Deborah Erdman, of Geisinger Medical Center, demonstrates the Heimlich maneuver.

Lingering over your Thanksgiving meal and laughing through dessert and coffee makes for happy memories … until someone chokes, and things get serious quickly.

“Everybody’s going to be talking and laughing and having a good time, and that’s when you can suck something back up in,” said Deborah Erdman, Geisinger outreach injury prevention coordinator and RN. “That’s when trouble happens.”

Erdman speaks not only from a medical standpoint but also from personal experience. Enjoying a meal with fellow nurses, she laughed while eating a bite of an apple.

“I inhaled, and there I was,” she said, noting that she was unable to talk or breathe. “They were all looking at me. Someone said, ‘Are you choking?’

“I made the universal signal for choking. My head’s bobbing up and down and probably turning three shades of red at that point. Somebody got behind me and did the Heimlich.”

That dislodged the apple, and Erdman took a big breath.

“I was so relieved,” she said. “Because you’re panicking at that point. You can’t inhale, you can’t exhale, and that’s the classic sign of someone choking, is that they can’t make any sounds.”

That’s the clue to watch for. If a person is coughing and gagging, let them go. As hard as it might be, it’s best to give them a chance for their body to get rid of whatever is making them choke.

If they’re not making any sounds, however, and especially if they show the universal sign for choking — putting their hands to their throat and making “help me” gestures — then it’s time to step in.

“If the individual is coughing and can speak, stand by and do not interfere,” said Yvonne T. Delgado, RN, ACLS and CPR instructor, AHA TC coordinator from UPMC Susquehanna Sunbury. “However, if the individual is responsive with:

• difficulty breathing 

• inability to speak or breath

• a silent cough

• turning blue 

• clutching their throat (universal sign for choking)

… you must intervene. Ask if they are choking, and if they respond yes (shaking their head), tell them you can help. Acting fast is critical.”


Know the Heimlich

Cutting food into bite-sized pieces and then chewing before swallowing are the best ways to prevent choking, but as Erdman learned, things can happen fast. 

That’s why it helps to review the Heimlich maneuver, as suggested by the American Red Cross:

• Stand behind the person. Place one foot slightly in front of the other for balance. Wrap your arms around the waist. Tip the person forward slightly. If a child is choking, kneel down behind the child.

• Make a fist with one hand. Position it slightly above the person’s navel.

• Grasp the fist with the other hand. Press hard into the abdomen with a quick, upward thrust — as if trying to lift the person up.

• Perform between six and 10 abdominal thrusts until the blockage is dislodged.

If the individual becomes unresponsive, it’s time to call 911 and begin CPR (30 compressions to 2 breaths) until a first responder arrives.

It might be awkward or scary to help someone who’s choking, and you might worry that you’ll hurt them, but they’ll be grateful you stepped in.

“It is possible that an injury can occur after administering abdominal thrusts,” Delgado said. “However not assisting a choking victim can result in their death.”

“I’m glad I had people with me,” Erdman said about her choking incident. But if a person is choking when alone, he or she can try administering the Heimlich to themselves. “Forcibly bending yourself over the back of a chair can help with that diaphragm pressure.”


Choking hazards

Special oversight must be given with young children during the holidays. Watch them with small ornaments, toys, even batteries. A rule of thumb: anything that can fit inside a toilet roll tube is small enough to be a choking hazard.

“One of the big offenders are those button batteries,” Erdman said. “If they’re lodged (in a throat) for any length of time they can actually dissolve and burn. They can cause internal injuries.”

If your child swallows a battery or even lodges it in his or her ear or nose, get to the Emergency Department. Don’t try to encourage them to swallow or vomit the battery. That can cause more damage.

There’s even a battery hotline: 800-498-8666.

“Preparation can go a long way in any emergency situation,” Delgado said. “Something as simple as making sure everyone of the appropriate age in your home knows basic first aid, CPR and the Heimlich maneuver can save lives.”

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