What Not to Do When Someone is Choking: A Lifesaving Guide to Avoiding Common Mistakes

The Critical Importance of Knowing What NOT to Do When Someone is Choking

In a moment of sheer panic, when someone is gasping for air, their face turning red then blue, our instinct is to act—fast. But in a choking emergency, a wrong move can be just as dangerous, if not more so, than no move at all. This article focuses on a crucial, often overlooked aspect of first aid: what not to do when someone is choking. While knowing the correct procedures like the Heimlich maneuver is vital, understanding and avoiding common, well-intentioned mistakes can mean the difference between a close call and a tragedy. A calm, informed response that sidesteps these pitfalls is your most powerful tool. Let’s be clear from the start: avoiding these errors is a fundamental part of providing effective help.

Don’t Panic and Freeze

This might sound obvious, but it is unequivocally the first and most critical mistake to avoid. Witnessing someone choke is terrifying. The sudden silence, the look of fear in their eyes—it’s enough to make anyone’s mind go blank. However, succumbing to panic is a luxury you simply cannot afford. Panic clouds judgment, wastes precious seconds, and prevents you from assessing the situation correctly.

When you freeze, you lose the window of opportunity to determine the severity of the choking. Is it a mild or a severe blockage? Can the person still make noise? Your ability to answer these questions guides your entire response. Instead of letting fear take over, force yourself to take one deep breath. This small action can interrupt the panic cycle and allow your brain to switch into problem-solving mode. Your calm demeanor will also be incredibly reassuring to the choking person, who is already experiencing extreme terror.

A Better Approach: Take a single, deliberate breath. Immediately ask, “Are you choking? Can you speak?” Their response (or lack thereof) is your first and most important piece of information.

Don’t Give the Person Water or Any Other Liquid

It’s a deeply ingrained instinct: someone is coughing or sputtering, so you rush to give them a glass of water. While helpful for a tickle in the throat, this is an incredibly dangerous thing to do to a choking person. A choking obstruction is a physical blockage of the airway, typically by a solid piece of food or an object. It’s like a cork in a bottle.

Think about it this way: you cannot flush out a solid cork with liquid. The water or juice you provide has nowhere to go but down the same partially or fully blocked path. It can’t dislodge the object. Instead, the liquid will likely pool around the obstruction, and if the person gasps for air, they can inhale the fluid into their lungs. This is called aspiration, which can lead to a serious lung infection (aspiration pneumonia) or even cause a complete airway spasm, making a bad situation significantly worse. It complicates any subsequent first aid efforts and can introduce severe medical issues even if the object is eventually dislodged.

• Why it’s dangerous: The liquid cannot push a solid object out.
• What it can cause: It can lead to aspiration, where fluid enters the lungs.
• The outcome: It can worsen the blockage and cause secondary complications like pneumonia.

Don’t Slap an Upright Person on the Back

This is perhaps the most widespread and misunderstood first aid myth. A hearty slap on the back seems like a natural way to jolt something loose. However, if the person is standing or sitting upright, this action can have the opposite effect. Gravity is not on your side here. When you slap an upright person between the shoulder blades, the percussive force combined with gravity can cause the object to drop further down into the trachea, potentially turning a partial, treatable obstruction into a complete and life-threatening one.

The correct technique for back blows is not just about *where* you hit, but about the person’s *posture*. The individual must be bent over at the waist, so their head is lower than their chest. In this position, gravity works *with* you. The sharp blows between the shoulder blades are then far more likely to propel the object upwards and out of the mouth. Without this crucial forward lean, you are playing a dangerous game of chance with their airway.

Correct vs. Incorrect Back Blows

• DO NOT: Slap the back of a person who is standing or sitting straight up.
• DO: Support their chest with one hand, lean them far forward, and then deliver five firm, separate blows between the shoulder blades with the heel of your other hand.

Don’t Perform the Heimlich Maneuver Incorrectly or Unnecessarily

The Heimlich maneuver (or abdominal thrusts) is a powerful, lifesaving technique, but its power also means it can cause harm if done wrong or when it’s not needed. It is not a one-size-fits-all solution for every choking incident.

Don’t Use it for Mild Choking

It is critical to distinguish between mild and severe choking.

• Mild Choking: The person can still speak, cry, cough, or make sounds. Their airway is only partially blocked. In this case, their own cough is the most effective tool for clearing the obstruction.
• Severe Choking: The person cannot speak, cough, or breathe. They may make a high-pitched wheezing sound (stridor) or no sound at all. They might use the universal sign for choking (clutching the throat with both hands). This is when first aid is required.

If you perform abdominal thrusts on someone who is effectively coughing, you interrupt their own natural, powerful efforts to expel the object. Furthermore, the maneuver exerts significant force on the abdomen and can cause internal injuries, such as bruised or broken ribs, or damage to organs like the spleen or liver, even when performed correctly. For mild choking, simply encourage the person to keep coughing and monitor them closely.

Don’t Perform it with Incorrect Hand Placement

When the Heimlich maneuver *is* necessary for severe choking, proper technique is non-negotiable. Common mistakes in hand placement can render the maneuver ineffective and increase the risk of injury.

• Don’t place your hands too high: Placing your fist on the sternum (breastbone) or ribs will not create the necessary upward pressure on the diaphragm. Instead, you are likely to fracture ribs or the xiphoid process (the small cartilage at the bottom of the sternum), which can be very dangerous.
• Don’t place your hands too low: Placing your hands too far down on the abdomen won’t be effective and can cause damage to other internal organs.

The Correct Placement: Make a fist and place the thumb side against the middle of the person’s abdomen, just above the navel and well below the breastbone. Grasp your fist with your other hand and deliver firm, sharp, inward and upward thrusts. Each thrust should be a distinct and forceful attempt to dislodge the object.

Don’t Attempt a Blind Finger Sweep

When a person is choking, especially a child, the temptation to stick your fingers in their mouth to pull out the object can be overwhelming. Do not do this. This action, known as a “blind finger sweep,” is extremely hazardous. You cannot see what you are doing, and you are far more likely to accidentally push the object deeper into the throat, sealing the airway completely. This can turn a situation where some air might still be passing into a complete medical emergency.

The only time you should ever put your fingers in a choking person’s mouth is if they have become unconscious and, after performing chest compressions or other first aid, you open their mouth and can *clearly see* the obstructing object. In that specific scenario, and only then, you can attempt to remove it with a careful hooking motion of your finger. If you can’t see it, don’t go fishing for it.

Don’t Leave the Person Alone to Get Help

A person with a severe airway obstruction can lose consciousness in under a minute. Brain damage can begin in as little as three to four minutes without oxygen. Never, ever leave a choking person alone to run and call for an ambulance or find someone else. Their condition can deteriorate in the few seconds you are gone.

The correct protocol is to stay with the person and begin first aid immediately. If you are alone, shout loudly for help to attract attention. If others are present, point directly to one person and give a clear command: “You in the blue shirt, call 911 right now and tell them someone is choking!” This direct instruction cuts through the bystander effect, where everyone assumes someone else will act. If you have a phone in your pocket, you can call 911 and put it on speakerphone while you begin administering back blows and abdominal thrusts.

Don’t Delay Calling for Emergency Services

Some people hesitate to call 911, thinking they can handle the situation themselves or not wanting to cause a fuss. This is a grave mistake. In any case of severe choking, calling for professional medical help should be done as soon as the problem is identified. Paramedics have advanced tools and skills that you do not, such as suction devices and intubation equipment.

Even if you successfully dislodge the object using first aid, the person should still be evaluated by a medical professional. The choking episode itself can cause swelling or injury to the throat, and procedures like the Heimlich maneuver can cause internal injuries that may not be immediately apparent. Calling 911 ensures that help is on the way, providing a critical backup if your initial efforts are unsuccessful and ensuring proper follow-up care if they are.

Mistakes to Avoid with Specific Populations

Choking first aid is not a one-size-fits-all procedure. What works for a healthy adult can be deadly for an infant or ineffective for a pregnant woman. Knowing what not to do in these cases is paramount.

For Infants (Under 1 Year Old)

• DO NOT perform the Heimlich maneuver. An infant’s body is too fragile for abdominal thrusts, which can cause severe damage to their liver, spleen, and other internal organs.
• DO NOT shake the infant. Shaking a baby, whether out of panic or a misguided attempt to dislodge an object, can cause Shaken Baby Syndrome, leading to bleeding in the brain, permanent brain damage, or death.
• DO NOT perform a blind finger sweep. An infant’s airway is tiny, and a blind sweep is almost guaranteed to push the object further in.

Instead, the correct procedure for a choking infant involves a combination of 5 back blows and 5 chest thrusts while the infant is supported on your forearm with their head lower than their body.

For Pregnant or Obese Individuals

• DO NOT perform standard abdominal thrusts. For a pregnant woman, thrusting into the abdomen can harm the fetus. For a significantly obese person, you may not be able to get your arms around their abdomen effectively to deliver a proper thrust.

In these situations, the hand placement must be modified. You should perform chest thrusts instead. Wrap your arms under the person’s armpits and around their chest. Place your fist on the center of their breastbone (sternum) and deliver firm, inward thrusts—similar to the Heimlich but on the chest.

Summary Table: Common Mistakes vs. Correct Actions

To provide a clear, at-a-glance reference, here is a summary of what to avoid and what to do instead.

Final Thoughts: Confidence Through Knowledge

In a choking emergency, your actions are dictated not just by what you know how to do, but also by what you know to avoid. The most well-intentioned gestures, if incorrect, can escalate a crisis. By understanding the “why” behind these crucial “don’ts,” you replace panic with purpose and hesitation with confident, effective action.

Remember the core principles: assess the situation calmly, differentiate between mild and severe choking, and never perform an action that could make the blockage worse. Your goal is to help the body’s natural defenses or, if they fail, to provide assistance in a way that is both powerful and safe.

Ultimately, the best way to prepare for such an event is to take a certified first aid and CPR course. Reading an article is an excellent first step, but hands-on training on a mannequin will build the muscle memory and confidence you need to act correctly under pressure. In a moment where every second counts, knowing precisely what not to do is one of the most powerful lifesaving skills you can possess.