Australian quick reference
Adult choking
What to do when an adult or older child cannot breathe, speak or cough effectively.
The short answer
Encourage effective coughing. If the obstruction is severe, call 000 and give up to five back blows followed by up to five chest thrusts, repeating as instructed.
First decide how effective the cough is
Coughing or severe choking?
If this is happening now, call Triple Zero (000) when coughing is not clearing the blockage and stay on the line. This adult pathway also applies to children over 1 year; babies need different instructions.
| What you find | Do next |
|---|---|
| Effective cough | Reassure them and encourage a strong cough. Stay close and watch; do not give food or drink and do not strike their back while upright. |
| Ineffective cough or cannot speak/breathe | Call 000, bend them well forward and give up to 5 sharp back blows, checking after each. If not cleared, give up to 5 chest thrusts and keep alternating as instructed. |
| Becomes blue, limp or unresponsive | Lower them safely to the floor, call 000 if not already done and start CPR with compressions. Remove only a visible object; never do a blind finger sweep. |
| Object clears but symptoms remain | Arrange medical advice for a cough or wheeze that does not settle, coughing blood, fever or difficulty breathing. |
Four things to remember
See the next decision
These visual cues are a memory aid. In a real emergency, call Triple Zero (000) and follow the call-taker's instructions.
Ask if they are choking and encourage them to cough if they can.
The person cannot breathe, speak or cough effectively, or may clutch their throat or look panicked.
Do not give food or drink.
Severe choking, blue lips, collapse or inability to breathe or speak requires 000.
Illustrated field notes
See the situation, then choose the next safe action
These original illustrations support recall. They are not a substitute for the written steps, a current first-aid course or the Triple Zero (000) call-taker.
Visual memory cue
See the pattern before you practise
Use this simple visual reminder alongside the written steps. In a real emergency, call Triple Zero (000) and follow the call-taker's instructions.
- 01Encourage coughOnly if the person can cough effectively.
- 02Call 000Call for ineffective breathing, speaking or coughing.
- 03Back blowsGive up to five, checking after each.
- 04Chest thrustsAlternate as instructed.
01
What to do first
- Ask if they are choking and encourage them to cough if they can.
- Call 000 if they cannot breathe, speak or cough effectively.
- Give up to five back blows, checking after each one.
- If ineffective, give up to five chest thrusts and keep alternating as instructed.
- If they become unresponsive, start CPR and follow the 000 call-taker.
02
What to avoid
- Do not give food or drink.
- Do not perform blind finger sweeps.
- Do not slap the back of someone who is coughing effectively.
03
When to call 000
- Severe choking, blue lips, collapse or inability to breathe or speak requires 000.
04
What to monitor
- Stay with the person and be ready to start CPR if they become unresponsive.
Recognition cues
What you may notice
- The person cannot breathe, speak or cough effectively, or may clutch their throat or look panicked.
- Breathing may be noisy, laboured or absent; the person may become blue, limp or unresponsive as the obstruction worsens.
- An effective cough is different from severe choking: a person who can cough and breathe should be encouraged to keep coughing while being watched closely.
- The person may be an older child as well as an adult; use the over-one-year pathway unless the person is an infant.
Avoid these traps
Common mistakes
- Giving water, food or another drink while the person is choking.
- Using abdominal thrusts or the Heimlich manoeuvre instead of the Australian back-blow and chest-thrust sequence.
- Performing blind finger sweeps or putting fingers into the mouth without seeing an object.
- Striking the back while the person is upright instead of bending them forward and checking after each blow or thrust.
- Waiting too long to call 000 or failing to start CPR if the person becomes unresponsive.
For a child over 1 year, use the age-appropriate back-blow and chest-thrust instructions from the 000 call-taker. For a baby under 1 year, the technique and position are different: call 000 immediately, support the head and follow the infant instructions. Never pick up a choking baby or child and turn them upside down. Do not use abdominal thrusts on a baby.
When help is on the way
Keep the handover useful
- If the person becomes unresponsive, start CPR immediately, beginning with compressions, and follow the 000 call-taker.
- Even when the object clears, seek medical advice for a cough or wheeze that does not settle, coughing blood, fever or difficulty breathing.
- Tell responders what the person was choking on, how many back blows or chest thrusts were given, whether the object came out and whether symptoms remain.
Practise the pattern
Make it easier to remember
Common questions
Quick answers
What if they can still cough?
Encourage strong coughing and watch closely. Be ready to act if it becomes ineffective.
What if the person can still cough?
Encourage a strong cough and watch closely. If the cough becomes ineffective or the person cannot speak or breathe, call 000 and start the severe-choking sequence.
Should I use the Heimlich manoeuvre?
No. Australian guidance recommends back blows and chest thrusts for severe choking rather than abdominal thrusts. Follow the 000 call-taker instructions.
Do they need medical help after the object comes out?
Seek medical advice for a cough or wheeze that does not go away, coughing blood, fever or difficulty breathing after the choking episode.
Keep it close
Print the reminder
Expanded with effective-versus-severe choking cues, common unsafe responses, infant and child notes, post-obstruction follow-up and additional FAQs against current Australian airway guidance.