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What are back blows in first aid and when should they be used?

Back blows are an essential first aid response for treating choking caused by a blocked airway. This technique involves delivering a sharp, upward blow between the person's shoulder blades using the heel of the hand. The force and positioning of the back blows help create enough pressure in the airway to dislodge the object causing the blockage.

Back blows are used when a person shows signs of severe airway obstruction, such as being unable to speak, cough, or breathe. For adults and children over one year old, the rescuer stands (or kneels for smaller children) behind the casualty, supports their chest with one hand, and bends them forward so the airway points downward. Up to five back blows are then given forcefully between the shoulder blades.

For infants under one year, the technique is modified: the infant is positioned face-down along the rescuer’s forearm, supported by the head and neck, with the body angled downwards. Up to five gentle but firm back blows are delivered between the shoulder blades.

If back blows do not relieve the obstruction, they should be followed by chest thrusts. Continue alternating between back blows and chest thrusts until the object is cleared or the person becomes unresponsive—if so, start CPR and call 000 immediately.

Back blows are simple yet effective and can be life-saving when performed correctly during a choking emergency.

Back blows are used to treat choking by helping dislodge an object from the airway with firm strikes to the back.

Symptoms

  • Coughing or gagging

  • Inability to speak or breathe

  • Noisy or high-pitched breathing

  • Clutching the throat

  • Bluish lips or skin (cyanosis)

How to perform back blows:

  • Stand or kneel behind the person and support their chest.

  • Bend them forward so the head is lower than the chest.

  • Give up to 5 firm blows between the shoulder blades with the heel of your hand.

  • Check if the object is dislodged after each blow.

  • If still choking, follow with up to 5 chest thrusts and call 000.

Takeaway to Remember

Back blows are a first aid technique used to relieve airway obstruction caused by choking. They involve delivering firm blows between the shoulder blades to help dislodge a blockage.