Užspringimas: ką daryti suaugusiajam, vaikui ir kūdikiui

Choking: What to Do for Adults, Children, and Infants

November 1, 2026

Airway obstruction caused by food or a foreign object is an acute life-threatening condition that can lead to suffocation within minutes. First aid actions must begin immediately, as there is often not enough time to wait for medical personnel to arrive. Accurate situational assessment and age-appropriate actions allow clearing the obstruction and restoring breathing.

Recognizing Choking: Mild vs. Severe Obstruction

Before providing aid, it is necessary to distinguish a mild (partial) airway obstruction from a severe (complete) one, as the management approach differs:

Mild obstruction: The casualty can cough, speak, or make sounds. They can inhale some air. In this case, encourage the person to cough forcefully. Do not deliver back blows while they are coughing effectively, as the foreign object could dislodge deeper.
Severe obstruction: The casualty cannot speak, cough, or breathe. They often clutch their neck with both hands (the universal sign for choking), their skin and lips begin to turn blue, and panic sets in. This condition requires immediate intervention.

When commencing assistance in a severe obstruction, immediately call 112 (or local emergency services) or instruct bystanders to do so.

First Aid for Choking Adults and Children (over 1 year old)

If an adult or a child over 1 year old is experiencing severe choking and cannot cough, apply the following sequence of actions:

5 back blows: Stand to the side and slightly behind the casualty. Support their chest with one hand and lean them forward so that the dislodged object exits the mouth rather than moving further down. Give up to 5 firm back blows between the shoulder blades using the heel of your other hand. Check after each blow to see if the obstruction has cleared.
5 abdominal thrusts (Heimlich maneuver): If back blows fail to clear the obstruction, stand behind the casualty and wrap both arms around their waist. Form a fist with one hand and place it above the navel, well below the breastbone. Grasp your fist with your other hand and pull sharply inward and upward 5 times.
Repeat the cycle: Alternate between 5 back blows and 5 abdominal thrusts until the object is expelled or the casualty becomes unresponsive.

If the casualty loses consciousness, carefully lay them on their back on a hard surface, verify that emergency services (112) have been called, and begin basic CPR: perform 30 chest compressions. Before giving rescue breaths, open the mouth and, if you clearly see the object, remove it. Do not perform blind finger sweeps, as this can push the object deeper.

First Aid for Choking Infants (under 1 year old)

Anatomical characteristics of infants require a different technique. Abdominal thrusts are not performed on infants because they can cause injury to the liver or other internal organs.

Sequence of actions for an infant:

5 back slaps: Lay the infant face down along your forearm, supporting their jaw with your fingers (do not compress soft neck tissue). The head must be lower than the chest. Deliver up to 5 firm back slaps between the shoulder blades using the heel of your free hand.
5 chest thrusts: If the obstruction is not cleared, turn the infant face up onto your other forearm (keeping the head lower than the chest). Using two fingertips, press on the lower half of the sternum (as when performing infant CPR) 5 times. Chest thrusts are sharper and slower than regular CPR compressions.
Repeat and perform CPR: Repeat these steps. If the infant loses consciousness, begin infant CPR and call 112.

Suction Devices for Foreign Object Removal

In everyday situations and home first aid kits, the LifeVac anti-choking device - home kit can be used as an additional tool. It is a non-invasive suction apparatus with a mask designed to extract foreign objects from the airway when standard maneuvers are ineffective.

This device works by creating negative pressure when applied firmly over the mouth and nose. It is important to remember that such devices do not replace primary standard protocols (back blows and thrusts), but serve as an additional option, especially if the casualty is in a wheelchair or if standard maneuvers cannot be performed. When delivering aid, it is also recommended to use personal protective equipment, such as a pair of black nitrile gloves included in kits like the everyday personal first aid kit (boo boo kit). If CPR becomes necessary, a CPR face shield/mask with gloves keychain is used for safety.

The European Resuscitation Council (ERC) does not currently recommend substituting standard guidelines with these devices due to limited high-grade evidence. Therefore, always prioritize back blows and thrusts first.

Comparison of First Aid Steps by Age Group

Age Group	Back Blows	Thrust Technique and Location	Prohibited Actions
Adult	5 back blows with heel of hand between shoulder blades	5 abdominal thrusts above the navel (Heimlich maneuver)	Blind finger sweep in the mouth
Child (over 1 yr)	5 back blows with heel of hand between shoulder blades	5 abdominal thrusts (with less force than for adults)	Excessive force during thrusts
Infant (under 1 yr)	5 back slaps on forearm, head lower than chest	5 chest thrusts with 2 fingers on lower sternum	Abdominal thrusts (strictly forbidden)

Practical Checklist: Choking Management Algorithm

When facing a choking emergency, follow these steps:

Assess the situation: If the casualty is coughing, encourage coughing. If they cannot breathe or speak, act immediately.
Call for emergency help: Call 112 or direct a specific person to call.
Perform 5 back blows: Lean the casualty forward and strike between the shoulder blades.
Perform 5 thrusts: Abdominal thrusts for adults/children; 2-finger chest thrusts for infants.
If unconsciousness occurs: Lay them on their back, check the mouth, and begin CPR. For more details on airway management, read the guide Airway Opening and the guide on CPR and AED importance.