It is the most common scene at the club and almost no one notices it: the kids devouring their snack between one activity and the next, laughing with their mouths full, running with a piece of bread in hand. Most of the time nothing comes of it. The time it does, it happens in seconds — and severe choking has a cruel trait: it is silent. The child does not scream, does not cough, does not call out. They just stop.
Foreign-body airway obstruction is one of the emergencies that appear most where there are children eating, and the Pathfinder Club is exactly that: dozens of children, quick snacks, plenty of distraction. Knowing the right maneuver — and, more importantly, not doing the wrong one — is the difference between a scare and a tragedy.
This guide gathers the current official public-health protocol, updated in October 2025 by the new international guidelines and echoed by the state health departments and the Brazilian Society of Pediatrics. Data verified on 07/23/2026 in the official sources listed at the end. Nothing here replaces an in-person first-aid course or professional care — but it can hold the situation until help arrives.
Why is choking such a common emergency at the club?
Put three things together: a child, food and haste. It is the portrait of any snack break at a unit meeting.
A child's airway is narrow, the molars that grind food well only arrive later, and the reflex to chew calmly loses badly to the urge to get back to the game. Add to that the choking-champion foods — whole grapes, sliced hot dogs, popcorn, nuts, hard candy, a large piece of bread or fruit — and you have the perfect setting for an obstruction. Small inedible objects, such as bottle caps and game pieces, round out the list.
The frightening detail is the silence. Many people imagine that a choking person will cough loudly and call for help. That happens in partial obstruction — and it is great, because it means air is still passing. In total obstruction, no air passes at all: there is no cough, no voice, no scream. The child may bring their hands to their neck (the universal sign of choking), open their eyes wide and begin to turn blue in the lips and face. That is when every second counts.
That is why the first skill is not the maneuver. It is knowing how to tell apart mild choking from severe — because the response is opposite in each case, and acting wrongly in the mild case can turn it into the severe one.
How to tell whether it is mild or severe choking?
That is the question that defines everything. Look at and listen to the person before laying a hand on them.
Mild choking (partial obstruction): the person can cough, cry, speak or make noise while breathing. Air is still passing. The official guidance here is clear and counterintuitive: do not hit the back, do not perform any maneuver. Encourage the person to cough hard — coughing is the most efficient choke-clearing maneuver there is — and stay by their side observing. Hitting the back of someone who is still coughing can dislodge the object and block the airway for good, turning it into severe choking.
Severe choking (total obstruction): the person cannot cough, speak or breathe; the crying stops; the face changes color (turns pale or blue); they may bring their hands to their neck and, before long, lose consciousness. Here, yes, you intervene immediately with the maneuvers — and the technique changes according to age.
| Sign | Mild choking | Severe choking |
|---|---|---|
| Cough | Strong, loud cough | Weak or absent cough |
| Voice / crying | Can speak or cry | Silence, no sound |
| Breathing | Difficult, but air passes | No air passes; may wheeze or nothing |
| Color | Normal or reddened | Pale or blue (cyanosis) |
| Your response | Encourage coughing and observe | Maneuvers now, and call 192 |
Keep the golden rule: while they cough, let them cough. Your rush to help is the greatest danger in mild choking.
Choking infant (up to 1 year): back blows and chest compressions
At the club you will rarely have an infant in arms, but counselors are parents, uncles, aunts and siblings — and this is the technique that kills most when done wrong, precisely because the instinct to shake and turn upside down is strong. In infants up to 1 year, the Heimlich maneuver is not performed (abdominal compression): the small abdomen and internal organs cannot withstand it. You perform the sequence of back blows and chest compressions.
Only intervene if the obstruction is severe: the infant does not cry, does not cough, does not breathe and starts to change color. The official step-by-step:
1. Support the infant face down over your forearm, with the face turned downward and the head slightly lower than the body. Firmly hold the chin and jaw with your fingers, without squeezing the throat, to keep the airway open. If you prefer, rest the forearm on your thigh.
2. Give five firm back blows, between the shoulder blades (the 'little wings' of the shoulder), with the heel of your palm. Truly firm — a timid blow does not work.
3. Turn the infant face up, supporting the head, and give five compressions in the center of the chest, over the middle bone (sternum), on the nipple line. The traditional technique uses two fingers; the 2025 update of the international guidelines began advising the heel of the palm to make the compression more effective. The essential point is: five firm compressions, downward, in the center of the chest.
4. Repeat the sequence — five back blows, five chest compressions — checking the mouth each cycle. Only remove the object with your fingers if it is visible and within reach. Never do a 'blind sweep'.
If the infant loses consciousness, start CPR (resuscitation) and get 192 called at the same moment. If there is another person nearby, send them to call while you do the maneuvers.
Read alsoWhen to call SAMU 192Older child and adult: back blows + the Heimlich maneuver
Here is the update that many old handbooks still have not carried. The international guidelines updated in October 2025 — which the Brazilian health departments and the Brazilian Society of Pediatrics began to publicize — brought back the back blows to the protocol for children over 1 year and adults. Before, the guidance was to start straight with abdominal compressions. Now, you alternate five back blows with five abdominal compressions.
For a child over 1 year or a conscious adult, with severe obstruction:
1. Stand behind the person (kneel, if it is a small child) and tilt their trunk slightly forward.
2. Give five firm back blows, between the shoulder blades, with the heel of the palm.
3. If it does not work, do five abdominal compressions — the Heimlich maneuver. Wrap your arms around the person from behind, close one hand into a fist and place it on the 'pit of the stomach', above the navel and below the breastbone. Cover the fist with the other hand and compress forcefully inward and upward, in a 'J' motion, like someone trying to lift the person from the inside.
4. Alternate the five back blows with the five abdominal compressions until the object comes out or the person loses consciousness.
Two important caveats. In pregnant women or very obese people, the compression is not on the abdomen, but in the middle of the chest (chest compression), because there is no safe abdominal space. And if you are alone and choking: lean your trunk over the back of a chair or the edge of a table and thrust your own abdomen against the edge, repeatedly, to simulate the compression. Do not wait for someone to show up.
What you should NEVER do during a choke
This is the part that saves more lives than the maneuver itself, because the mistakes below are exactly the ones instinct tells you to make — and they all appear as warnings from health authorities and the Brazilian Society of Pediatrics.
| Never do | Why it is dangerous |
|---|---|
| Give water or any liquid | The liquid takes up the little air space that remains and can cause aspiration pneumonia. It does not push the object down. |
| Blindly poke a finger into the mouth to 'fish out' the object | The blind sweep usually pushes the foreign body farther in, turning a partial obstruction into a total one. |
| Turn the child upside down and shake them | It does not dislodge the object and can cause injury to the cervical spine and the infant's brain. It is a myth, not a technique. |
| Hit the back of someone who is still coughing and speaking | In mild choking, the slap can dislodge the object and block the airway for good. |
| Perform the Heimlich (abdominal compression) on an infant up to 1 year | The small abdomen and internal organs cannot withstand it; the correct approach in the infant is chest compressions. |
| Continue the maneuvers after the object came out, as if nothing had been done | Every victim who went through the Heimlich or passed out needs to be evaluated by a professional afterward. |
Notice the common thread in almost all the mistakes: the rush to pull the object out with your hand or to do something 'extra'. In choking, less improvisation and more technique. Follow the sequence, do not improvise.
What if the person passes out? When to call 192
If the maneuvers do not work and the person loses consciousness, the situation changes category — and you cannot freeze.
1. Lay the person on their back on the floor, carefully.
2. Call for help immediately: call SAMU at 192 or the Fire Department at 193. If there is someone nearby, point at a specific person and say 'you, call 192' — a generic order to the group usually makes no one call.
3. Start cardiopulmonary resuscitation (CPR): firm, fast compressions in the center of the chest, at a rate of 100 to 120 per minute. Each time you open the airway to ventilate, look inside the mouth — if the object is visible, remove it; if it is not, do not rummage blindly. Continue the compressions until help arrives or the person breathes again.
Two observations that apply to the club. First: even if the choke clears and the person seems fine, if they passed out or went through the Heimlich maneuver, take them for medical evaluation — there may be internal injury or part of the object still in the airway. Second: this is the reason every club should keep an up-to-date health record of each Pathfinder and the emergency phone numbers on hand. In a crisis, no one has the presence of mind to go looking for information.
How to prevent choking at club snacks
The best maneuver is the one you never need to perform. Prevention at the club is cheap and fits into the routine of an attentive counselor.
- Cut the risky foods. Grapes and cherry tomatoes always into quarters, lengthwise; hot dogs into strips, never into rounds (the round is the exact size of a child's windpipe); hard fruits into small pieces.
- Extra caution with the champions: popcorn, nuts, peanuts, hard candy and chewing gum are high-risk for the little ones. Think twice before serving them at the younger group's snack.
- Eat sitting down and without running. The simplest rule and the most ignored. No eating while running, lying down, laughing loudly or playing with a full mouth.
- An adult watching during the snack. It is not the time to sort out the schedule on your phone. It is the highest-risk moment of the meeting.
- Small objects away from the mouth. Game pieces, bottle caps, whistles and beads become a foreign body in the blink of an eye with the little ones.
And there is a step that raises the whole club to another level: doing a hands-on choke-clearing training with the leadership and the counselors. Reading the step-by-step helps; practicing on a mannequin, with a first-aid instructor, truly cements it. It is worth reaching out to the Fire Department, SAMU or a health professional from your own church for an afternoon of training — it is the kind of investment you pray you never use, and thank on the day you do.