How to recognise the signs of choking

The universal sign for choking is most typically a person immediately clutching their throat as soon as a foreign object becomes lodged. This is most often closely followed by intense panic. There are several other signs and symptoms to look out for in those critical moments, which relate to the type of airway obstruction (either partial or complete) that is being experienced.

1. Partial airway obstruction:

• Noisy, gasping, wheezing, whistling or laboured breathing (stridor)
• Ability to cough (this may be frantic, as well as weak)
• Attempts to speak will result in difficulties with delivering complete sentences or being able to communicate at a normal / full volume
• Watery eyes
• Red (flushed) facial complexion
• Extreme distress and anxiety (sometimes confusion)
• Some air may escape from the mouth (indicating that there is some air movement)

2. Complete or total airway obstruction:

• Inability to breathe (no air movement), speak, cough or even cry
• Vigorous attempts to breathe (signs may be noted by in-drawn spaces between the ribs and above the collarbones)
• Extreme distress, agitation and anxiety
• Facial discolouration – flushed / pale / cyanosis (blue) – affecting the skin, lips and nails
• Loss of consciousness

It’s important to recognise the type of airway obstruction being experienced as this has an effect on how you will go about caring for a person in the best way possible. A partial obstruction means that a little air is able to pass through the narrowed windpipe (although not comfortably). Breathing is strained and noisy, but some air is still capable of reaching and leaving the lungs.

Full, and hard back blows could worsen a person’s state and lead to total airway obstruction. In this instance, a choking person should rather be encouraged to try and cough in order to help expel the obstruction. If they are unable to do so, the Heimlich Manoeuvre can be used.