Barry Rodgers was ready for a cozy family Christmas Eve, nestled on the sofa with his four-year-old daughter, Amelia, to enjoy a holiday film. However, what was meant to be a joyful evening quickly turned into a frightening ordeal.

Amelia, delighted with her favorite meal of chicken nuggets from a local eatery, was having dinner on her lap as a special treat. Suddenly, Barry, a 42-year-old optical lab technician from Cambuslang, Scotland, heard an unsettling gargling noise coming from his daughter.

Amelia was choking. A piece of chicken was lodged in her throat, preventing her from breathing. Barry’s wife, Heather, 40, rushed into the room upon hearing his calls for help. She found Amelia on the sofa, frighteningly lifeless.

Heather, witnessing the terrifying scene, described her daughter’s eyes as glazed over and her body limp. Amelia was unresponsive, prompting Heather to immediately dial for an ambulance.

“It was as if time had stopped. We experienced every possible emotion,” Heather recounted, describing the heart-stopping moments as they awaited emergency assistance.

‘It felt like time stood still and we went through every emotion,’ she says.

‘I was screaming down the phone while Barry was trying everything he could. He gave her back blows, performed abdominal thrusts [previously known as the Heimlich manoeuvre] and even tried to fish the chicken out of her mouth with his fingers – but he couldn’t see it. Nothing seemed to be working.’

Heather adds: ‘I was sure that we were going to lose her right there on the sofa.’

Heather, Barry and Amelia Rodgers. Their daughter almost died when she choked on chicken

Barry had been trained in first aid, but says ‘in that moment, it all went out the window’. He recalls: ‘I was in such a state and crying. I was panicking because she’s my own child – if it had been someone else’s, I would have maybe been calm and focused. Only when the calm voice of the 999 call handler came through could I start to think again.’

The call handler told Barry to alternate between five back slaps and five abdominal thrusts. The latter involved positioning himself behind his daughter, and making a fist between her belly button and her chest – then pulling inwards and upwards.

Her parents sagged with relief when, moments later, Amelia suddenly came round – though she remained weak and silent.

‘She was lying there, exhausted and blue,’ says Barry. ‘I put her in the recovery position on her side, and when the paramedics arrived, they checked her over. Though it hadn’t felt like it at the time, I had helped to save Amelia’s life.’

She was taken to hospital as a precaution, but was discharged later that evening.

Every day in the UK around 40 children under the age of five are taken to hospital after choking or swallowing something dangerous, NHS figures show.

Too often it ends in tragedy – 17 children died as a result of choking, nine of them on foods as seemingly innocuous as grapes and sausages, according to figures from the National Child Mortality Database 2020/2022.

If the airway is blocked, it can deprive the heart and brain of oxygen, which can lead to a cardiac arrest. Perhaps surprisingly, it’s not the very young who are most at risk, but the over-50s – 256 people aged over 65 died in 2022 as a result of choking, according to official figures.

Barry saved the four-year-old by following a call handler’s guidance, which dislodged the food

Experts suggest that one reason is that we produce less saliva as we age, making it harder to swallow when we eat.

Dr Alison Carter, a consultant ear, nose and throat (ENT) surgeon, says Amelia’s experience highlights just how quickly choking can happen. ‘Young children are at risk of choking as it takes them time to learn how to coordinate their chewing and swallowing with their breathing,’ she explains.

‘Their airways are small – the narrowest point in a toddler is only around 5mm across – and if food or small objects are accidentally inhaled rather than swallowed, they can create a seal over the airway, a bit like a plug.’

When a child – or adult – starts choking, ‘our bodies will try to clear the obstruction with forceful coughing, but if it is completely blocked then they may be silent and their face may become red – and then blue’, she adds.

The skin turning blue is a sign that not enough oxygen is getting round the body and Dr Carter says this ‘can occur within seconds – with loss of consciousness occurring after one to two minutes and cardiovascular collapse [leading to a cardiac arrest] after four to six minutes’. She adds that ‘even partial obstruction can become life-threatening’. And Christmas can bring particular hazards, she adds, as even food you might not expect can lead to choking for children.

‘Pigs in blankets are perhaps the worst offender – sausages should be cut length-ways, not into discs – as these are more likely to plug the airway,’ she says.

‘Chicken and turkey can sometimes be dry and hard to chew – especially for those without molars, meaning they are at risk of swallowing it in larger pieces.

‘It can be a risk because it doesn’t break apart or dissolve, so can form a plug in the airway.

‘Brussels sprouts are small, round and dense, essentially the same shape and size of a large grape – which is one of the most common choking hazards.

‘I’d recommend cutting sprouts into quarters and ensure they are well-cooked and soft. Consider mashing or shredding them for smaller children – this can be helpful for older relatives, too.’

Adding to the risk, she says, is that ‘Christmas tables can be full of noise, laugher and distractions’, which is why Dr Carter advises ensuring that ‘young children are alert and seated upright in highchairs while eating and always supervised by an adult’.

While food is a major risk, children are often in unfamiliar environments during the festive season, which can bring its own dangers. Dr Carter warns that while your own home may be child-proofed, your relative’s sofa may have things like coins or buttons down the back of it – or in the excitement of all the presents, an older sibling’s Lego or marbles might be left on the floor, leading to an increased risk of choking.

James McNulty-Ackroyd, head of clinical delivery at St John Ambulance, says it’s common for people to be unsure how to help when someone starts choking, ‘but the quicker people respond, the better the outcome’.

‘The first thing you should do is ask if they are choking and advise them to try to cough,’ he says. ‘If they are unable to speak or can’t cough, you will have to help. Give up to five sharp back blows between the shoulder blades, supporting them to lean forwards. If that doesn’t work, give up to five abdominal thrusts. Alternate back blows and abdominal thrusts, calling 999 if the blockage does not clear.’

The official advice is to use back blows or chest thrusts on babies under one, or up to five back blows and up to five abdominal thrusts for children aged one or over and adults.

Amelia, now five, was back to normal within 24 hours of the incident – but it has left Barry and Heather anxious.

‘We were worried about Amelia eating any type of food,’ says Barry. ‘Even now, we watch her carefully. The Christmas period has a new significance to us and we will never forget what happened. We were seconds away from losing our daughter.’

James McNulty-Ackroyd suggests people attend a first aid course to learn how to give abdominal thrusts properly – a suggestion Barry agrees with.

He says: ‘You think you might never need to perform back slaps or abdominal thrusts – but trust me, it’s better to be ready for the unimaginable.’

sja.org.uk/first-aid-advice

The manoeuvre we all need to learn

1) Try back slaps before abdominal thrusts; 2) Clench fists and thrust upwards

If someone is choking, the first thing to do is to encourage them to cough and clear the obstruction. If this doesn’t work, then try back slaps, where you strike the person on the back with five sharp blows.

If this fails, then try abdominal thrusts. Standing behind them, clench your hands to make one fist and put it between the person’s belly button and their breastbone. Grasp tightly and thrust sharply inwards and upwards, five times.

If this fails, call 999 – then go back and administer five back blows, alternated with five abdominal thrusts, until help arrives. You should be prepared to perform cardiopulmonary resuscitation (CPR) to keep blood pumping around their body. The 999 call handler can direct you to properly do CPR.

Do not perform abdominal thrusts on an infant, you can cause significant damage. Instead, lay them across your thighs, face down – with their face over the edge of your leg – before starting back blows.

If that hasn’t cleared the obstruction, turn the child over, face up on your thigh, with one hand underneath their back tilting them, so their head is tilted to the floor. Use two fingers to perform an abdominal thrust, pushing upwards into the chest.

For older children: 

1. Stand or kneel behind your child; 

2. Clench your fist and place it between the navel and ribs;

3. Grasp this hand with your other hand and pull sharply inwards and upwards;

4. Repeat up to five times; 

5. Make sure you don’t apply pressure to the lower ribcage, as this may cause damage.