Page 1 Session 4 Choking

Choking Child


Choking Child

Choking is a subject that concerns many teachers, nursery staff and parents. The fact is that choking can be dealt with very quickly and effectively with some good knowledge and training.

The questions that you should be asking is what do I do if the object does not come out?

​This is when choking becomes complicated.


Recognition of Choking

There are two types of choking which need to be recognised and dealt with, they are partial blockage and full blockage of the airways. 


Choking Fact

 2600 under 4 years old's have been admitted to A&E in the UK in 2016.

Since 2001, 14 babies have suffocated after a nappy sack covered their mouth and nose, or have choked after putting a nappy sack in their mouth.

(The Royal Society for the Prevention of Accidents)

Partial Blocked Airway


The recognition features of a partial  blockage is that the child will be:

  • Grasping their throat
  • Making gagging noises
  • Redness of the face
  • Eyes enlarging
  • Eyes watering
  • Coughing
  • They may be able to speak

First Aid For Partial Blocked Airway


The method to unblock the partial blockage is 

straight forward:

  1. Remain calm, don't panic
  2. Get the child to stand up
  3. Help them to stand up if needed
  4. Tell them to cough it up
  5. Pat the back lightly  and encourage the child to cough up.
  6. Once removed calm the child down and offer a drink.

Identify the object, some object may have sharp edges and could cause injury to the airway.  Always be prepared for the partial blockage to be come a full blockage. Do not be tempted to use tweezers as these may force the object further down or the child's jaw may lock shut.

Important Information!


A choking child can be a frightening  experience. The incident can be dealt with quickly or it can go badly wrong. The decision has to be made to contact the emergency services when it does go wrong. Should you have help available and the object can not be removed from the child airways you must send them for help as soon as possible. CPR must commence once the child is unresponsive. Read information below.

First Aid For Full Blockage

Recognise The Blockage


The recognition features of the full blockage

  • No noise
  • Grasping at throat
  • Shock (Pale, blue skin)
  • Goes unconscious quickly
  • Not breathing


                Let others know

First Aid
Step 1


 Encourage the child to cough up .

Most children will be frightened that they cannot breath shout clearly " COUGH IT UP" Repeat for a few seconds .

               Get Ready for Step 2

Choking Child
Step 2


 Place one arm around the child's body at chest height, you should have a firm grip of the child, lean them forward and strike the center of the back with the heel of the hand 5 times. The strike should be in a upward motion between the shoulder blades. The aim is to send a vibration which will allow the throat to release the obstruction and the child to use their cough reflexes to dislodge the obstruction.

At this stage you may have a doubt of the outcome, send your help to call for the emergency services if your on your own complete the process of removing the obstruction.

                 NOT WORKING

            Get Ready For Step 3

Abdominal Thrusts

Choking Child
Step 3


 Place a clenched fist just under the

sternum, clasp your other hand over

the top of your fist. Pull both hand 

and fist sharply inwards and upwards

repeat the " abdominal thrust" 5

​times, the aim is to force the air from the lungs to

Force the obstruction out of the airways


The moment you can no longer hold the child up to perform back slaps or abdominal thrusts you

"MUST" place them on the floor and start CPR, the child is not breathing.  

Repeat The Cycle 3 times, 5x Back slaps followed by 5x Abdominal thrust



   What do I do if i'm on my own? 

You should do every thing possible to remove the Object, Use the process taught above. The child will

become weak they will go unconscious, they are not breathing and will quickly go into cardiac arrest. 

    What Next?

 Give child 5 good  rescue breaths, mouth to mouth. Remember to pinch child's nose to prevent air escaping. Should the chest rise and fall this indicates you can pass air past the object. If there is no rise and fall the airway is still fully blocked. 

What Now?

 Give child another 30 compression's with one hand placed in the center of child's chest between nipple line. Push a little harder as this may force the object up. 

Continue With 

  2 more rescue breaths, mouth to mouth. Remember to pinch child's nose to prevent air escaping. Followed by another 30 compression's .

If the airway does not clear then you must go and make the 999/112 call.



Once you have made the 999/112 call return to the child and continue with CPR. Remember a baby can be taken with you.

Why would I use this process?


 This is a good question, the reality is that in 3 minutes a child could have brain damaged in 6-10 minutes this brain damage may be irreversible. This process when on your own may take a few minutes from choke to CPR there is an opportunity in the first few moments to release the object as the child's body goes limp and relaxed the object may release, these are vital moment when the object can be released and the child resuscitated. 

The harsh reality, if you fail to remove the object the child in a short period of time the child may die.