When choking occurs

Choking occurs when a small object inside the mouth, often food or chewing gum, goes down the wrong way and ends up at the entrance to the voice box or larynx. This can cause a complete blockage of the airway, where air can neither get in or out, or it may cause a partial obstruction where some air can still get through but the irritation caused by the obstruction is very distressing for the individual.

Severe airway obstructions are a real emergency as, unless the object moves to allow air through the larynx, the casualty will soon lose consciousness and suffer a cardiac arrest. If no air is moving in, the casualty will look distressed, they may be pointing to their throat and will be quiet as they are unable to effectively cough or speak. They can, however, still communicate, so ask them “Are you choking?” They will nod their head back to you.

Mild airway obstructions do allow some movement of air and so the casualty will be distressed but may be able to tell you what the problem is and may have a reasonable cough.

Partial obstructions simply need you to encourage the casualty to cough up the object. Complete obstructions, on the other hand, may need some help.

General signs of choking

• Casualty may have been eating.
• Casualty may clutch their neck.

Signs of severe airway obstruction

Response to question - “Are you choking?”:

• Casualty unable to speak.
• Casualty may respond by nodding.

Other signs:

• Casualty may be unable to breathe.
• May sound wheezy.
• Silent, ineffective coughing.
• May be unconscious.

Signs of mild airway obstruction

Response to question - “Are you choking?”:

• Casualty speaks and answers “Yes!”

Other signs:

• Casualty able to speak, cough and breathe