Conscious (Awake) Adult
If the victim cannot cough, speak, or breathe at all, have someone immediately call 911. Perform the Heimlich Maneuver as follows:
  • Stand behind the patient and wrap your arms around their waist. Keep your elbows out, away from the patient's ribs.
  • Make a fist with 1 hand. Place the thumb side of the fist in the middle of their abdomen, just above their navel.
  • Grasp your fist with your other hand, thumbs toward the patient. Press your fist into the patient's abdomen with a quick inward and upward thrust. If you need to repeat the movement, make each new thrust separate and distinct. Repeat the thrusts until the object is expelled or the patient becomes unconscious.
Unconscious (Not Awake) Adult
Have someone immediately call 911 and proceed as follows:
  • Position the victim on their back. Remove all pillows from behind the head.
  • Open their airway using the head-tilt/chin-lift method. Attempt to give breaths. If unsuccessful, reattempt the head-tilt/chin-lift procedure and blow more forcefully. You may be able to blow past the object.
  • If air won't go in, place the heel of 1 hand against the middle of their abdomen, just above the navel. Give up to 5 abdominal thrusts.
  • Then, lift their jaw and tongue and perform a finger sweep to draw the tongue from the back of the throat and dislodge any obstruction that may be in the mouth or throat. Tilt head back, lift chin, and give breaths again. (Never perform a finger sweep on a conscious patient or on the victim of a seizure.)
  • Repeat breaths, thrusts, and sweeps until breaths go in. Once breaths go in, check victims breathing and pulse. If there is no breathing and no pulse, start CPR.
A child is defined as being 1 year to 8 years old. If the child is conscious and sitting or standing, then perform the Heimlich Maneuver as you would for an adult in the same position. Make sure you position your hands properly, keeping in mind the smaller size of the child.

Follow the same procedures as you would on an adult for a child who is unconscious. It is not recommended that you perform blind finger sweeps in a child because of the danger of pushing the object farther into the throat. Restrict your finger sweep to the mouth and the visible part of the throat.

An infant is defined as being 1 year old and younger. Compared to an adult, an infant has a proportionally larger tongue. Suspect an infant is choking if they suddenly start to experience respiratory distress for no obvious reason and watch for the following:
  • A high-pitched, noisy sound during breathing
  • Coughing, becoming gradually weaker and punctuated by wheezing sounds
  • Gagging
  • Bluish colored skin
  • Anxious or agitated behavior
  • Small objects or toys located nearby that could cause choking
Conscious (Awake) Infant
Have someone immediately call 911 and proceed as follows:
  • Straddle the infant over one of your arms, face down and head lower than the rest of the body. Rest your arm on your thigh for support. Support the infant's head by firmly holding the jaw with your hand.
  • With the heel of your other hand, deliver as many as 5 blows between the infant's shoulder blades within 3 to 5 seconds. (The blows need to be forceful, but remember that you are dealing with an infant.)
  • If the foreign body is not expelled, then sandwich the infant's body between your hands. Turn the infant onto the back. One of your hands should support the infant's head, neck, jaw, and chest, while the other hand supports the infant's back. Lay the infant on your thigh or over your lap. The head should be lower than the rest of the body, supported by your hand.
  • Deliver as many as 5 quick downward chest thrusts within 3 to 5 seconds in the same location as you would to provide chest compressions for CPR.
Unconscious (Not Awake) Infant
Have someone immediately call 911 and proceed as follows:
  • Open the infant's airway by tilting the head back and attempt to give breaths.
  • If you are initially unable to ventilate, reposition the head to make sure you have an open airway. Attempt to give breaths again.
  • Perform back blows and chest thrusts as you would for a conscious infant.
  • Look in the infant's mouth. If you see a foreign object, attempt to remove it by performing a finger sweep with your little finger. Do not perform a finger sweep if no object is visible.
  • Attempt to give breaths.
  • Repeat back blows and chest thrusts, look in the airway, and attempt to give breaths. Continue until the object is expelled or the paramedics arrive.