If the child is still conscious but has absent or ineffective coughing, give back blows.
If back blows do not relieve choking, give abdominal thrusts. These maneuvers create an ‘artificial cough’ to increase intrathoracic pressure and dislodge the foreign body
Repeat up to 4 more times.
If the obstruction is still not relieved continue alternating 5 back blows with 5 abdominal thrusts.
To give abdominal thrust:
Stand or kneel behind the child. Place your arms under the child’s arms and encircle their torso.
Clench your fist and place it between the umbilicus (naval) and the ribcage.
Grasp this hand with your other hand and pull sharply inwards and upwards.