Choking alone? Here’s how to do the Heimlich manoeuver on yourself

In a famous episode of Sex and the City, Miranda starts choking alone on Chinese food in her apartment for an agonising 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 paediatrics and emergency medicine at Yale University, tells me; 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 oesophagus and goes down into the airway or the trachea.”

While it’s not productive to agonise 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 manoeuvre 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.