An infant younger than 1 year is choking. What maneuver should be used?

• A. Abdominal thrusts
• B. Back blows and chest thrusts
• C. Chest compressions only
• D. Rescue breaths only

Answer: (B)

For an infant under 1 year who is choking, the maneuver to use is back blows followed by chest thrusts. This sequence is chosen because infants have delicate airways and small chest walls, so delivering forceful abdominal pressure (the adult Heimlich maneuver) is not appropriate and can cause injury. Chest compressions alone aren’t the right intervention for a conscious choking infant, and rescue breaths alone won’t relieve the obstruction.

To perform correctly: hold the infant face-down along your forearm with the head supported and the head lower than the chest. Use the heel of your other hand to deliver five firm back blows between the shoulder blades. If the obstruction persists, turn the infant face-up and place two fingers on the lower half of the sternum to deliver five chest thrusts. Alternate back blows and chest thrusts until the object is expelled or the infant becomes unresponsive. If unresponsive, begin CPR and check the mouth for the object between cycles, removing it if visible.