Choking first aid Australia — back blows and chest thrusts step by step

Reviewed by the Medibc First Aid Team — last updated July 2026. This is general first aid information, not a substitute for an accredited first aid course or professional medical advice. In an emergency, call 000.

Choking happens when an object — often food — blocks the airway and stops a person breathing. It is a true emergency, and quick, correct first aid can save a life. Importantly, in Australia the recommended technique is back blows and chest thrusts — not the abdominal-thrust "Heimlich manoeuvre", which is no longer recommended by the Australian and New Zealand Committee on Resuscitation (ANZCOR) because of the risk of internal injury.

This guide explains how to recognise choking and exactly what to do for an adult, a child and a baby.

Signs of choking: mild vs severe

How you respond depends on whether the airway is partly or completely blocked.

  • Mild (partial) blockage: the person can still cough, cry or speak and is getting some air. Encourage them to keep coughing — a strong cough is the most effective way to clear the airway. Do not slap the back at this stage.
  • Severe (complete) blockage: the person cannot breathe, cough, cry or speak, may clutch their throat, go red then blue, and may become silent or collapse. Act immediately.

Choking first aid for an adult or child (over 1 year)

For a severe blockage, follow these steps:

  1. Call 000 (or get someone else to) if the blockage is severe or the person cannot breathe.
  2. Give up to 5 back blows. Lean the person forward and give up to five sharp blows between the shoulder blades with the heel of your hand. Check after each one to see if the blockage has cleared.
  3. Give up to 5 chest thrusts. If back blows do not work, place one hand in the middle of the chest (the same spot as CPR compressions) and give up to five sharp, downward thrusts — slower and sharper than compressions. Check after each.
  4. Alternate 5 back blows and 5 chest thrusts until the object clears or help arrives.
  5. If the person becomes unconscious, lower them to the floor, call 000 if not already done, and start CPR following the DRSABCD action plan.
Do not use abdominal thrusts (the Heimlich manoeuvre) and do not try to pull the object out with your fingers if you cannot see it — a blind finger sweep can push it deeper.

Choking first aid for a baby (under 1 year)

Babies are managed with the same principles but scaled down — and never with abdominal thrusts.

  1. Call 000 and position the baby face-down along your forearm, supporting the head, with the head lower than the chest.
  2. Give up to 5 back blows between the shoulder blades using two fingers (not the heel of your hand), scaled to the baby’s size. Check after each.
  3. Give up to 5 chest thrusts using two fingers on the centre of the chest, just below the nipple line. Check after each.
  4. Alternate back blows and chest thrusts until the airway clears or help arrives; start infant CPR if the baby becomes unresponsive.

Why not the Heimlich manoeuvre?

Many people learned abdominal thrusts (the Heimlich) years ago, but ANZCOR now advises against them: reviews of real-world cases found life-threatening complications, and back blows and chest thrusts are effective with a much lower risk of harm. Following current Australian guidance keeps both the rescuer and the casualty safer.

After a choking episode

Even once the object is out, see a doctor if the person had chest thrusts, had a severe episode, has a persistent cough, difficulty breathing or swallowing, or a feeling that something is still stuck — there may be a lingering obstruction or minor injury. Anyone who was unconscious needs urgent medical assessment.

Choking First Aid FAQs

What are the 5 steps if someone is choking?

Encourage coughing if they can; call 000 for a severe blockage; give up to 5 back blows between the shoulder blades; give up to 5 chest thrusts in the centre of the chest; and alternate back blows and chest thrusts until the object clears or help arrives — starting CPR if the person becomes unconscious.

Do you do the Heimlich manoeuvre in Australia?

No. Australian (ANZCOR) guidelines recommend back blows and chest thrusts, not abdominal thrusts. The Heimlich manoeuvre is no longer advised because of the risk of internal injury.

What do you do if a baby is choking?

Call 000, lay the baby face-down along your forearm with the head low, give up to 5 back blows with two fingers, then up to 5 chest thrusts with two fingers just below the nipple line. Alternate until the airway clears, and start infant CPR if the baby becomes unresponsive. Never use abdominal thrusts on a baby.

What is the difference between mild and severe choking?

In mild choking the person can still cough, speak or cry, so you encourage them to keep coughing. In severe choking they cannot breathe, cough or speak — this needs immediate back blows and chest thrusts and a 000 call.

Should I put my fingers in their mouth to remove the object?

Only remove an object you can clearly see and easily reach. Do not perform a blind finger sweep, as it can push the object deeper and worsen the blockage.

Be ready for an airway emergency. Keep a stocked first aid kit on hand, and for workplaces consider CPR & resuscitation equipment and first aid room equipment. Fast shipping Australia-wide.

Sources: ANZCOR Guideline 4 — Airway; healthdirect — Choking. For hands-on skills, complete an accredited first aid course. In an emergency, call 000.

Published: July 03, 2026