2025 American Heart Association (AHA) Latest Airway Foreign Object Obstruction Emergency Guidelines: Major Changes in Emergency Care for Choking in Children (Heimlich Method Update)

The American Heart Association (AHA) and the International Resuscitation Association (ILCOR) have released the 2025 edition of the Airway Foreign Object Obstruction (Choking) Emergency Guidelines , based on the latest scientific research evidence . This is the first major update since 2020 and includes significant changes to the choking relief method for children and infants – back blows have been prioritized to increase safety and ensure effective foreign object removal.

These modifications are simple and safe for the general public, parents, teachers, and caregivers. Learning them could save lives!

Diagnosis of severe airway obstruction (choking)

• Unable to speak, cough, or cry
• Difficulty breathing, blue face
• Holding both hands around the throat (the universal choking signal)

Act immediately! Also call 120 ambulance.

Key changes in the new guidelines: Sequence and age-based strategy

1. Children over 1 year old and adults (adjust chest compressions for pregnant women)

• First, 5 back blows
• Then alternate 5 abdominal thrusts (i.e., the traditional Heimlich method).
• Repeat the cycle : 5 back pats + 5 abdominal thrusts, until the object is removed or the person becomes unconscious (then begin CPR)
• The reason for the change? While the old method involved only abdominal thrusts, new evidence shows that patting the back first is more effective and reduces the risk of internal injury.

2. Infants under 1 year of age

• After patting on the back 5 times
• Then do 5 chest thrusts with the heel of one hand.
• Repeat the cycle until the object is removed or the child becomes unconscious.
• Pushing on the stomach is strictly prohibited! The baby's organs are delicate, and this could cause serious injury (such as liver rupture).

The new guidelines emphasize: Start patting the back first at every age – this is very different from the old Heimlich-only method.

Detailed operation illustration (embed when posting to blog)

• Patting the back (adult/child/infant)
• abdominal push correct posture
• baby chest pushes
• Watch the official AHA video

Why update in 2025?

• Evidence from large studies: Patting back earlier results in higher success rates and fewer complications
• Consistent process for all ages, easy to remember
• Completely eliminates abdominal pressure in infants, protecting delicate organs

Parents must know: Tips to prevent choking in children

• Avoid giving whole walnuts, grapes, or round objects like hotdogs to children under 1 year of age.
• Choose toys according to age and avoid small parts.
• Supervise your child while eating, keeping them seated upright and allowing them to chew slowly.

Learn these new skills quickly, join an AHA certified CPR training course!

Source : American Heart Association 2025 Guidelines for Cardiopulmonary Resuscitation and Cardiac Emergency Care