Foreign body aspiration: when something blocks or enters the airway

Aspiration means that something other than air has entered the airway. In everyday terms, the most obvious form is choking: the British Red Cross describes it as an object getting stuck in the throat and blocking the airway. In a small child the object can be a toy part, a coin, a button battery, food or, in newborn babies, things like curdled milk, mucus or vomit, as the Red Cross notes.

Not every case is a complete blockage. If the airway is only partly blocked, the person may be able to cough, and the sources advise encouraging them to keep coughing. If the blockage is severe, the person cannot speak, breathe or cough, and without help will lose consciousness. The British Red Cross also notes that an object can pass beyond the throat into a lung, in which case it needs to be dealt with in hospital.

The NHS says that children, particularly those aged 1 to 5, often put objects in their mouth as a normal part of exploring the world. Food is another common cause, and the NHS advises thinking about size, shape and texture when preparing a child's food.

The NHS explains that in most cases you or someone else will see the child swallow the object that causes choking. But if a child suddenly starts coughing, is not ill and has been eating or has a habit of putting small objects in their mouth, there is a good chance they are choking. Adults can choke too, and the British Red Cross gives step-by-step advice for adults, children and babies.

For adults, the British Red Cross says someone who is choking may be clutching at their chest or neck and will not be able to speak, breathe or cough. For a child, the NHS says to look at whether coughing is effective. If a child is coughing loudly, encourage them to carry on and do not leave them. If the cough is not effective, because it is silent or they cannot breathe in properly, shout for help immediately and decide whether they are still conscious.

The British Red Cross sets out these steps for an adult who is choking.

• Encourage them to cough. If the blockage is severe, they may hold their chest or neck and be unable to speak, breathe or cough, and you will need to help.

• Bend them forwards and give up to 5 back blows firmly between the shoulder blades with the heel of your hand.

• If still choking, give up to 5 abdominal thrusts: stand behind them, join your hands around the tummy, form a fist above the belly button and pull sharply inwards and upwards.

• If they are still choking, call 999 and repeat the steps until they can breathe again or help arrives.

• If they become unresponsive, lower them gently to the ground and treat them as someone who is unresponsive and not breathing.

The NHS and British Red Cross give age-specific steps. Both say that if the object is clearly visible and you can pluck it out safely with your fingertips you may do so, but you should not put your fingers into the mouth if you cannot see an object, because you could push the blockage further down or damage the back of the throat.

The NHS says that even if the object has come out, you should get medical help. Part of the object might have been left behind, or your child might have been hurt by the back blows or thrusts. The British Red Cross adds that a choking child should not be given a drink or something to eat to try to clear the blockage, as it will not dislodge it and may make things worse.

The NHS says to call 999 if the blockage does not come out after trying back blows and thrusts, and to keep trying the cycle until help arrives.

The NHS says the best way to avoid choking is to keep small objects such as marbles, beads and button batteries out of young children's reach, and to think about size, shape and texture when preparing food. The British Red Cross notes that as babies move onto solids and explore by putting things in their mouths, food or small toys can easily get stuck in the throat.

Learning first aid helps. The British Red Cross runs first aid courses, and the NHS also gives written steps. Knowing the difference between a baby and a child sequence is important, as is making sure other carers know it too.

Airway emergencies are dealt with by the ambulance service and hospital emergency departments on the NHS, and an object that has gone into the lung is dealt with in hospital, as the British Red Cross notes. A blocked airway needs 999, not a booked appointment. After an episode, the NHS advises getting medical help even if the object has come out.