Choking is a life-threatening medical emergency that requires immediate action. In 2022, there were 458 choking-related deaths, according to official Office for National Statistics figures, a 16% increase compared to 2013.
For workplace first aiders, knowing how to recognise the signs of choking and deliver effective choking first aid can make the difference between life and death. Quick intervention helps restore breathing and prevent oxygen deprivation and potential brain damage.
Here’s an overview of how to respond to a workplace choking emergency:
Call 999 if choking is identified 📲
Encourage coughing
Give 5 back blows
Give 5 abdominal thrusts
Repeat the cycle 🔁
If the person becomes unresponsive, start CPR
Do NOT use blind finger sweeps to try to remove a foreign body from the mouth.
Keep reading for a detailed breakdown on what to do if someone is choking in your workplace and how to deliver timely and effective choking first aid.
This guide explains whether first aid training is a legal requirement in the UK and when employers must provide trained first aiders. Continue reading for further details of employers' legal responsibilities to provide adequate first aid provision in the workplace.
What is first aid for choking?
The recommended first aid procedure for choking differs between adults, children and infants.
Below are step-by-step instructions for a choking adult, a child above the age of 1, and an infant one year and below.
Step-by-Step First Aid for Choking (Adults and Children Over 1 Year)
Call 999
If choking has been identified
Encourage Coughing
Ask, “Are you choking?” If the person can, support them and encourage coughing to
clear the obstruction.
Back Blows (5 sharp strikes)
Stand slightly behind the person
Support their chest with one hand and lean them forward
With the heel of your other hand, deliver up to 5 back blows between the shoulder blades
After each blow, check the mouth for the object and remove it if visible and easy to grasp
Abdominal Thrusts (5 inward-upward thrusts)
If back blows fail:
Stand behind and wrap your arms around their waist
Make a fist, place it just above the belly button, and grasp it with your other hand
Deliver up to five sharp inward and upward pulls (abdominal thrusts)
Check their mouth after each thrust
Repeat Cycle
If the person is still choking, alternate five back blows and five abdominal thrusts until:
The object dislodges
Emergency help arrives
The person becomes unresponsive
If Unresponsive
Gently lower them to the ground
Start CPR immediately
Step-by-Step First Aid for Choking (Infants)
You should never use abdominal thrusts on babies under 1 year.
Instead, deliver 5 back blows followed by 5 chest thrusts.
1. Back Blows (5)
Sit and support the baby face down along your forearm, head lower than the body
Give five back blows with the heel of your hand between the shoulder blades
Check the mouth each time
2. Chest Thrusts (5)
Turn the baby face-up on your forearm/thigh, keeping the head lower than the body
Place two fingers in the centre of their chest (just below the nipple line)
Give up to five chest thrusts—firm but controlled
Check after each thrust
3. Repeat Back Blows & Chest Thrusts
Alternate sets of 5 back blows and 5 chest thrusts until clear or help arrives
If the object has still not cleared, call 999 & continue the sequence
4. If Unresponsive
Begin baby CPR and ensure emergency services are on the way
Babies who have needed chest thrusts should be seen by a clinician
Looking for hands-on paediatric first aid experience in responding to choking?
Book an in-house Paediatric First Aid course to develop practical first aid skills under expert guidance.
First Aid for Choking Safety Tips
Do not perform abdominal thrusts on babies under 1 year
Avoid sweeping the mouth blindly, as this can push the obstruction deeper
Only remove an object if it’s visible and can be easily removed
Even if the obstruction clears, seek medical attention after abdominal or chest thrusts
What causes choking in the workplace?
Choking occurs when an object becomes lodged in the airway, preventing normal breathing. In workplace environments, choking incidents most commonly occur during meals or when small objects are accidentally swallowed.
The most common causes of choking in the workplace include:
Food lodged in the airway
Accidentally swallowing small objects
Poorly fitting dentures, which can make chewing difficult and increase the risk of choking
Medical conditions that affect swallowing, such as dysphagia
Poor eating posture, rushing food or distracted eating
Understanding these risk factors can help workplace first aiders recognise potential hazards and respond quickly if an incident occurs.
Who is Most at Risk?
Some individuals may be more at risk of choking due to age, medical conditions, or difficulties with swallowing.
Employees who may be at greater risk include:
Those with neurological conditions which affect muscle coordination, such as ALS or cerebral palsy
Older employees due to weaker swallowing muscles and reduced saliva production
Infants and children, especially those aged between 3 and 5, are much more likely to choke than adults. This is because:
They have smaller airways, which are more easily blocked.
They often explore objects with their mouths
They are still developing their chewing and swallowing skills
In childcare settings, extra supervision and vigilance is therefore essential to reduce the risk of choking incidents. Because of the higher risk of choking in young children, it is a legal requirement to have at least one member of staff who has completed a paediatric first aid training course under the Early Years Foundation Stage (EYFS) framework.
Ensure your childcare team meets EYFS compliance
Workplace Situations Where Choking Risks Are Higher
While choking can occur in any workplace, there are some workplace environments where the likelihood of choking is higher. Common high-risk workplace situations include:
Staff kitchens and lunchrooms
Care environments
Schools and childcare settings
Hospitality workplaces
Displaying a choking first aid poster in high-risk areas is a great way to mitigate risk and ensure employees are aware of the correct first aid procedure for conscious choking.
How do you recognise a person who is choking?
Quickly recognising that someone is choking is the vital first step in delivering effective and timely choking first aid, and helping you respond quickly to workplace choking emergencies.
According to The Cleveland Clinic, “brain damage begins within four minutes of not having enough oxygen”, so acting fast is critical. Early recognition allows workplace first aiders to intervene immediately, potentially saving a life and preventing serious injury.
Signs of mild choking:
Coughing forcefully
Difficulty speaking
Wheezing or noisy breathing
Panicked or distressed behaviour
Red or flushed face, watery eyes
Able to speak or make sounds
Clutching at their throat
People with mild choking may still be able to cough, so encourage them to keep coughing to try to clear the obstruction.
Signs of Severe Choking:
Inability to speak or breathe
Silent attempts to breathe
Weak gagging or coughing
Clutching the throat
Skin, lips or fingertips may turn grey, blue or pale
Panicked or distressed behaviour
Loss of consciousness if the blockage is not cleared (if this happens, start CPR)
“If choking is severe, the person won’t be able to speak, cry, cough or breathe, and without help they’ll eventually become unconscious.”
If a person is severely choking, call 999 straight away and then follow the step-by-step process outlined above.
Action Steps:
Ask: "Are you choking?"
Mild Choking: If they can cough or speak, encourage them to keep coughing
Severe Choking: If they cannot speak, cough, or breathe, call 999 immediately and start 5 back blows between the shoulder blades, followed by 5 abdominal thrusts.
If the person remains unresponsive, start CPR.
Workplace first aid training can give staff members the skills and confidence to recognise the signs of choking and act quickly and effectively.
What to do if someone becomes unconscious from choking?
If the choking person becomes unconscious begin CPR. Call 999 immediately if you haven’t already done so.
If the casualty is unresponsive, call 999 or 112 and activate speakerphone if available
If a bystander is present, ask them to make the call and fetch an AED
If the casualty is not breathing normally, start CPR immediately
If an AED is available, attach the pads as soon as possible and follow the prompts
Start with chest compressions.
The heel of one hand must be placed in the centre of the chest – the bottom half of the sternum or breastbone
Place your other hand on top and clasp them together with your arms locked straight
Push at a depth of at least 5cms but no more than 6cms and at a speed of 100–120 compressions per minute
After delivering 30 chest compressions, give 2 rescue breaths.
Tilt the person's head gently and lift the chin up with 2 fingers. Pinch the person's nose. Seal your mouth over their mouth and blow steadily and firmly into their mouth for about 1 second. Check that their chest rises.
The recognised methods for providing rescue breaths are either mouth-to-mouth or mouth-to-nose.
Do not attempt more than two breaths each time, taking no longer than 10 seconds, before returning to chest compressions.
Repeat 30 compressions and 2 rescue breaths until:
Emergency services take over
You become exhausted
The casualty wakes up, moves, opens their eyes, and starts breathing on their own again.
If the initial rescue breath of each sequence does not make the chest rise, check:
The casualty’s mouth for any visible obstruction and remove without risking pushing it deeper.
There is adequate head tilt and chin lift.
Training on CPR (Cardio Pulmonary Resuscitation) with AED (Automated External Defibrillator) is included in both the 1-day Emergency First Aid at Work course and the 3-day First Aid at Work course.
Investing in workplace first aid training is designed to give employees the skills and confidence to respond to choking incidents and a wide range of other common workplace emergencies.
How to prevent choking incidents in the workplace?
Preventing choking incidents in the workplace requires employers to encourage safe eating practices, identify potential hazards and ensure staff are adequately trained in first aid.
We dive into the best practices for preventing workplace choking emergencies below.
Promote Safe Eating Habits
Encourage employees to eat slowly and chew food thoroughly.
Discourage talking, laughing, or rushing while eating.
Encourage a quiet mealtime environment.
Promote good posture when eating to support safe swallowing.
Ensure employees have adequate break and lunch times so meals are not rushed.
Limit alcohol consumption at lunch breaks (for example, during a corporate lunch) as this can impair swallowing.
Food Preparation and Environment
Keep food preparation and eating areas clear of small choking hazards (such as paper clips).
Ensure food is cut into manageable pieces, particularly in care or childcare settings.
Keep the kitchen and break areas clean and tidy.
Ensure adequate kitchen equipment is provided for food preparation, for example, knives to cut food into smaller pieces.
Support Higher-Risk Individuals
Be aware of employees who may have medical conditions affecting swallowing, such as dysphagia.
Provide additional supervision or support where needed in care or childcare settings.
Training and Preparedness
Ensure staff receive relevant first aid training that covers choking response procedures in line with the workplace’s first aid needs assessment.
Ensure staff complete regular first aid refresher courses to ensure their first aid knowledge is up to date.
Carry out workplace risk assessments in work environments where the choking risk is higher (e.g., childcare, adult care and hospitality).
Make sure staff know who the trained first aiders are.
Display a choking first aid poster in your break room that provides a visual reminder of the correct response procedure.
Why workplace first aid training is important?
A blocked airway can lead to death within minutes. Immediate intervention by a trained first aider is necessary to save lives.
Workplace first aid training equips employees with the knowledge to recognise choking symptoms, the practical skills to provide back blows and abdominal thrusts, and the confidence to act in an emergency
Workplace first aid training also:
Supports compliance with HSE guidance and the Health and Safety at Work Act.
Improves employee confidence and wellbeing as they know trained first aiders are ready to act if there’s an emergency
Creates a safer workplace culture and ensures preparedness for unexpected incidents
In-house first aid training from First Aid Safety
All regulated first aid course certificates are valid for three years and accredited by Qualifications Network UK.
The training courses are delivered in-house, at your business or workplace, covering London and the UK.
To learn more about workplace first aid courses or to book a training session, get in touch with us today.
Choking first aid FAQs
Choking occurs when a foreign object becomes lodged in the airway and blocks airflow into the lungs. In most choking cases, the person will likely still be able to cough or speak. According to NHS Inform, if a person “won’t be able to speak, cry, cough or breathe, and without help they’ll eventually become unconscious,” this is classified as severe choking and requires immediate first aid.
Abdominal thrusts are recommended only for adults and children over 1 year old, and only after 5 back blows have been given and these have failed to dislodge the obstruction.
Abdominal thrusts are NOT recommended for infants under 1 year. Instead, you should use 5 chest thrusts, as described in the step-by-step process outlined earlier in this guide.
If a person is showing signs of severe choking (unable to breathe, speak or cough), you should call 999 immediately. Continue choking response procedures (back blows and abdominal/chest thrusts) until emergency services arrive or the obstruction is dislodged. Even if the obstruction is cleared, individuals who have had abdominal thrusts should receive medical attention.
Ask the person, “Are you choking?” If they can cough or speak, encourage them to keep coughing forcefully. If they cannot cough, speak, or breathe, call 999 and begin first aid for choking with back blows and abdominal thrusts.
If someone is choking and cannot breathe, speak or cough (severe choking), you should:
Call 999
Encourage them to cough
Give 5 back blows
Give 5 abdominal thrusts
Repeat the cycle
Avoid blind finger sweeps in the mouth, as this may push the object deeper.
If the person becomes unresponsive, lower them to the floor and start CPR immediately.
In conscious choking emergencies, give up to 5 firm back blows between the shoulder blades, checking the mouth after each blow. If the obstruction persists, proceed with abdominal thrusts for adults/children over 1 year old, or chest thrusts for infants.
After a choking incident, even if the blockage is cleared, you should always encourage the individual to seek medical attention to check for injuries, especially if abdominal or chest thrusts were used. Even if the person appears fine, there could be internal abdominal injuries.
Individuals at higher risk include those with swallowing disorders (e.g., dysphagia), neurological conditions affecting muscle coordination, older adults and young children aged 1–5 who are still developing swallowing skills.
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