The Silent Killer: Why Choking First Aid Should Be Everyone's Business

A 3-minute read on recognising and responding to choking emergencies.

It happened during a company Christmas party. One minute everyone was laughing and enjoying their meal, the next minute someone was frantically pointing at their throat, unable to speak. The room went silent as people realised what was happening – someone was choking.

This scene brought back memories from my 14 years as a police officer when we were called to a similar incident at a local pub. A customer had been choking on a piece of steak, and by the time we arrived, the situation was critical.

That experience, combined with my 22 years in the Army where we trained extensively for medical emergencies, taught me that choking incidents can escalate from manageable to fatal in a matter of minutes. The key is recognising the signs early and acting decisively – skills I now pass on to every student as founder of Typhon Training Solutions.

The Universal Sign of Distress

After over five years of teaching first aid with Typhon Training Solutions, I've seen this scenario play out countless times in training. But when it happens for real, it's terrifying.

The person can't speak, can't cough effectively, and their face starts turning red, then blue.

They might grab their throat with both hands – what we call the "universal choking sign."

Here's what most people don't realise: you've got minutes, sometimes less, before someone loses consciousness from choking. Unlike other emergencies where you might have time to think, choking demands immediate action.

The Five-and-Five Approach

In our HSE-approved First Aid at Work courses, I teach what's called the "five-and-five" method. It's simple, effective, and could save someone's life before the ambulance even arrives.

First, try five sharp back blows. Stand to the side and slightly behind the choking person. Support their chest with one hand and lean them forward. Give five sharp blows between their shoulder blades with the heel of your other hand. Check their mouth after each blow – sometimes this is enough to dislodge whatever's stuck.

If back blows don't work, move to five abdominal thrusts – (the Heimlich manoeuvre). Stand behind them, place your arms around their waist. Make a fist with one hand and place it just above their navel, below the ribcage. Grasp your fist with your other hand and give five quick, upward thrusts.

Keep alternating between back blows and abdominal thrusts until the object comes out or they become unconscious.

When Things Go Wrong

Here's the bit that makes people uncomfortable: if someone becomes unconscious while choking, you need to start CPR immediately. I know it sounds counterintuitive, but chest compressions can help force the obstruction out. This is why proper training is so crucial – you need to know how to adapt when the situation changes.

I remember training a restaurant manager who was initially sceptical about the course. Six months later, he called to thank me. A customer had started choking on a piece of steak, and he'd successfully used the techniques we'd practised. The customer walked away completely fine, and the restaurant avoided what could have been a tragedy.

The Workplace Reality

Choking isn't just about food. In workplaces, people choke on all sorts of things – sweets, chewing gum, even small parts or tools in industrial settings. I've trained factory workers who've dealt with colleagues choking on everything from nuts to small components.

The key is recognising the signs quickly. Effective coughing means their airway isn't completely blocked – encourage them to keep coughing. But if they can't cough, can't speak, or are making high-pitched noises, that's when you need to act fast.

Don't Be the Bystander

One of the saddest things I see in emergency situations is the "bystander effect" – everyone assumes someone else will help. With choking, there's no time for that. If you see someone in distress, step forward. Even if you're not perfectly trained, attempting to help is better than doing nothing.

Building Confidence Through Practice

At Typhon Training Solutions, we use realistic scenarios to build confidence. Students practice on each other (safely, of course) so they know exactly how much pressure to apply and what the technique should feel like. It's one thing to read about it, quite another to actually do it.

Your Workplace Responsibility

If you're responsible for workplace safety, choking response should be part of your first aid provision. It's not just about having a first aider on site – it's about having people who can respond immediately when seconds count.

Want to ensure your team knows how to respond to choking emergencies? Get in touch with me at Typhon Training Solutions. Call 07939557029 or email mark.phillips@typhontrainingsolutions.co.uk to discuss your training needs.

Because when someone can't breathe, you don't have time to look up instructions on your phone.

Mark Phillips delivers practical, hands-on first aid training through Typhon Training Solutions, helping workplaces across the UK prepare for real emergencies.