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As a parent–or just a human being in general–there are some basic first-aid things you need to know. Cuts, scrapes and burns are pretty self-explanatory, but helping someone who is choking can be an intimidating task. We’ve all heard of the Heimlich Maneuver, but that doesn’t necessarily mean we know the nuances of performing it on someone or that it’s not the only thing you should do for someone with a blocked airway.

Don’t worry. Here’s exactly what you should do when someone is choking according to an actual first-aid instructor, Dean Rideout.

First things first

Are they actually choking?

There are two types of choking: mild and severe. Mild means that the airways are not fully restricted and the person can still cough. If that’s the case, keep them coughing. Hopefully, their body will be able to cough out whatever is caught in their throat–it’s the natural reaction.  Any patting on the back at this point could actually make it worse. Hands off.

Severe choking is when the airway is fully restricted and the person can’t cough or breathe. This is when they need somebody’s help right away.

Ask if you can help them

Still gotta cover your bases. You can’t touch someone and administer first-aid without their consent. Since they’re choking and probably can’t speak, look for body language–like nodding and making choking motions–that indicates they want your help.

Back-blows and abdominal thrusts

When you’re giving your blows and thrusts, these actions need to be incredibly forceful. Some abdominal bruising is far better than dying from choking on your dinner. Rideout says ‘when you do abdominal thrusts, it hurts like and feels like a punch to the stomach.’

You only have about 30 seconds after the person starts severely choking before they pass out from lack of oxygen, so you need to act quickly. If there is someone else around, have them call 9-1-1 while you administer first-aid.

The maneuvers

First, standing perpendicular to the person, reach your arm across their chest and lean them down forward over your arm. Then take the base of your palm and give them five good, hard smacks right between the shoulder blades. If they’re still choking after that, it’s onto the abdominal thrusts.

Position yourself so the person is directly in front of you and your foot is forward, just barely between their feet. Then reach around their midsection and make a fist, put the flat part down and grab it with your other hand. Once you’re positioned, pull in and up in an L-shaped motion five times.

Repeat these until either the object is expelled or the person passes out from lack of oxygen. If the person falls unconscious, call an ambulance (if someone hasn’t done it already) and begin administering CPR.

What if the person is bigger than you?

Do the maneuvers in the same way as best you can, but protect your head by moving it to the side when you thrust in and up.

What if the person is pregnant?

If a pregnant woman is choking, replace the abdominal thrusts with chest-pulls. To execute that, stand behind them, reach up under their armpits and make a fist in the same way you would for the Heimlich but over their chest. Then pull straight back hard enough to knock the wind out of them. Remember, she may be pregnant, but you’re still going to need to be forceful, or your first-aid won’t do any good. As Rideout explains, ‘What’s good for mom is good for baby.’

What about Babies?

Speaking of babies, you can’t exactly give them the Heimlich. They require a modified technique.

How do you know if they’re choking?

Since babies can’t talk, you have to rely on physical indicators to show you if they’re choking. Like adults, their choking could be mild or severe. If it’s mild, it means they can still cough so let them do that. If their choking is severe, it might look like they’re crying but there won’t be any sound coming out. They will also start changing colour quickly from lack of oxygen. Time to act quickly.

Now what?

Hold the baby in one arm while sitting. Take the hand that isn’t cradling them and grab onto their jaw without blocking the mouth, then flip the baby face down onto one of your legs. In this position, give them five forceful back-blows between the shoulder blades. Yes, forceful, you’re trying to save a life.

Then grab the back of the head and flip the baby to your other leg to give them chest thrusts. With two fingers, press forcefully five times just below the nipple line in the center of the chest.

Again, keep repeating the maneuvers until the food comes out or the baby goes unconscious. If the latter happens, call 9-1-1.

Those are your choking basics. For more detail on first-aid, check out the St. John Ambulance or the Canadian Red Cross websites.