First, encourage the child to dislodge the obstruction by coughing. If this does not clear it, apply the following techniques in sequence until the child is able to breathe freely again.
Bend child forwards and give up to five blows between shoulder blades with heel of your hand Check mouth for removable obstruction
Stand or kneel behind child, bend them forwards and put your arms around their upper abdomen Place your fist against lower part of child's breastbone Grasping fist with your other hand, pull sharply upwards and inwards, trying with each thrust to clear the obstruction Check mouth for obstruction bRepeat up to five times, if necessary
If the obstruction still hasn't cleared, continue a cycle of five back blows and five abdominal thrusts up to three times.
If the child is still in difficulties, call for emergency help. If the child loses consciousness, begin resuscitation.