Mark it once you can do it without this page open.

How to do it

  1. Ask, are you choking? If they can cough hard or talk, encourage them to keep coughing and stay with them.
  2. If they cannot speak, cough or breathe, tell someone to call 911, or call yourself on speaker.
  3. Stand beside and slightly behind them, support their chest with one hand and lean them forward.
  4. Deliver up to five firm back blows between the shoulder blades using the heel of your other hand.
  5. Stand behind them, make a fist, put it thumb side in just above the belly button and below the ribs, and grasp it with your other hand.
  6. Give up to five quick inward and upward thrusts.
  7. Keep alternating five back blows and five thrusts until the object comes out or they collapse.
  8. If they collapse, lower them to the ground, make sure 911 has been called, and start CPR.

Stop and call a professional if

  • Call 911 as soon as the person cannot speak, cough or breathe.
  • After any abdominal thrusts, the person should be checked by a doctor, as thrusts can cause internal injury.
  • For a pregnant person or someone too large to reach around, a class teaches chest thrusts instead; infants need a different method.
  • Take a certified class in first aid and CPR: this page is a refresher, not training or certification.

In an emergency, call your local emergency number, 911 in the US. Take a certified class to practice this with an instructor.

Common mistakes

  • Slapping the back of someone who is coughing forcefully, which can make it worse.
  • Placing the fist on the ribs or breastbone.
  • Sweeping a finger blindly in the mouth.
  • Skipping a medical check afterward because they feel fine.

Quick self-check

Three questions. Your last score is kept in this browser.

1. The person is coughing hard and can speak. What do you do?
2. Where does your fist go for abdominal thrusts?
3. The person collapses and does not respond. What next?

Teach this to someone

A one-page sheet for showing a friend, a roommate or a kid: what to say, what to show, and one question to check it landed.

Words on this page

Sources

  • National resuscitation and first aid guidelines, 2025 guidelines. Checked September 28, 2026.

Last reviewed . First published .