Choking and CPR for Seniors: Heimlich and Hands-Only CPR Basics

Choking and CPR: What Every Family Should Know

This page is not a substitute for training. CPR is best done by someone trained in an accredited course.[3] Use this page as a reminder, and take a hands-on class from the American Red Cross or American Heart Association.

When to call 911

• Someone is choking and can't speak, cough, or breathe: act now, and have someone call 911.[1][2]
• Someone collapses and doesn't respond: call 911 (or have someone else call), then start CPR.[3][4]
• If you're alone with an adult who is unresponsive, call 911 first, then start CPR. Use speakerphone so you can keep your hands free.

Key takeaways

• If a person can cough hard or speak, let them keep coughing. Don't hit or squeeze them.[1]
• If they can't speak or breathe: give 5 back blows, then 5 abdominal thrusts, and repeat.[1][2]
• If they pass out, lower them to the floor, call 911, and start CPR.[1][2]
• Hands-only CPR: push hard and fast in the center of the chest, at least 2 inches deep, 100 to 120 times a minute.[4]
• Use an AED as soon as one is available. It tells you what to do.[3]

Part 1: Choking

Choking is when food or an object blocks the airway. Without oxygen, brain damage can occur in as little as 4 to 6 minutes.[1]

First, ask

"Are you choking? Can you speak?" If the person is coughing forcefully and can talk, don't do first aid. A strong cough often clears the object.[1]

If they can't speak or breathe: adult or child over 1

Both the American Red Cross and MedlinePlus teach cycles of back blows and abdominal thrusts.[1][2]

5 back blows

1. Stand to the side and slightly behind the person.[2]
2. Support their chest with one arm and lean them forward at the waist.[1][2]
3. With the heel of your other hand, give 5 firm blows between the shoulder blades.[1][2]

5 abdominal thrusts (Heimlich maneuver)

1. Stand behind the person and wrap your arms around their waist.[1]
2. Make a fist and place the thumb side just above the belly button.[1]
3. Grab your fist with your other hand.
4. Give 5 quick, inward and upward thrusts.[1][2]

Repeat 5 and 5 until the object comes out, the person can cough, cry, or speak, or they become unresponsive.[1][2]

For a larger person or a pregnant person: use chest thrusts instead. Put your fist on the middle of the breastbone and give firm backward thrusts.[1]

If they become unresponsive: lower them to a firm, flat surface, make sure 911 has been called, and start CPR.[1][2] Look in the mouth before giving breaths. Only remove an object you can see. Never do a blind finger sweep.[2]

Infants under 1 need different steps. Most experts don't recommend abdominal thrusts for babies.[1] A class will teach infant care.

If you're alone and choking

You can do abdominal thrusts on yourself. MedlinePlus has separate instructions.[1]

Lowering choking risk

If an older family member coughs or chokes often when eating or drinking, mention it to their doctor.

Part 2: Hands-only CPR for adults

CPR keeps blood moving when someone's heart has stopped. Brain damage can begin after about 4 minutes without oxygen.[3] The American Red Cross teaches hands-only CPR, CPR without rescue breaths, for people not trained in full CPR.[4]

Before you start

1. Check the scene is safe. Tap the person and shout, "Are you OK?"[4]
2. Look for normal breathing. Gasping is not normal breathing.[3][4]
3. Call 911, or have someone else call.[4] If you know an AED is nearby, send someone for it.[3]

Hands-only CPR steps

From the American Red Cross:[4]

1. Lay the person on their back on a firm, flat surface.
2. Kneel beside them.
3. Put the heel of one hand in the center of the chest and your other hand on top. Lace your fingers and keep them off the chest.
4. Shoulders over your hands, elbows locked, arms straight.
5. Push hard and fast: at least 2 inches deep, 100 to 120 compressions a minute.
6. Let the chest come all the way back up after each push.

Keep going until the person starts breathing, an AED is ready, or trained help takes over.[3]

A trained rescuer may add 2 rescue breaths after every 30 compressions.[3] If you haven't been trained in breaths, keep doing compressions.[4]

Using an AED

An automated external defibrillator (AED) is found in many public places, and some people keep one at home.[3] It checks the heart rhythm and gives a shock only if one is needed.[3] Turn it on and follow its voice instructions exactly.[3]

Important cautions

• If the person is breathing normally, coughing, or moving, don't start compressions.[3]
• If you suspect an opioid overdose and the person isn't breathing, give naloxone if you have it, without stopping CPR.[3]
• If they start breathing again, place them in the recovery position on their side and keep watching their breathing.[3]

Take a real class

Reading is not the same as practice. A hands-on course lets you practice on a manikin and learn to use an AED.

• American Red Cross classes: redcross.org (search "CPR class" with your ZIP code)[4]
• American Heart Association course finder: cpr.heart.org[3]

Related pages

• Keep key health facts ready for responders:

• Heart attack signs in women
• Stroke symptoms
• What to do after a fall

FAQ

What is the first thing to do when someone is choking? Ask if they can speak. If they're coughing hard, let them cough. If they can't speak or breathe, give 5 back blows and 5 abdominal thrusts.[1][2]

How do you do hands-only CPR? Call 911, then push hard and fast in the center of the chest, at least 2 inches deep, 100 to 120 times a minute.[4]

Can I hurt someone by doing CPR? Don't start compressions on someone who is breathing normally, coughing, or moving.[3] For someone unresponsive who isn't breathing normally, CPR is their best chance until help arrives.[3]

Do I need certification to help? No. But a certified class is the best way to learn and gain confidence.[3]

Sources

1. MedlinePlus Medical Encyclopedia. Abdominal thrusts. National Library of Medicine (NIH). Review date February 17, 2026. https://medlineplus.gov/ency/article/000047.htm. Accessed October 30, 2026.
2. American Red Cross. Adult/Child Choking. n.d. https://www.redcross.org/take-a-class/resources/learn-first-aid/adult-child-choking. Accessed October 30, 2026.
3. MedlinePlus Medical Encyclopedia. CPR - adult and child after onset of puberty. National Library of Medicine (NIH). Review date February 10, 2026. https://medlineplus.gov/ency/article/000013.htm. Accessed October 30, 2026.
4. American Red Cross. How to Perform Hands-Only CPR. n.d. https://www.redcross.org/take-a-class/cpr/performing-cpr/hands-only-cpr. Accessed October 30, 2026.

Disclaimer

This article is for general education only and is not medical, legal, or financial advice. Talk to your doctor, a licensed attorney, or a SHIP counselor (Medicare) about your situation. In an emergency, call 911.

Attribution

Portions of this page are adapted from "HowToLiveBetter" (高性价比人生指南) by eternity4719, https://github.com/eternity4719/HowToLiveBetter, licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Changes: topic and evidence approach adapted from Chapter 13 (Emergencies: choking and CPR); rewritten for the U.S. context and re-sourced to U.S. research and official guidance. Not a direct translation.