Choking first aid

Introduction

Choking occurs when an object or some fluid blocks the airway. A child may choke on or inhale food or small items.

Young children are exploring their world, often by putting things in their mouth. They are also developing their eating skills and are not able to completely chew their food.

When certain items are swallowed, the human body can react protectively by tightening the airway around the object to try to stop it from going deeper into the throat. As children’s airway muscle reflexes are not yet fully developed, children are unable to cough up items stuck in the airway.

Items smaller than a 20-cent piece can choke a child aged less than three years.

Examples of potential hazards include:

• raw, hard fruit and vegetable pieces
• large pieces of meat, bones or sausage skins
• popcorn, nuts, hard lollies and corn chips
• small magnets and batteries
• coins, beads, marbles and small uninflated balloons
• broken toys and smaller toys.

Your child may cough, gag or become unresponsive (where they do not open their eyes or make a noise when you touch or talk to them).

If you see a child swallowing an object or suspect they have, what you do will depend on if your child has an effective cough or an ineffective cough.

Signs of an effective cough include the child:

• crying or talking in response to questions
• being able to cough loudly
• being able to take a breath before coughing
• being fully responsive.

Signs of an ineffective cough include the child:

• being unable to cry or talk
• having a quiet or silent cough
• being unable to breathe
• having a bluish colour to their skin
• having a decreasing level of consciousness.

Effective cough

If your baby or child has an effective cough, encourage them to cough, while keeping them calm, as this may help the object come out.

Ineffective cough and conscious

If your baby or child has an ineffective cough and are conscious, call Triple Zero (000) for an ambulance.

If you are helping a baby

• Place your baby along one of your arms in a head down position, supporting their head with your hand.
• Use the heel of your other hand to give up to five sharp back blows between the shoulder blades. Check between each blow to see if the object has come out.
• If the back blows have not removed the object, lay your baby along your thigh, in the head down position, facing you and give up to five chest thrusts. To do this, place two fingers on the lower part of the chest and push down, as you would with chest compressions during CPR, once per second. Continue to repeat the five back blows and five chest thrusts cycle until the object is cleared.

If you are helping a child

• Lay your child across your lap or lean them forward, supporting their head with your hand.
• Use the heel of your other hand to give up to five sharp back blows between the shoulder blades. Check between each blow to see if the object has come out.
• If the back blows have not removed the object, lay your child on their back, on the floor. Place your hand on the lower part of the chest, as you would for compressions during CPR, and push down up to five times, once per second. Continue to repeat the five back blows and five chest thrusts cycle until the object is cleared.

Ineffective cough and unconscious

If at any time, the baby or child becomes unconscious, call Triple Zero (000) for an ambulance, and begin CPR.  

Prevention tips

In addition to using barriers/guards to create child-safe areas households should be regularly checked for risks by reducing clutter, throwing away damaged items and storing potential hazards out of reach of children.

At mealtimes

• use safe, age-appropriate food
• chop, grate, cook or mash hard fruit and vegetables, i.e. grapes and carrots
• remove bones and skin from meat and serve the meat chopped into small pieces
• do not give whole nuts, hard lollies or other foods that can break off as hard pieces, i.e. apples
• try to minimise laughing and crying during mealtimes
• teach toddlers NOT to store food in their mouths. They should take small sized bites, chew well and swallow each mouthful
• never force feed young children.

Toys

• use age-appropriate toys made by reputable manufacturers and make sure that they comply with Australian Standards and choking hazard guidelines
• use the choke check tool to identify hazards
• teach older children about the potential hazards of small toys when buying new toys
• avoid allowing young children to play with handbags and other items which may hold small objects.

Social/family functions

• always store and dispose of party goods in a safe manner (including food items such as nibbles and serving ware made of polystyrene material as these can break into smaller pieces).