• Posted October 27, 2025

New Guidelines Detail How To Respond To A Choking Emergency

Want to be ready to respond if an adult starts choking on their food, or a child on some object they’ve swallowed?

Updated guidelines are available that let people know just what to do if an infant, child or adult is choking — and it’s pretty much the same thing for everyone.

Rescuers should alternate five back blows with five abdominal thrusts until the object is expelled, according to guidelines issued by the American Heart Association (AHA) as part of its update on CPR protocols.

For infants, rescuers should alternate between five back blows and five chest thrusts using the heel of one hand, rather than abdominal thrusts, the guidelines say.

The back blows help dislodge the blockage, which can then be expelled through the abdominal or chest thrusts.

Previous guidelines offered no choking guidance for adults and recommended abdominal thrusts only for children, the AHA noted.

“The American Heart Association’s 2025 CPR guidelines represent gold standard science. It reflects a rigorous examination of the most up-to-date evidence that guides how resuscitation is provided for critically ill patients,” Dr. Ashish Panchal said in a news release. He’s volunteer chair of the AHA’s Emergency Cardiovascular Care Science Committee.

“As the science continues to evolve, it’s important that we continue to review new research specific to the scientific questions considered of greatest clinical significance that affect how we deliver life-saving care,” added Panchal, a professor of emergency medicine at Ohio State University.

The expanded guidelines also provided updated recommendations for treating victims of a suspected opioid overdose (OD). 

The guidelines recommend that either bystanders or trained rescuers should administer the OD-reversal medication naloxone, provided that the drug doesn’t interfere with the delivery of CPR.

Further, adults and children who survive an opioid OD should receive a naloxone prescription and instructions on how to use it, so they are ready to respond to potential future overdoses.

The AHA crafted its infant and child rescue recommendations in collaboration with the American Academy of Pediatrics (AAP).

The guidelines now recommend delaying umbilical cord clamping for newborns for at least 60 seconds — up from the previously recommended 30 seconds — because it’s been shown to improve the baby’s blood health and iron levels.

“The guidelines also observe that one out of every 10 to 20 newborns each year needs help transitioning from the fluid-filled environment of the womb to the air-filled room,” said Dr. Henry Lee, a professor of pediatrics and neonatologist at the University of California-San Diego.

“It is essential that every newborn infant has a health care professional dedicated to facilitating that transition who is trained and equipped for the role using these recommendations,” Lee said in a news release.

“We’re proud that these guidelines will be jointly published in the American Heart Association journal Circulation and the American Academy of Pediatrics journal Pediatrics. This action underscores our joint commitment to advancing pediatric and neonatal resuscitation — together,” Dr. Javier Lasa said in a news release. He’s an AHA and AAP volunteer, co-chair of the 2025 Pediatric Advanced Life Support Writing Group, and associate professor in critical care and cardiology at Children’s Health in Dallas.

More information

Mass General Brigham has more on the Heimlich maneuver.

SOURCES: American Heart Association, news release, Oct. 22, 2025; American Academy of Pediatrics, news release, Oct. 22, 2025; Circulation, Oct. 22, 2025