF PERSON BECOMES UNCONSCIOUS, LAY ON
BACK AND GO TO PAGE 32, RIGHT COLUMN,
STEP 6 OF CPR INSTRUCTIONS.
FOR OBESE OR PREGNANT PERSON
Stand behind person and place your arms under the
armpits to encircle the chest. Place thumb side of fist
against lower half of breastbone and thrust backwards.
1. Reproduced with permission, Pediatric Basic Life Support,
© 1997, Copyright American Heart Association
2. Text based on Community First Aid & Safety, 2002 ,
American Red Cross