A choke is any obstruction that cuts off airflow to the lungs or blood flow to the brain. The term most commonly refers to a foreign body blocking the airway, which killed 5,553 people in the United States in 2022 alone. But “choke” also describes specific restraint techniques in martial arts and the psychological phenomenon of failing under pressure. Each meaning involves a different mechanism, and understanding them can be genuinely life-saving.
Choking on a Foreign Object
The most familiar type of choke happens when food or a small object gets lodged in the airway, blocking air from reaching the lungs. This can be partial or complete. A partial blockage still lets some air pass, giving you more time to clear it, though it can still cause serious complications like pneumonia if the object isn’t removed. A complete blockage is immediately life-threatening: with no oxygen reaching the blood, a person can lose consciousness within minutes.
The universal sign of choking is grabbing the throat with one or both hands. If someone near you does this, ask them directly: “Are you choking? Can you speak?” If they can cough forcefully and talk, their airway is only partially blocked, and a strong cough may dislodge the object on its own. If they can’t speak, can’t cough effectively, or their skin starts turning blue, they need immediate help.
How to Help Someone Who Is Choking
Updated guidelines from the American Heart Association recommend alternating five back blows with five abdominal thrusts for conscious adults and children. You deliver back blows between the shoulder blades with the heel of your hand, then switch to abdominal thrusts (the well-known Heimlich maneuver) by placing your fist just above the navel and pressing inward and upward. Keep alternating until the object comes out or the person becomes unresponsive.
Infants under 12 months require a different approach. Abdominal thrusts are not recommended for babies because of the risk of internal injury. Instead, alternate five back blows with five chest thrusts using the heel of one hand on the breastbone. For children under five or weighing less than 45 pounds, you can use abdominal thrusts but should use less force. If anyone, adult or infant, becomes unconscious during choking, switch to CPR immediately.
Who Is Most at Risk
Choking risk sits at both ends of the age spectrum. In young children, the airway is small and the instinct to put objects in the mouth is constant. The CDC lists dozens of high-risk foods for toddlers, including whole grapes, hot dogs, popcorn, nuts, raw carrots, chunks of peanut butter, hard candy, and marshmallows. Round, firm, or sticky foods are the most dangerous because they can form a tight seal in a small airway. Cutting food into thin strips rather than round pieces significantly reduces the risk.
At the other end, choking death rates rise sharply after age 71. Older adults face higher risk because of weaker chewing muscles, dental problems, reduced saliva production, and neurological conditions that impair swallowing. Food is the most common culprit in elderly choking incidents, particularly tough meats and dry or crumbly foods.
Chokes in Martial Arts
In combat sports like Brazilian jiu-jitsu, judo, and mixed martial arts, a “choke” is a submission technique applied to the neck. There are two distinct types, and they work very differently.
A blood choke compresses the arteries on either side of the neck, cutting off blood supply to the brain. Because the brain is immediately deprived of oxygen and nutrients, unconsciousness can occur in as little as 5 to 10 seconds. A rear naked choke and a triangle choke are common examples. An air choke, by contrast, targets the windpipe directly, preventing air from entering the lungs. This takes considerably longer to cause unconsciousness because oxygenated blood is still circulating. In practical terms, an air choke works on the same timeline as holding your breath. Most competition chokes aim for the blood supply rather than the windpipe because they’re faster and considered less likely to cause lasting structural damage to the throat.
Choking Under Pressure
The phrase “choking” also describes a sudden, dramatic drop in performance when the stakes are high. A basketball player missing free throws in the finals or a musician blanking on a piece they’ve played a thousand times are classic examples. This isn’t just a metaphor. It has a well-studied neurological basis.
The leading explanation is called explicit monitoring theory. When pressure mounts, self-consciousness and anxiety spike, and you begin paying close attention to movements that are normally automatic. For well-practiced skills, this step-by-step monitoring actually disrupts the smooth, unconscious execution your brain has developed through years of practice. You essentially revert to performing like a beginner, with erratic and inefficient movements. Neuroimaging research supports this: excessive motivation registered in deeper brain regions produces choking, while increased activity in areas responsible for cognitive control can reduce it. This is why athletes often describe their best performances as feeling effortless, and their worst as feeling like they were “thinking too much.”
Strategies that redirect attention outward, toward a target or outcome rather than the mechanics of the skill, tend to protect against this type of choking. Pre-performance routines and controlled breathing serve a similar purpose by keeping the brain from fixating on the step-by-step process.