Choking is one of the most frightening emergencies to witness because it can escalate in seconds. A person who is choking may still be coughing and able to speak, or they may suddenly become silent, panicked and unable to breathe. Knowing the difference matters. So does knowing the right response.
In Australia, choking first aid is built around a simple principle: act early, stay calm, call Triple Zero (000) when needed, and use back blows followed by chest thrusts if the airway is not clearing. For babies, the response is different in positioning and technique, but the same urgency applies. Healthdirect, Better Health Channel and St John all treat choking as an emergency and emphasise that fast, correct first aid can save a life.
At CPR First Aid, choking response sits within practical, hands-on training across courses such as HLTAID011 Provide First Aid, HLTAID012 Childcare First Aid and HLTAID009 Provide CPR. If you want a broader parent-focused read after this article, see Baby First Aid Guide for Parents and CPR for New Parents: A Lifesaving Skill for Spring.
Quick Answer: What Should You Do If Someone Is Choking?
If the person can still cough forcefully or breathe, encourage them to keep coughing. If coughing does not remove the blockage, call Triple Zero (000), bend them forward, give up to 5 back blows, then give up to 5 chest thrusts. Continue alternating 5 back blows and 5 chest thrusts until the blockage clears or medical help arrives. If the person becomes blue, limp or unconscious, start CPR straight away, beginning with compressions.
For a baby under 1 year old, call Triple Zero (000) immediately, place the baby face down with their head lower than their body, give up to 5 back blows, then up to 5 chest thrusts using 2 fingers on the lower half of the breastbone. Keep alternating until the blockage clears or help arrives. If the baby becomes unconscious, start CPR.
What Is Choking?
Choking happens when something gets stuck in the windpipe and blocks the flow of air to the lungs. In adults, that is often food entering the trachea instead of the oesophagus. In babies and young children, choking can also be caused by small toys, coins, beads, food pieces and other small household objects. Healthdirect notes that babies, young children and people living with disability are at higher risk of choking.
A choking episode can be partial or complete. With a partial blockage, some air is still moving and the person may cough, wheeze or speak in broken phrases. With a complete blockage, they may be unable to talk, cough or breathe at all. That is when immediate first aid becomes critical.
Signs and Symptoms of Choking
The most common signs and symptoms of choking include:
- clutching the throat
- coughing, wheezing or gagging
- trouble breathing, speaking or swallowing
- a whistling or crowing noise, or no sound at all
- panic, agitation or distress
- blue lips, face, earlobes or fingernails
- loss of consciousness in severe cases
One of the biggest mistakes people make is waiting too long because the casualty is still standing or looks “mostly okay”. A person with a partly blocked airway can still breathe, speak or cough, but that can change quickly. Better Health notes that a person with a complete airway blockage may progress from vigorous breathing attempts to pallor, cyanosis and collapse.
Silent choking is especially dangerous. If the person cannot make sound, cannot speak and cannot cough effectively, treat it as an emergency immediately.
Choking First Aid for Adults and Children Over 1 Year
For adults and children over 1 year old, Australian choking first aid follows a clear sequence.
1. Encourage Coughing First
If the person is coughing and still getting air in, encourage them to cough hard. A forceful cough may be enough to dislodge the object without further intervention.
2. Call Triple Zero (000) If Coughing Does Not Work
If the blockage is not clearing, call Triple Zero (000) for an ambulance. Stay on the phone and follow instructions while giving first aid.
3. Give Up to 5 Back Blows
Bend the person well forward and deliver up to 5 sharp blows between the shoulder blades using the heel of your hand. Check after each blow to see whether the obstruction has cleared. Back blows are more effective when the person is leaning forward, not upright. Better Health specifically warns against slapping a choking person on the back while they are upright because gravity may push the object further down the windpipe.
4. If Needed, Give Up to 5 Chest Thrusts
If the object is still stuck after 5 back blows, give up to 5 chest thrusts. Support the casualty’s back with one hand and place the heel of the other hand on the lower half of the sternum. The thrusts should be slower and sharper than CPR compressions, with a check after each one to see whether the object has moved.
5. Keep Alternating 5 Back Blows and 5 Chest Thrusts
Continue until the blockage clears or help arrives. If the casualty becomes blue, limp or unconscious, move straight to CPR. Healthdirect says to begin with compressions, not breaths, in a choking collapse.
For a practical CPR and first aid class that includes emergency response skills for choking, you can book CPR First Aid’s HLTAID011 Provide First Aid course or HLTAID009 Provide CPR course. CPR First Aid describes HLTAID011 as nationally accredited training for workplaces and the public, and HLTAID009 as a practical CPR course with same-day certification available.
What Are Chest Thrusts?
Chest thrusts are a choking first aid technique used when back blows have not cleared the airway. For adults and children over 1 year, they are delivered to the lower half of the breastbone while you support the casualty’s back. They are not the same as full CPR compressions. St. John describes them as slower and sharper than CPR compressions.
For babies, chest thrusts are done with 2 fingers on the lower half of the sternum. They are also sharper than CPR compressions and are delivered after back blows if the airway is still blocked.
Since the term “chest thrusts” is often searched separately from “choking first aid”, it is worth being clear: chest thrusts are not a last resort technique for a very specific scenario. They are a standard part of the Australian choking response sequence when back blows alone do not work.
Choking First Aid for Babies Under 1 Year
Infant choking first aid is different from adult choking first aid. Positioning matters more, force must be reduced, and the technique uses 2 fingers for chest thrusts.
Step 1: Call Triple Zero (000) Immediately
Healthdirect and St John both state that if a baby is choking, you should call Triple Zero (000) immediately, stay on the phone and begin first aid.
Step 2: Position the Baby Head-Down on Your Forearm
Support the baby’s head and shoulders on your hand, with their head lower than the body. Hold the mouth open with your fingers.
Step 3: Give Up to 5 Back Blows
Use the heel of one hand to give up to 5 sharp blows between the shoulders, checking after each blow to see if the airway has cleared. The aim is to clear the obstruction, not to automatically deliver all five if the object comes free earlier.
Step 4: Give Up to 5 Chest Thrusts if Needed
If the blockage has not cleared, turn the baby onto their back on a firm surface and place 2 fingers on the lower half of the breastbone. Give up to 5 chest thrusts, checking after each one. Continue alternating 5 back blows and 5 chest thrusts until the blockage clears or medical help arrives.
Step 5: Start CPR if the Baby Becomes Unconscious
If the infant becomes blue, limp or unconscious, start CPR immediately.
Parents, grandparents, babysitters and educators often want a first aid course for infants that goes beyond theory. CPR First Aid’s HLTAID012 Childcare First Aid course is designed for education and care settings and includes infant CPR and first aid. CPR First Aid also has useful reads such as Choking in Children and Adults, Baby First Aid Guide for Parents and Common Childhood Injuries and Their First Aid in Australia.
What Not to Do When Someone Is Choking
Knowing what not to do is just as important as knowing the correct sequence.
Do not hit a choking person on the back while they are upright. Australian guidance says the person should be leaning forward.
Do not pick up a choking child and turn them upside down. Healthdirect specifically advises against this.
Do not perform the Heimlich manoeuvre or abdominal thrusts. Healthdirect says not to do the Heimlich manoeuvre because it can break ribs and damage internal organs. This is one reason Australian first aid training places so much emphasis on back blows and chest thrusts. You may see US-based articles discuss abdominal thrusts, but if you are following Australian guidance, use the Australian approach.
Do not blindly sweep inside a baby’s mouth with your finger. Only remove an object if you can clearly see it. Better Health warns against a blind finger sweep in infants because it can push the obstruction further or cause injury.
Do not waste time asking “Are you okay?” if choking is obvious. Healthdirect advises asking whether the person is choking, because they may be having difficulty breathing for another reason such as asthma.
After Choking: When Should Someone Get Medical Help?
Even if the person seems better, follow-up can still matter. Healthdirect advises seeking medical review after choking if there is a cough or wheeze that does not go away, coughing up blood, fever or ongoing difficulty breathing. An object can remain lodged further down the airway even after the initial crisis appears to have passed.
Better Health also notes that if a child continues noisy breathing or coughing after the event, they should be taken to a doctor because the object may still be lodged in the airway and may need hospital removal.
How to Reduce Choking Risk at Home and in Care Settings
Prevention matters, especially with babies, toddlers and children who are still learning to chew well. Healthdirect recommends keeping small objects out of reach of babies and children, and lists common hazards including coins, beads, buttons, balloons, small toy parts and button batteries. The same source advises making sure children sit down to eat, cutting food into small pieces, encouraging chewing, and avoiding risky foods such as whole grapes, nuts, popcorn and hard raw foods until the child is developmentally ready.
Better Health adds that toddlers are at risk from both food and small objects such as buttons or beads, and recommends supervising children while they eat, cooking or mashing hard foods, cutting meat into small pieces, and keeping objects smaller than a ping-pong ball out of reach.
If you work in childcare or regularly care for young children, it is worth combining prevention knowledge with practical emergency training. CPR First Aid’s HLTAID012 Childcare First Aid course is built for educators and carers, while First Aid Charts and Resources offers extra printable learning materials.
Why Formal Choking First Aid Training Matters
Reading an article can help you understand the steps, but emergencies are physical. In a real choking event, you need to recognise the signs quickly, position the casualty correctly, apply the right amount of force, and transition to CPR without hesitation if the person collapses.
That is why formal training matters. CPR First Aid’s course range is built around practical response. The website states that HLTAID011 Provide First Aid is nationally accredited and suitable for workplaces and the public, HLTAID012 Childcare First Aid includes infant CPR, AED use and first aid for education and care settings, and HLTAID009 Provide CPR gives hands-on CPR practice. CPR First Aid’s recent article on What Does a CPR Course Include in Australia (HLTAID009)? also notes that HLTAID009 training covers DRSABCD, adult and infant/child manikins, AED operation, and the communication and review steps after a resuscitation attempt.
Frequently Asked Questions
What Are the Main Choking Symptoms?
The main choking symptoms are coughing, wheezing, gagging, difficulty breathing, speaking or swallowing, clutching the throat, unusual breathing sounds or no sound at all, blue lips or face, agitation and loss of consciousness in severe cases.
What Is the First Aid for Choking in Australia?
For adults and children over 1, encourage coughing first. If coughing does not clear the blockage, call Triple Zero (000), give up to 5 back blows, then up to 5 chest thrusts, repeating until the airway clears or help arrives. For babies, call Triple Zero immediately, then give 5 back blows and 5 chest thrusts using infant positioning and technique.
Are Chest Thrusts the Same as CPR Compressions?
No. Chest thrusts are used to try to clear an airway blockage. CPR compressions are used when the person is unconscious and not breathing normally. St John describes choking chest thrusts as slower and sharper than CPR compressions.
Should I Use the Heimlich Manoeuvre?
Not if you are following Australian guidance. Healthdirect says not to do the Heimlich manoeuvre or abdominal thrusts because they can break ribs and damage internal organs. Australian choking first aid uses back blows and chest thrusts instead.
What Should I Do if a Baby is Choking?
Call Triple Zero (000) immediately, place the baby head-down on your forearm, give up to 5 back blows, then place them on their back and give up to 5 chest thrusts with 2 fingers on the lower half of the sternum. Repeat until the blockage clears or help arrives. Start CPR if the baby becomes unconscious.
Which CPR First Aid Course is Best for Infant First Aid?
If you need training that includes infant CPR and first aid for education and care settings, HLTAID012 Childcare First Aid is the strongest fit. For broader workplace or public first aid training, HLTAID011 Provide First Aid is a strong option, and for CPR-focused practical training, HLTAID009 Provide CPR is the direct pathway.
Conclusion
Choking first aid is not something to guess. In Australia, the response is clear: if the person can cough, encourage coughing. If they cannot clear the blockage, call Triple Zero (000), give 5 back blows and 5 chest thrusts, and continue until the obstruction clears or help arrives. For babies, call immediately and use the infant-specific back blow and chest thrust sequence. If the casualty becomes unconscious, start CPR.
If you want more than theory, learn the skill properly with CPR First Aid. You can book HLTAID011 Provide First Aid, HLTAID012 Childcare First Aid or HLTAID009 Provide CPR depending on your role and needs. For extra reading, see Choking in Children and Adults, Baby First Aid Guide for Parents, Common Childhood Injuries and Their First Aid in Australia and First Aid Charts and Resources.