Just as Kevin took a bite of his hot dog, his friend Peter made a goofy face and it cracked Kevin up. But it's hard to laugh and swallow food at the same time. A piece of the hot dog slipped down Kevin's throat and got stuck. He couldn't talk, he couldn't breathe — he couldn't make any sound at all.

At first Peter thought Kevin couldn't catch his breath because he was laughing so hard. But when Kevin started waving his hands and grabbing at his throat, Peter knew his friend was in trouble. He yelled for help.

A teacher rushed over to Kevin and performed a technique called the Heimlich maneuver (say: hime-lik mah-noo-ver), which caused the hot dog piece to shoot out of Kevin's mouth and land a good 6 feet away. Gross, yes. But that teacher saved Kevin's life.

What Is Choking?

To understand choking, you first have to understand what goes on at the back of your throat hundreds of times per day. All the food you eat and the air you breathe passes through your throat to get into your body.

Food and liquid go down one pipe — the esophagus (say: eh-sah-fuh-gus) — to your stomach. Air goes down another pipe — the trachea (say: tray-kee-uh), or windpipe — to your lungs. These two pipes share an opening at the back of your throat.

So if they share an opening, how does the food know which pipe to go down? Lucky for you, your body has it all under control. A little flap of cartilage (say: kar-tel-ij) called the epiglottis (say: eh-pih-glah-tis) sits near your trachea, and every time you swallow, it springs into action. Acting like a little door, it closes off the entrance to your trachea so that food is sent down your esophagus into your stomach instead of into your lungs.

But every once in a while, especially if you are laughing while you are eating, the epiglottis doesn't close in time. A piece of food, like Kevin's hot dog, can slip down into the trachea. Most of the time, it's no big deal. Your body makes you cough and forces it back up.

'Went Down the Wrong Pipe'

Did you ever have a sip of a drink that "went down the wrong pipe"? You probably coughed a lot and it might have been scary, but usually you're fine in just a few seconds. That's because coughing is the body's natural defense against stuff that doesn't belong in the trachea. A good cough often can clear out a piece of food — or even an object — that heads down the trachea. If a person can still breathe and talk, coughing often does the trick.

But when someone is truly choking it means the food or object is completely blocking the airway and air cannot flow into and out of the lungs. The person cannot cough the object out and cannot breathe, talk, or even make noise. The person might grab at his or her throat or wave his or her arms. If the trachea remains blocked, the person's face may turn from bright red to blue.

The body needs oxygen to stay alive. When oxygen can't reach the lungs and the brain, a person can become unconscious, sustain brain damage, and even die within minutes. That's what makes choking such a serious emergency.

What Is the Heimlich Maneuver?

The Heimlich maneuver is a way to help someone who is choking. It's usually performed by another person, but there's even a way to do it on yourself, if necessary.

The traditional Heimlich maneuver is to be used on adults and children over 1 year old. A helper gets behind the choking person and gives a certain kind of quick squeeze in the middle of the abdomen. This squeeze sends a quick, powerful burst of air from the person's lungs upward, dislodging the problem food or object and often sending it flying out of the person's mouth.

To do it properly and safely, it's best to learn it from a health care professional who can show you how it's done. Sometimes, kids learn the Heimlich maneuver in a health class or a first-aid class.

What Should I Do if Someone Is Choking?

Choking is serious stuff. If you think someone is choking, yell for help and have somebody call 911 right away. If you are trained to do the Heimlich maneuver, you should do it immediately. It can be a lifesaver, but it's safest when done by someone trained to perform it. If it's done the wrong way, the choking person — especially a baby or child — could be hurt.

If a choking person is unconscious and has already stopped breathing, the Heimlich needs to be performed along with cardiopulmonary resuscitation (CPR), which is also best performed by someone who knows how to do it correctly.

When to Call the Doctor or Go to the ER

Any kids who have had a really bad choking episode should see a doctor immediately to get checked out. Sometimes this means going to the ER. Someone who has choked and keeps coughing, drooling, or has noisy breathing or trouble breathing needs to get checked out by a health care provider right away. These symptoms could be a sign that something is still stuck in the windpipe and this can be dangerous.

Even someone who had a choking episode with coughing and then felt totally fine after should still check in with a doctor.

How Can I Prevent Choking?

Here are four great ways to prevent choking:

  1. Be extra careful when eating certain foods that are easy to choke on. They include things like: hot dogs, nuts, grapes, raw carrots, popcorn, and hard or gooey candy. Ask your parents to check food labels to make sure the food isn't the kind that can lead to choking.
  2. Sit down, take small bites, and don't talk or laugh with your mouth full! Do we sound like your mom? Well, she's right. And more than good manners are at stake. Following that advice will help prevent choking.
  3. Look out for the little guys — and girls. Babies and toddlers love to put things in their mouths, so help keep them safe by picking up anything off the floor that might be dangerous to swallow — like deflated balloons, pen caps, coins, beads, and batteries. Keep toys with small parts out of reach, and never share your food or candy with a baby unless an adult says it's OK.
  4. Learn the Heimlich maneuver. It's usually taught as part of any basic first-aid course — the kind that might be held by the Red Cross, the YMCA, the American Heart Association, schools, or hospitals in your community. Who knows? You could be a lifesaver someday!

Reviewed by: Yamini Durani, MD
Date reviewed: July 2011

Kids Health

