How do I tell mild from severe choking?

Ask "Are you choking?" If they can cough, speak or breathe, it is mild — encourage coughing and do not interfere. If they are silent, cannot breathe and may be turning blue, it is severe and needs back blows and thrusts.

Why can’t I do the Heimlich (abdominal thrusts) on a baby?

An infant’s organs, especially the liver, are fragile and easily damaged. For a choking infant under 1, use 5 back blows and 5 chest thrusts instead of abdominal thrusts.

What if I am choking and alone?

Call 995 if you can, and give yourself abdominal thrusts using your own fist, or by pressing your upper abdomen firmly over the back or edge of a chair.

The object came out after thrusts — do I still need a doctor?

Yes. Abdominal and chest thrusts can cause internal injury or leave part of the object behind, so anyone who received them should be checked by a doctor even if they seem fine.

What should I do for a choking pregnant woman?

Use back blows followed by chest thrusts — hands on the centre of the breastbone — rather than abdominal thrusts.

Choking First Aid: Adult, Child & Infant (Singapore)

Written & reviewed by the BestDoctors.sg editorial team · Last updated 22 Aug 2026 · General information, not medical advice

Quick answer. First judge severity. If the person can still cough, speak or breathe (mild), do not hit or thrust – encourage them to keep coughing. If they cannot cough, speak or breathe, are silent, clutching the throat or turning blue (severe), act at once: for a conscious adult or child, give up to 5 back blows between the shoulder blades, then up to 5 abdominal thrusts, and keep alternating. For an infant under 1, use 5 back blows and 5 CHEST thrusts – never abdominal thrusts. Call 995 if it doesn’t clear quickly or the person collapses, and start CPR if they become unconscious.

Choking is when something blocks the airway. The key first step is deciding whether the blockage is partial or complete, because the right action is very different – and hitting someone who is coughing effectively can make things worse.

Step 1: recognise and triage

Ask, “Are you choking?” A severely choking person cannot answer, cough or breathe and may clutch the neck (the universal choking sign). If the choking is mild – they can cough, speak, wheeze or breathe – do not interfere; encourage forceful coughing and stay with them until it clears. If it is severe – silent, cannot cough or breathe, going blue – act immediately and get someone to call 995.

Conscious adult or child (over 1 year)

5 back blows. Stand to the side and slightly behind; support the chest with one hand and lean the person well forward. Give up to 5 firm blows between the shoulder blades with the heel of your hand, checking after each whether the object has cleared.
5 abdominal thrusts. If back blows fail, stand behind and wrap your arms around the abdomen. Place a fist (thumb-side in) in the midline just above the navel and well below the tip of the breastbone; grasp it with your other hand and pull sharply inward and upward, up to 5 times.
Keep alternating 5 back blows and 5 abdominal thrusts until the object clears or the person becomes unconscious. Use gentler force for a small child.

Note: Singapore’s SRFAC Standard First Aid Manual teaches abdominal thrusts (with chest thrusts for pregnant or larger casualties), while the Singapore Heart Foundation, St John and international bodies teach the alternating back-blows-then-thrusts method shown here. Both are taught in Singapore; a certified course will show you your provider’s exact sequence.

Conscious infant (under 1 year) – no abdominal thrusts

5 back blows. Lay the infant face-down along your forearm, supporting the head and jaw, with the head lower than the chest (rest your forearm on your thigh). Give 5 firm back blows between the shoulder blades with the heel of your hand.
5 chest thrusts. Turn the infant face-up along your other forearm, head still lower than the chest. Place two fingers on the centre of the breastbone just below the nipple line and give 5 thrusts – sharper and slower than CPR compressions.
Check the mouth after each cycle and remove an object only if you can see it, with a single hooking sweep of your little finger – never a blind finger sweep. Keep alternating until it clears or the infant becomes unresponsive.

Pregnant or larger casualties

Use chest thrusts instead of abdominal thrusts: stand behind, bring your arms under the armpits around the chest, place a fist on the middle of the breastbone, and give quick backward thrusts (back blows are still given first in the alternating method).

If the person becomes unconscious

Lower them carefully to the floor, call 995 (or confirm it’s been called), get an AED if one is near, and start CPR beginning with chest compressions. Before giving any rescue breaths, look in the mouth and remove any object you can see. Continue until they recover or help takes over.

Do and don’t

Do: check severity first and let them cough if they can; lean the casualty well forward; check after every blow and thrust; use chest thrusts (not abdominal) for infants and pregnant or larger casualties; call 995 early and start CPR if they collapse; and get a doctor to review anyone who received abdominal or chest thrusts.

Don’t: slap the back or thrust on someone who can still cough or speak; ever perform abdominal thrusts on an infant under 1; do blind finger sweeps; give up before it clears or they collapse; or send someone home without a medical check after thrusts.

Related first-aid & emergency guides

Related condition guides

Sources

SRFAC / Singapore Red Cross — Standard First Aid Manual (Rev 1/2020): foreign-body airway obstruction, unconscious-casualty CPR, 995.
Singapore Heart Foundation — CPR/AED and choking for infants (5 back blows + 5 chest thrusts; finger positions; unconscious-infant CPR).
Resuscitation Council UK — choking guidance (alternating back blows and abdominal thrusts; start CPR if unresponsive).
British Red Cross / St John — infant back-blows-and-chest-thrusts technique; chest thrusts for pregnant casualties; medical review after thrusts.

In an emergency, call 995 (ambulance/fire) in Singapore — or 999 for police. This guide is general first-aid information, not a substitute for certified training or professional medical care. Consider a hands-on first-aid and CPR+AED course accredited by the Singapore Resuscitation and First Aid Council (SRFAC). If you are untrained, a 995 call-taker can coach you through what to do.

Choking First Aid in Singapore: Adult, Child & Infant