Foreign object inhaled: First aid

Updated: 2020-10-24

The 'five-and-five' approach

The 'five-and-five' approach

If a person is choking and cannot talk, cry or laugh forcefully, the American Red Cross recommends a 'five-and-five' approach to delivering first aid.

If you or your child inhales a foreign object, see your doctor. If an inhaled foreign object causes choking, you'll need to perform first aid.

If the person is able to cough forcefully, the person should keep coughing. If the person is choking and cannot talk, cry or laugh forcefully, the Red Cross recommends a "five-and-five" approach to delivering first aid:

• Give 5 back blows. Stand to the side and just behind a choking adult. For a child, kneel down behind. Place one arm across the person's chest for support. Bend the person over at the waist so that the upper body is parallel with the ground. Deliver five separate back blows between the person's shoulder blades with the heel of your hand.
• Give 5 abdominal thrusts. Perform five abdominal thrusts (also known as the Heimlich maneuver).
• Alternate between 5 blows and 5 thrusts until the blockage is dislodged.

If you're the only rescuer, perform back blows and abdominal thrusts before calling 911 or your local emergency number for help. If another person is available, have that person call for help while you perform first aid.

If the person who has inhaled an object becomes unconscious, lay the person on his or her back on the ground. If you can see an object in the mouth, reach a finger in and sweep the object out. Be careful not to push it deeper into the airway. If the object remains stuck and the person doesn't respond to your efforts, perform cardiopulmonary resuscitation (CPR).

The American Heart Association does not teach the back-blow technique, only the abdominal thrust procedures. It's OK not to use back blows if you have not learned the back-blow technique. Both approaches are acceptable.

To perform abdominal thrusts (the Heimlich maneuver) on someone else

• Stand behind the person. Place one foot slightly in front of the other for balance. Wrap your arms around the waist. Tip the person forward slightly. If a child is choking, kneel down behind the child.
• Make a fist with one hand. Position it slightly above the person's navel.
• Grasp the fist with the other hand. Press hard into the abdomen with a quick, upward thrust — as if trying to lift the person up.
• Perform between six and 10 abdominal thrusts until the blockage is dislodged.

A modified version of the technique is sometimes taught for use with people who are pregnant or obese. The rescuer places his or her hand in the center of the chest to compress, rather than in the abdomen.

To perform the Heimlich maneuver on yourself

How to perform abdominal thrusts (Heimlich maneuver) on yourself

How to perform abdominal thrusts (Heimlich maneuver) on yourself

To perform abdominal thrusts (Heimlich maneuver) on yourself, place a fist slightly above your navel. Grasp your fist with the other hand and bend over a hard surface. Shove your fist inward and upward.

If you're choking and alone, call 911 or your local emergency number immediately. You can't perform back blows on yourself. But you can perform abdominal thrusts.

• Place a fist slightly above your navel.
• Grasp your fist with the other hand and bend over a hard surface — a countertop or chair will do.
• Shove your fist inward and upward.

To prepare yourself for these situations, learn the Heimlich maneuver and CPR in a certified first-aid training course.