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Choking Standing Stand behind the victim and make a fist. Place the thumb end of the fist against the abdomen of the victim, with the fist definitely below the rib cage, between the belly button and the rib cage, but well below the rib cage. Place the other hand over the fist and pull up and in, quickly. The force should depend on the amount required to move enough air to remove the obstruction. In order to prevent injury from using more force than is necessary, one may wish to start with minimal force and increase with each attempt. It may be necessary to repeat the Maneuver four or five times. With small children, use only the fingers to apply pressure. Sitting When the victim is sitting, the chair can provide a good brace or support to perform the Maneuver, which is performed as above. Lying Down If the victim has collapsed, or if the victim is so large that the person applying the treatment is unable to reach around the victim, the victim should be placed on the floor on his back. The person applying the treatment quickly straddles the hips of the victim, places one hand over the other and with the heels of the hands well below the rib cage (between the rib cage and the belly button) quickly pushes up and in. Remove the food quickly after it is expelled. Also the patient may vomit, so quickly turn him on his side after treatment. After all, there is very little time. Death or brain damage will occur in just a few minutes. You must act fast. The victim should be examined by a physician after a choking episode and treatment. If Alone This can be administered to yourself by placing the hands as if standing behind a victim and then letting yourself fall over a chair or table. A Distress Signal Placing the hand to the throat is an almost automatic response of someone choking. This will convey the message, " I am choking!" Teach this maneuver to every member of your family so that they may react quickly to save the life of another. Back to the First Aid page.