Choking is a common cause of accidental death and first aiders should be aware of the basic management of choking. First aiders should initiate care in cases of severe choking when a person is unable to speak, makes the universal choking sign, or is turning blue. When witnessing someone believed to be in severe choking you should initiate care without delay.

In adults, first attempt to deliver five back blows to attempt to dislodge the object. If this does not work then move onto the Heimlich maneuver. 

The Heimlich uses abdominal thrusts to place pressure on the diaphragm simulating a coughing reflex in the choking victim to help expel the object. To perform the Heimlich maneuver stand behind the victim and wrap your arms around their abdomen. Create a fist with one hand and place the thumb side against the victim’s stomach above the belly button but below the rib cage. Place your other hand over the fist and thrust inward, hard and fast, until the victim begins breathing or goes unconscious.

If the victim becomes unconscious and stops breathing normally then begin CPR immediately. 

The Heimlich maneuver can be applied to any person or child who is unable to stand. For children, you should kneel down to perform abdominal thrusts.

All victims who require the Heimlich maneuver to be performed should be advised to seek medical attention. There is a small risk of damage to underlying organs in the abdomen.