What is choking?

Choking happens when something gets stuck in your windpipe and blocks air from getting to your lungs.

In adults, choking may happen when a piece of food goes down the trachea (windpipe) instead of the oesophagus (food pipe).

Sometimes the windpipe is only partly blocked. If you can still breathe, coughing forcefully may help clear the blockage.

What are the symptoms of choking?

Someone might be choking if they:

• clutch their throat
• cough, wheeze or gag
• have trouble breathing, speaking or swallowing
• make a whistling or 'crowing' noise — or can't make any sound at all
• have a blue face, lips, earlobes or fingernails
• look very agitated
• lose consciousness

CHECK YOUR SYMPTOMS — Use the Symptom Checker and find out if you need to seek medical help.

When should I call an ambulance or go to the emergency department?

While you wait for the ambulance, give first aid for choking.

First aid for adults and children over 1 year old

1. Try to keep the person calm. Ask them to cough hard to try to remove the object.
2. If coughing doesn't work, call triple zero (000) and ask for an ambulance.
3. Bend the person forward. Give up to 5 sharp blows on the back, between the shoulder blades, using the heel of one hand.
   Check after each blow to see if the blockage has cleared.
4. If the blockage is still there after 5 blows, give up to 5 chest thrusts. Place one hand on the person’s middle back for support. Put the heel of your other hand on the lower half of their breastbone. Press hard into the chest with a quick thrust.
   Check after each thrust to see if the blockage has cleared.
5. Keep giving 5 back blows and 5 chest thrusts, one after the other, until the blockage clears or medical help arrives.
6. If the person turns blue, becomes limp or loses consciousness, start CPR straight away. Begin with compressions, not breaths.

First aid for babies under 1 year old

After calling for an ambulance:

1. Lay the baby face down on your forearm. Keep their head lower than their body. Support their head and shoulders on your hand.
2. Hold their mouth open with your fingers.
3. Give up to 5 sharp blows on their back, between the shoulders, using the heel of your hand.
   Check after each blow to see if the blockage has cleared.
4. If you can see the object, gently remove it from their mouth with your little finger.
5. If the blockage hasn’t cleared after 5 back blows, lay the baby on their back on a firm surface. Put 2 fingers on the lower half of their breastbone and give up to 5 chest thrusts.
Check after each thrust to see if the blockage has cleared.
6. Keep giving 5 back blows and 5 chest thrusts, one after the other, until the blockage clears or medical help arrives.
7. If the baby loses consciousness, start CPR straight away. Begin with compressions, not breaths.

What not to do

• Don't ask the person if they're okay. Instead, ask them if they are choking. They may have difficulty breathing for another reason, such as asthma.
• Don't try to do the Heimlich manoeuvre (abdominal thrusts). This can break ribs and damage internal organs.
• Don't pick up a choking child and turn them upside down.
• Don't hit their back while they are upright.

What should I do if I am choking?

If you are choking and alone, stay calm and try to get help. Try to clear the blockage with a forceful cough.

When should I get medical help after choking?

See your doctor if you have any of these symptoms after choking:

• a cough or wheeze that doesn't go away
• coughing up blood
• a fever
• difficulty breathing

What causes choking?

Babies and young children put all sorts of things in their mouths. This can lead to choking if they put small items in their mouths.

Choking can happen in adults and children if an object becomes fully or partly stuck in the windpipe. This is known as a foreign body airway obstruction.

How is choking diagnosed?

If your doctor thinks you have been choking, they will try to find out:

• what happened
• when it happened
• what you may have inhaled

To help diagnose choking, your doctor will:

• ask you questions — if you can’t speak, they may ask questions to the person who was with you
• check your breathing and listen for wheezing or uneven breath sounds
• check your ears, nose and throat for other objects
• look for signs, such as drooling, voice changes, blue lips (called cyanosis) or coughing

How is choking treated?

In the emergency department, doctors can use different techniques to clear your windpipe.

Sometimes, even if the choking episode seems to have passed, an object might still be stuck further down. You may need a test called a bronchoscopy to check your airways. If something is stuck there, it can be removed to prevent infection.

You might need to stay in hospital to make sure there is no damage to your lungs.

FIND A HEALTH SERVICE — The Service Finder can help you find doctors, pharmacies, hospitals and other health services.

Who is at risk of choking?

Anyone can choke but babies and young children are most at risk because:

• their airways are soft and narrow
• they are still learning how to eat safely
• they often put things in their mouths to explore

Other people who have a higher chance of choking include:

• adults over 65 years of age
• people living with disability, such as cerebral palsy, intellectual disability or dementia
• people with epilepsy — they may choke during a seizure

ASK YOUR DOCTOR — Preparing for an appointment? Use the Question Builder for general tips on what to ask your GP or specialist.

What are the complications of choking?

If your windpipe is completely blocked and you can’t breathe, it's a medical emergency and can lead to death.

Choking games

The 'choking game' is a dangerous activity where people choke themselves or others to feel a 'high'. This is also known as the pass-out or blackout challenge.

You may think you can stop before you pass out but you may be wrong. This can lead to brain damage or death, especially if done alone.

There have been reports of young children doing choking games, often due to peer pressure or to feel a thrill. Parents may not be aware.

Signs that your child might be taking part include:

• showing interest in choking
• bruises on their neck or wearing clothes that cover their neck
• tiny red spots on or around their eyes or eyelids
• headaches
• irritable behaviour
• spending a lot of time alone and seeming confused after
• ropes, scarves or cords in their bedroom

Talk to your child about the dangers of choking games. Understanding the risks may stop them from trying it.

Can choking be prevented?

There are steps to help lower the chance of choking for babies, children and adults.

Prevent choking on small objects in babies and children

Keep small items out of reach of babies and children. Common choking hazards include:

• batteries — keep toy battery covers secure and avoid toys with button batteries
• toys with small parts, such as marbles or bouncy balls
• polystyrene beads inside bean bags and stuffed toys
• coins, safety pins, magnets, buttons and beads
• water-absorbing beads used in some toys
• balloons — especially broken, popped or deflated

Make sure your child's toys meet Australian safety standards and are not broken or damaged. Find out more about choosing safe toys.

Use the Choke Check tool from Product Safety Australia to help you spot choking hazards.

Preventing choking while eating in children

Here are some things you can do to reduce your child's chance of choking while eating:

• Make sure your child sits down to eat and drink. Don’t let them eat lying down or running around. Watch your child when they eat.
• Cut food into small pieces and encourage them to chew well.
• Avoid giving risky foods, such as lollies, raw apple or carrot, whole grapes, nuts and popcorn until they are old enough.
• Cook, grate or mash hard foods to suit your child's age and developmental stage.
• Cut grapes lengthways and then in half again. Remove bones from meat and fish. Cut sausages and take off the skin.
• Don't force your child to eat.

Read more on food textures and how to introduce your baby to solid foods.

Preventing choking in adults

• Eat and drink slowly and chew food well.
• Take small bites, especially of risky foods, such as popcorn or nuts.
• Don’t eat while talking, laughing or lying down.
• Cut food into small pieces, especially if you have a dry mouth or difficulty chewing or swallowing.

Resources and support

The best way to help with choking is to learn first aid, especially if you care for a child.

You can find first aid courses through:

• St John Ambulance Australia
• Royal Life Saving Society Australia
• Australian Red Cross

Download and read the St John Ambulance fact sheets on choking first aid for adults and infants.

Use the Product Safety Australia Choke Check tool to help you find choking hazards.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available 24 hours a day, 7 days a week.

Do you prefer to read in languages other than English?

Raising Children Network has information on choking first aid for babies in many community languages.