What to Do When Someone Is Choking: The Updated 2025 Guidelines

How to Recognize Severe Choking

If a person can still cough forcefully, speak, or breathe, encourage them to keep coughing and stay with them. A strong cough is the most effective way to clear an airway.

• Inability to speak or breathe normally
• A weak or silent cough
• Grabbing or pointing toward the throat
• A change in skin color
• Increasing distress or altered responsiveness

The 2025 Sequence: 5 and 5

• 1. Call for help. Have someone call 911 and bring an AED; if alone, call on speakerphone and start helping.
• 2. Give 5 back blows. Stand to the side and slightly behind, lean the person forward, and strike firmly between the shoulder blades with the heel of your hand.
• 3. Give 5 abdominal thrusts. Arms around the waist, fist above the navel and below the breastbone, quick inward and upward thrusts.
• 4. Repeat: 5 back blows → 5 abdominal thrusts, until the object comes out or the person becomes unresponsive.

When to Use Chest Thrusts Instead

Abdominal thrusts aren't right for everyone. In late pregnancy, or when you can't adequately reach around the person's abdomen, the 2025 guidance recommends 5 chest thrusts in place of abdominal thrusts.

Infants require a different technique entirely — never perform abdominal thrusts on an infant. Infant choking care alternates back slaps and chest thrusts.

If the Person Becomes Unresponsive

• Lower them carefully to the floor and make sure 911 has been called.
• Begin CPR, starting with chest compressions.
• Before giving breaths, look in the mouth for a visible object and remove it only if you can clearly see it.
• Never perform a blind finger sweep — you can push the object deeper.
• Continue CPR until the person responds or EMS takes over.

Common Mistakes to Avoid

• Don't intervene on someone who is coughing effectively.
• Don't give a choking person water.
• Don't reach blindly into the mouth.
• Don't wait to call 911 — severe choking is an emergency.