In a famous episode of Sex and the City, Miranda chokes on Chinese food alone in her apartment for an agonizing 20 seconds—I counted each painful one—until she finally hurls her body over a box to eject the chunk of meat from her throat. Once she regains control of her airway, she calls Carrie (who screens the call because she’s stressing about Big). After she finally picks up, Miranda shouts, “I’m gonna die alone, Carrie!”
As a 30-something single person, I feel this scene in my bones. When you live solo like I do, without someone to immediately help you in scary situations, your imagination sneaks down dark paths late at night: What if I choked, right here, right now? If I pounded on my neighbor’s door, would they freak out and not answer? Am I going to perish alone with my cat, Jeeves, left to gnaw on my remains?
Calm the F down, Julia. Yes, choking is serious, Kirsten Bechtel, MD, a professor of pediatrics and emergency medicine at Yale University, tells SELF; it accounts for roughly 1.7 deaths per 100,000 people each year. But most of those cases occur in children or the elderly, she says, and, importantly, it’s preventable. “When adults choke, they’re often multitasking,” Dr. Bechtel explains. “They often take a deep breath as they’re eating—say, they’re talking at dinner—so food enters the esophagus and goes down into the airway or the trachea.”
While it’s not productive to agonize over the “what ifs” (and there’s a solid chance you won’t be chatting to yourself at dinner), according to Dr. Bechtel, knowing how to avoid this situation—and having a plan if the far-fetched actually does occur—can give you peace of mind. Here’s what to do if you find yourself choking alone.
How to do the Heimlich maneuver on yourself
Your respiratory tract and digestive system are in pretty close proximity. Usually, a little flap of tissue (called the epiglottis) blocks foods from heading down your trachea when you swallow. But when you take in a lot of air while eating or drinking (again, usually while talking with your mouth full), things might accidentally go “down the wrong pipe” or create an obstruction.
According to Elizabeth Hewett Brumberg, MD, an American Red Cross Scientific Advisory Council member, there are varying degrees of choking. “A person’s airway may be partially or completely blocked,” she explains (say, a few crumbs slipped down your trachea, but they’re small enough to not get stuck). “Someone who can speak, cry, or cough forcefully is likely getting enough air. Their body is trying to clear the obstruction.” Keep coughing (like hell) to get it out, she advises.
But if you’re completely unable to speak or are making high-pitched noises when you do manage to squeeze a sound out, “this is a life-threatening situation and the person will soon become unresponsive unless their airway is cleared,” Dr. Hewett Brumberg warns. This often happens when you swallow something that’s “the perfect diameter to go down your airway,” like a chunk of meat, Dr. Bechtel says.
If you’re around another person, get their attention ASAP: Clutch your throat to show them you need the Heimlich maneuver, a series of quick, upward thrusts on the abdomen. Typically, this other person would do that for you. (Here’s a video with instructions.) But when you’re alone, you need to take a different approach to get the same result. Here’s how:
When your airway is obstructed, your brain is deprived of oxygen. “Your brain needs oxygen,” Dr. Bechtel explains. “So you don’t want any choking to go on for more than a couple minutes.”
While you definitely want to move fast, try your best to stay calm, Dr. Bechtel says. Just try to focus on what you’re going to do next—panic can cloud your judgment and waste precious seconds.
Dr. Bechtel suggests getting ahold of emergency responders (or just other people) ASAP if possible. Obviously, you won’t be able to articulate what’s happening, but if you can dial 911 on a landline, they’ll know where you are and will come regardless. Calling on a smartphone can be tricky—whether or not it forwards your location to first responders varies depending on what country you are in and your particular device. (If you want to brush up on how to make an emergency call, here are details for iPhones, Androids, Apple Watches, and Pixel phones.)
If you’re near other people and you know for certain they’re present—say your neighbor works a routine remote schedule—“you could even knock on your wall a few times, and maybe leave the door open so people can easily access you,” Dr. Bechtel recommends. “But I don’t know if I would go up or down a flight of stairs or try to flag down a passing car.”
Again, time is ticking here, so skip this step entirely if you’re even remotely unsure about your neighbors’ availability or whether your phone is set up correctly to send out an SOS.
If you called 911, leave the phone on: “Even if you can’t speak, the dispatcher can send help,” Dr. Hewett Brumberg says. “Leave the line open, don’t hang up, then attempt to give yourself abdominal thrusts.”
Here’s how to do it, per Dr. Hewett Brumberg:
- Back up against a wall.
- Make a fist with one hand and place the thumb side against your abdomen just above your navel.
- Pull your fist inward and upward with force. (It should be intense enough to hurt.)
- Continue thrusting until the object is dislodged. (You’ll know you can stop when you can talk again.)
If this doesn’t work after a few blows, find a firm piece of furniture with a defined, but not supersharp, edge (the top of a couch or kitchen counter) and throw yourself over it so your upper abdomen gets the most pressure, Dr. Bechtel says. You don’t need to be standing, either—she says you can likely get enough force to eject the object when kneeling over a coffee table, for example.
But what if you’re driving? Dr. Hewett Brumberg says to get out of the car, back up against it, and try to dislodge the food or item like you would at home—but Dr. Bechtel says your steering wheel would theoretically suffice. “In car crashes, when a person doesn’t have an airbag and they hit the steering wheel, this has been shown to cause a lot of pressure.”
Both experts agreed that even if you got all (or some) or whatever was causing the choking out, head to the ER as soon as possible to get checked out.
The best way to prevent choking
Again, this kind of stuff isn’t something you necessarily need to stress about 24/7—you’re a lot more likely to slip and fall, for example, than find yourself choking (which, coincidentally, is an issue poor Miranda faces in another SATC episode). The big thing, Dr. Bechtel urges, is to slooowww down: “I don’t want this to sound too infantile or condescending, but the same thing I tell parents of little kids, I tell adults: Cut your food into small, bite-size pieces, chew it fully, and don’t ever swallow anything whole.”
Of course, eating and drinking are inherently enjoyable activities—don’t take this article as a sign to skip chowing down on your favorite meal while streaming comedy reruns. Just try your best to separate big belly laughs from bites of food, and save the call to mom for when you’re entirely finished eating.
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