Signs and symptoms:

Coughing or gagging, clutching of the throat, inability to speak, difficulty breathing, signs of cyanosis (bluish discoloration of the skin and mucous membranes) and loss of consciousness.

First-aid treatment:

1. If the child is conscious and able to speak or cough, he should be encouraged to continue coughing. Manoeuvres should not be made to interfere with the child's attempts to expel the foreign body, and he should not be given anything to drink.

2. If the child is conscious but unable to speak or cough, perform back blows between his shoulder blades using the heel of your hand or do the abdominal thrust (Heimlich manoeuvre).

In performing the abdominal thrust, stand behind the child and wrap your arms around his waist. Slightly move him forward then make a fist with one hand and position it slightly above his navel.

Grasp the fist with the other hand then press hard into the abdomen with a quick and upward thrust.

3. If the child is unconscious and the foreign body is visible, an attempt to remove the foreign body by finger sweep may be done but be careful not to lodge the object in further. If it's not visible, then perform the abdominal thrust.

4. If the child is not breathing and does not have a pulse, do cardiopulmonary resuscitation (CPR).

While performing these manoeuvres, someone should be simultaneously contacting the emergency medical services or the child should be already in transit to the nearest hospital.

Even if the child's condition improves after the manoeuvres, it is still advisable to see a doctor to know the exact cause of the choking, to make sure that no other objects are left blocking the airway, and to ensure that there are no complications.

Associate Professor Henry Tan, head and senior consultant of the Otolaryngology department at KK Women's and Children's Hospital

This article was first published in The New Paper.