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For Choking Emergencies: Five and Five

Before the holiday season gets into full swing, we at Fast Track Urgent Care invite you to take a moment to learn a critical procedure that could save lives—the Five and Five.

The Five and Five procedure is the American Red Cross’ recommended aid to give to someone who is choking in order to remove the obstructing object from his or her throat and prevent suffocation.

It’s called “Five and Five” because the main components are:

  • Five back blows
  • Five abdominal thrusts

Health organizations differ on what they recommend for choking aid. The Red Cross teaches the Five and Five procedure while the American Heart Association omits the back blows. Either procedure is appropriate—you can do just the abdominal thrusts if you aren’t sure you can administer the back blows correctly.

Choking cuts off oxygen to the brain. Do not hesitate if you suspect someone is choking—assess the situation as quickly as possible and act immediately.

What to Do When Someone Is Choking

If the person is unable to breathe, cough, or speak, take the following steps:

  1. Look around to make sure the area is safe.
  2. If there are others nearby, point out one specific person and ask them to call 911.
  3. Ask the choking person for consent to begin the procedure (or the parent or guardian if the victim is a minor).
  4. Give five back blows. Give five back blows between the victim’s shoulder blades with the heel of your hand. If possible, brace the victim by putting your other arm around the front of his or her chest.
  5. Give five abdominal thrusts. Give five abdominal thrusts as described below:
  • While standing behind the victim, wrap your arms around her waist while gently tipping her forward.
  • Make a fist with one hand and place it slightly above the victim’s navel.
  • Grasp your fist with your other hand and give a quick, upward thrust into the victim’s abdomen, as if you were trying to lift him up.
  • Do five abdominal thrusts (fewer if the object becomes dislodged).

Repeat the Five and Five procedure until:

  • The object is forced out
  • The person can breathe or cough forcefully
  • The person becomes unconscious

If the victim becomes unconscious:

  • Carefully lower him to the ground
  • Try two rescue breaths:
    • Tilt the victim’s head and lift the chin, then pinch the nose shut
    • Take a breath and make a complete seal over the person’s mouth with your mouth
    • Blow in to make the victim’s chest rise visibly
    • If the first two rescue breaths do not go in (if you do not see the victim’s chest rise), tilt the head back farther and try two more rescue breaths
    • If breaths still do not go in, stop and give 30 chest compressions.

To get further instruction on how to aid a choking victim: