Children who are choking cannot cry, cough or speak. They may produce high pitched sounds. Unlike adults, they may or may not use the universal choking sign of placing their hands around their throats.
So you must determine if they can speak or cough. Ask the child to speak. Ask the child if they are choking? If they are choking, don't frighten a child by grabbing them. Tell them that you will help them and proceed to the next step.
- Stand behind the child and get down on your knees if you need. Do not raise the child up. Should the child become unresponsive you will not want to lose your balance and fall.
- Make a fist with one hand just above the belly button. Cover the fist with your other hand. Perform abdominal thrusts (Heimlich maneuver) inward and upward repeatedly until the foreign body is expelled or until the child becomes unresponsive.
- If the child becomes unresponsive, lower the child to the floor. If someone else is around, have them call 9-1-1.
- Begin 30 chest compression, look in the mouth for a foreign object, remove if seen. Attempt a breath, if no chest rise, reposition airway and attempt another breath. If still no chest rise, continue with 30 compressions; look in mouth for object, 2 breaths. Repeat sequence until 2 breaths are successful or obstruction is cleared and child is breathing.
Continue care until help arrives
If you do see the object in the child's mouth, you may remove it. Then give two rescue breaths. This is to help re-oxygenate the child. Then check the carotid pulse closest to you. If no pulse, begin child CPR. If there is a pulse but no breathing, continue rescue breathing at the rate of 1 breath every 3 seconds and reassess every 2 minutes as long as there continues to be a pulse.