Choking

What All Three Sources Agree On

Adults and children over 1 year

Mild obstruction

• Encourage coughing

Severe obstruction

• Give up to 5 back blows, then up to 5 abdominal thrusts. Alternate until cleared
• Call 999 if the obstruction does not clear
• If unresponsive, start CPR

Infants under 1 year:

• Back blows followed by chest thrusts (never abdominal thrusts)

All casualties:

• Do not perform blind finger sweeps
• Anyone treated with abdominal or chest thrusts must be assessed by a healthcare professional afterwards, even if the obstruction has cleared

2025 RCUK Guidelines Update

RCUK published updated guidelines in October 2025, implemented in accredited training from January 2026. For choking, the core sequence is unchanged. The key update is that infant chest thrusts should now be delivered using the two-thumb encircling technique rather than two fingers, consistent with the updated infant CPR guidance. The NHS and SJA websites have not yet been updated to reflect this.