Choking persons are usually incapable of speaking or breathing while they are choking. You must take immediate action.

PREVENTION
Adults:
-Cut food into small pieces.
-Chew food slowly and thoroughly, especially if wearing dentures.
-Avoid laughing or talking with food in your mouth.
-Avoid walking or other physical activity with food in your mouth.
-Avoid excessive intake of alcohol before and during meals.

Infants and Children:
-Keep marbles, beads, thumbtacks, and other small objects out of their reach and prevent them from walking, running, or playing with food or toys in their mouths.

SIGNS
Coughing forcefully, can not speak or breathe, wheezing. Panic accompanies choking. The choking victim’s face often assumes an expression of fear or terror. At first he or she may turn purple, the eyes may bulge, and he or she may wheeze or gasp.
You must take immediate action.

FIRST AID
If the victim can speak, cough, or breathe, DO NOT INTERFERE.

Adults and children over 1 year old:
If the victim CANNOT speak, cough, or breathe, give the abdominal thrust, also called Heimlich maneuver until the foreign body is expelled or the victim becomes unconscious. In case of extreme obesity or late pregnancy give chest thrusts.
Be persistent.
Continue uninterrupted until the obstruction is relieved or advanced life support is available.

To perform the Heimlich maneuver on someone else:
Stand behind the person and wrap your arms around waist. Bend the person slightly forward.
Make a fist with one hand and place the thumb side of the fist on the middle of the abdomen slightly above the navel and well below the tip of the breastbone.
Grasp your fist with the other hand and give quick, upward thrusts into the abdomen to dislodge the object.
Repeat this procedure until the object is expelled from the airway or the person becomes unconscious.

To perform the Heimlich maneuver on yourself:
Make a fist with one hand and place the thumb side of the fist on the middle of your abdomen slightly above the navel and well below the tip of the breastbone.
Grasp your fist with your other hand and give quick upward thrust.
You can lean forward and press your abdomen over the back of a chair or any firm object.

Infant (Under 1 year old):
Support the head and neck with one hand. Straddle the infant face down over your forearm, head lower than trunk, supported on your thigh.
Deliver four back blows, forcefully, with the heel of the hand between the infant's shoulder blades.
While supporting the head, immediately sandwich the infant between your hands and turn onto its back, head lower than trunk.
Using 2 or 3 fingers, deliver four thrusts in the sternal (breastbone) region. Depress the sternum 1/2 to 1 inch for each thrust. Avoid the tip of the sternum.
Repeat both back blows and chest thrusts until foreign body is expelled or the infant becomes unconscious.
ALTERNATE METHOD: Lay the infant face down on your lap, head lower than trunk and firmly supported. Perform 4 back blows. Turn infant on its back as a unit and perform 4 chest thrusts.

Chest Thrusts
Stand behind the person.
Place your arms under the persons's armpits and around the chest.
Make a fist with one hand and place the thumb side against the centre of the person's breastbone.
Be sure that your fist is centred on the breastbone,not on the ribs.
Make sure that your fist is not near the lower tip of the breastbone.
Grab your fist with your other hand and thrust inward.
Repeat this procedure until the object is expelled from the airway or the person becomes unconscious.

CALL IMMEDIATELY FOR EMERGENCY MEDICAL ASSISTANCE IF VICTIM BECOMES UNCONSCIOUS!
While waiting for emergency assistance:
Position victim on back, arms by side.
Open the airway and look in the mouth.
If an object is seen, try to remove it by sweeping it out with your finger.
Perform CPR. One addition is made to the regular CPR sequence. Between chest compressions and ventilations look in the person's mouth for an obstruction. If an object is seen, try to remove it by sweeping it out with your finger.
Repeat sequence.
Continue uninterrupted until obstruction is removed or EMS arrives and takes over.
If the person starts breathing, monitor breathing and circulation until EMS arrives and takes over.

Unconscious Infant
1. Perform tongue-jaw lift. If you see the foreign body, remove it.
2. Attempt rescue breathing.
3. Perform the sequence of back blows and chest thrusts as described for conscious infant.
4. After each sequence of back blows and chest thrusts, look for the foreign body and, if visible, remove it.
5. Attempt rescue breathing. Repeat steps 3 and 4.
6. If foreign body is removed and victim is not breathing, begin CPR.