BLS Choking Infant Algorithm

You cannot effectively perform the Heimlich maneuver on an infant less than one year of age. Therefore, infant choking victims (who are conscious and responsive) can be treated with a combination of back blows and chest thrusts. With your forearm resting on your thigh, place the infant face down on your forearm. His head should be lower than the level of his chest. Support the child’s weight by holding the chest and head—keep the throat straight and do not put pressure directly on the throat. Deliver five blows to the infant’s back between the two shoulder blades. Move the infant to your other forearm, this time facing upward. Again, the victim’s head should be lower than his chest. Using two fingers of your free hand, deliver five chest thrusts to the bottom half of his breastbone. In both cases, you are trying to rapidly increase the pressure inside the lungs to expel the airway obstruction.

After these five back blows and chest thrusts, take a moment to determine if the obstruction has been cleared. The infant should immediately start crying. If the infant is still choking, repeat the process (five back blows followed by five chest thrusts) until the obstruction is cleared or emergency help has arrived.