1. Resources needed
Lesson presentation
Sticky notes / labels to annotate whiteboard
Activity 1: copies of activity sheets, Choking Check (optional)
Activity 2: copies of activity sheet Helping a Choking Baby; baby doll (for role play) (optional).

2. You will learn: a. to assess how serious a person’s choking is
Learning objectives
You will learn:
a. to assess how serious a person’s choking is
b. how to treat mild and severe choking in adults and children
c. how to treat a choking baby.
Using the presentation
This lesson is designed to allow for flexible planning for lessons between 30 and 90 minutes. Refer to the lesson plan to help select activities. For a 30 minute lesson, for example, follow:
the introduction.
one 10 minute activity from ‘Activity one’
one 10 minute activity from ‘Activity two’
then finish with a five minute plenary.

3. a. to assess how serious a person’s choking is
Suddenly your friend starts choking on a piece of food…
… struggling for breath… holding his throat… turning red in the face…
a to assess how serious a person’s choking is
Ask students: “What is choking?”
Explain that choking occurs when the airway is blocked, or partially blocked. This could be by food or a small toy for example.
“What would you do if you were on your own?”

4. a. to assess how serious a person’s choking is
First ask: “Are you choking?”
mild choking
severe choking
both
a to assess how serious a person’s choking is
Ask the class to sort the boxes into the Venn diagram. In Slideshow view they could come to the board and draw arrows. In Normal view they could drag and drop them to the correct position. Click to the next slide for the correct answer.
(Time needed: 10 minutes)
answers when questioned
unable to
speak
holding throat
unable to
cough
difficulty
breathing
unable to breathe
coughs
red face
Sort the boxes into the Venn diagram. See the next slide for answers…

5. answers when questioned
a. to assess how serious a person’s choking is
First ask: “Are you choking?”
mild choking
severe choking
coughs
both
unable to breathe
red face
answers when questioned
unable to
cough
holding throat
a to assess how serious a person’s choking is
difficulty
breathing
unable to
speak

6. a. to assess how serious a person’s choking is
If choking is mild, encourage the choking person to cough. This should clear the problem.

7. a. to assess how serious a person’s choking is
If your friend can’t speak or cough, the choking is severe.
Your friend’s airway has been blocked by food.
Unable to breathe, your friend may quickly pass out.
You must act right away.
Airway
a to assess how serious a person’s choking is
Food

8. b. how to treat severe choking
When someone’s choking badly, you must take charge. The video clip on the right shows you what to do…
> where should you give the person backblows?
> what should you do after each one?
> what should you do with your hands when giving abdominal thrusts?
> how many cycles of back blows and abdominal thrusts should you give?
> then what should you do?
b how to treat severe choking
Students should watch the video clip and then replay it. Ask them to put their hand up to pause the video at the key moments when it answers the questions.
(Time needed: 10 minutes)

9. b. how to treat severe choking
If someone’s choking severely, try back blows.
Get the casualty to lean forwards, support their chest with one hand.
Give up to 5 sharp blows between the casualty’s shoulder blades with the heel of your hand.
Quickly check their mouth to see if the blockage has come out after each back blow.
b how to treat severe choking
Ask: “What is the heel of your hand? Point to it.”
Ask each student to illustrate (either by drawing or acting out freeze frames) one of the 3 instructions shown onscreen in sets of 3. The 3 students should then be lined up in the correct order at the front of the room.
(Time needed: 10 minutes)

10. b. how to treat severe choking
Still choking? Try abdominal thrusts…
4. Stand behind the casualty.
5. Put both arms around the casualty.
6. Put one fist just above their belly button.
7. Grab your fist with your other hand.
8. Pull sharply inwards and upwards up to 5 times.
9. Quickly check their mouth to see if the blockage has come out after each thrust.
b how to treat severe choking
Ask: “What is the heel of your hand? Point to it.”
Ask each student to illustrate (either by drawing or acting out freeze frames) one of the 6 instructions(4-9) shown onscreen in sets of 6. The 6 students should then be lined up in the correct order at the front of the room.
(Time needed: 10 minutes)

11. (5 back blows + 5 Abdominal thrusts) x3.
b. how to treat severe choking
Still Choking?
Give back blows and abdominal thrusts 3 times.
(5 back blows + 5 Abdominal thrusts) x3.
If there’s no change call 999 for an ambulance. Keep going until the casualty stops choking, or the emergency services arrive. Be prepared to perform CPR if they collapse and are not breathing.
b how to treat severe choking
Explain to students that back blows (steps 1-3) should be followed by abdominal thrusts (steps 4-9). Ask 9 students to line up in front of the class to show all steps in order.
Make it clear that these should then be repeated 3 times (if there are enough pupils perhaps show one long line showing all 3 cycles).
Explain to students that CPR is “cardiopulmonary resuscitation”, which means a combination of chest compressions and rescue breaths. Explain that it will be covered in a separate lesson. If they haven’t learnt how to do it they can ask the ambulance telephone operator for instructions.
(Time needed: 5 minutes)

12. pushes doctor abdominal checked lungs hurt windpipe
b. how to treat severe choking
Where do the red words belong?
How does an abdominal thrust work?
It pushes air from the lungs and up the windpipe forcing the object out.
Can you hurt someone by doing abdominal thrusts?
Yes. Anyone who has had this treatment needs to be checked afterwards by a doctor.
b how to treat severe choking
The class could work together to complete the missing word puzzle. Alternatively students could complete the worksheet: “Choking check” in the lesson resources.
Ask: “Can you think of other questions?” Students can use the template on the “Choking check” worksheet to create their own fill in the gaps activity.
Note - If you are using Microsoft PowerPoint 2000 or earlier, these animations may not function. Remove the boxes manually to reveal the underlying text.
(Alternative activity. Time needed: 5 minutes)
pushes doctor abdominal checked lungs hurt windpipe

13. b. how to treat severe choking
Jon’s story
My dad started choking last year at a BBQ. He was panicking - couldn't breathe or anything. At first I thought he was mucking around. I gave him a whack on the back or 'back blows' as they're called. The first one didn't work so I had to do it again. The second one worked. Dad coughed up a bit of sausage. It was such a relief, I was treated like a hero for the rest of the day - well, I got extra pudding anyway.
b how to treat a severe case of choking

14. c. how to treat a choking baby
Treating a choking baby is slightly different from treating an adult or a child. When a baby is choking severely, he or she can't cough, cry or make any other noise.
In first aid, a baby means 0-1 years old.
c how to treat a choking baby

15. c. how to treat a choking baby
What to do
> check inside the baby’s mouth
> use your fingertips to gently take out anything that shouldn’t be there
> don’t push your whole finger into the baby’s mouth though – that could make things worse because babies are more delicate.
c how to treat a choking baby

16. c. how to treat a choking baby
Give up to 5 back blows, with the heel of your hand. They should not be as hard as for an adult or child.
b.) Use heel of hand, rather than palm, fingers or fist.
b.) Now decide on this label.
a.) Place baby along forearm, face down, with head low.
a.) What label
should go here?
Click to see!
c how to treat a choking baby
Explain that this is similar to treating adults and children. The labels should describe what the first aider is doing. Ask students to guess what the labels should say. Prompt them with questions such as: “ Which way up is the baby facing?” Students could annotate the whiteboard with sticky labels, compare notes and then vote for the wording they think most appropriate. They can then click the diagrams to check their ideas with those given onscreen. Alternatively, individuals could complete the activity sheet Helping a Choking Baby, given in the Lesson resources.
(Alternative activity. Time needed: 10 minutes.)
c.) Support baby’s head with your fingers.
c.) And what about this label?
Check the baby’s mouth after each blow. If choking continues…

17. c. how to treat a choking baby
Give up to 5 chest thrusts. Push inwards and upwards, against the middle of the baby’s chest between the nipples.
a.) Fingers should be just below the nipple line.
a.) What label
should go here?
b.) Support baby’s head with your fingers.
b.) And here?
c how to treat a choking baby
c.) Lay baby face up along forearm. Keep baby’s head low.
c.) And here?
Quickly check the baby’s mouth after each thrust.

18. c. how to treat a choking baby
If the baby is still choking…
> you should do three cycles of back blows and chest thrusts in total (two more)
> take the baby with you to call 999 for an ambulance
> keep going with chest thrusts and back blows until help comes.
c how to treat a choking baby
Students could use a doll to role play the treatment of a choking baby. Students could work in pairs, one advising the other on what to do.
(Alternative activity. Time needed: 25 minutes)

19. c. how to treat a choking baby
Tara’s story
My parent's had gone to the supermarket. I was looking after my 8 month-old baby sister. She likes putting stuff in her mouth like all babies. Suddenly she started to choke. I was terrified. I held her in front of me, face down, with her head low, then gave her 5 back blows. Nothing happened. I turned her over so she was face up and gave chest thrusts with two fingers. It worked! It felt like ages but must've only been a couple of minutes. Mum and Dad were amazed at the story. Mum said she wouldn't have known what to do herself - good job I was there.
c how to treat a choking baby

20. Mild Severe Plenary The main points again…
If not…
> 5 back blows
> 5 abdominal thrusts (chest thrusts for a baby)
> try this 3 times – call 999 if it doesn’t work
> keep going with the treatment…
> … until help comes, or the casualty starts breathing
> start CPR if the casualty passes out.
Mild
> ask: “Are you choking?”
> if they can talk, cough or breathe encourage casualty to cough.
Severe
Plenary
Explain that there are similarities between treating an adult or child and treating a baby. Ask students to explain what the similarities are. Students could write a check list to follow for both or two check lists for each one.

21. You’ve completed this lesson on choking.
Find out more
You’ve completed this lesson on choking.
Test your knowledge in our interactive quiz, or find out more with one of these activities…
Interactive quiz.
Design a poster about choking.
DAN: I… can’t… [GASP]
SUE: What’s wrong? Are you choking?
Finish this radio script.
Interactive quiz will take around minutes to complete. For questions on Choking go to the “Food Stalls” section.
Differentiated homework tasks are available:
Less able students – design a poster about choking. A poster is available in the kit to provide a model.
More able students – write a radio script about choking.