Stand behind the person with your foot between his feet. Reach around the waist. Make a fist (thumb outside fingers) and use the knuckle of the thumb in the navel as a landmark. The flat part of the thumb is placed against the abdomen just above the navel.
Grab your fist with the other hand. Keeping your arms off the person's rib cage, give 5 quick inwards and upwards thrusts. This might cause the object to pop out. Check the mouth. Repeat the procedure of 5 abdominal thrusts and 5 back slaps until the object is dislodged or medical help arrives. If he becomes unconscious, call an ambulance and start CPR. Each time you open the airway during CPR, look for an object and if visible, remove.
If you are alone:
- Try to cough up the object.
- If this doesn't help, do abdominal thrusts on yourself using your fists, or lean over the back of a chair and press down forcefully.
Conscious child (1 - 8 years)
- Encourage the child to cough. If this is ineffective, stand or kneel behind him and bend him forwards; or place a small child face down across your lap with head low.
- Do abdominal thrusts followed by back slaps (as for adult).
- Repeat the procedure until the object is dislodged or medical help arrives.
- If the child becomes unconscious, call an ambulance and start CPR.
Conscious baby (under 1 year)
- Kneel down, and lay the baby face down on your forearm or thighs, with the head lower than the trunk, and support the head with your hand. Don't cover the baby's mouth or twist the neck.
- Give 5 hard back slaps between the shoulder blades.
- Check if the object is clearly visible, and then remove with a hooked finger. Don't do blind finger sweeps. (It is safe to put a finger into a baby's mouth but in adults and children, reflex action may cause them to bite.)
- If the object cannot be removed, lay the baby face upwards along your forearm or lap, with the head lower than the trunk. Place two fingers on the breastbone just below the nipple line and give 5 downward chest thrusts to a depth of 2.5 cm.
- Check the mouth again and remove the object if visible.
- Repeat the sequence of back slaps and chest thrusts. If unsuccessful, call an ambulance and start CPR.
Note: Do not perform abdominal thrusts on a baby.