When giving back blows to a choking person, the responder should deliver firm blows with the heel of the hand between the person's shoulder blades , specifically in the middle of the upper back, between the shoulder blades

. Key points for proper technique include:

• Position the person leaning forward at the waist so their upper body is roughly parallel to the ground. This helps the object dislodge more easily

• Support the person’s chest with one arm diagonally across it to stabilize them while delivering back blows with the heel of the other hand

• Deliver up to five sharp back blows, checking after each blow if the obstruction has cleared

• The blows should be delivered firmly but carefully to avoid injury, targeting the area between the shoulder blades, not lower on the back or on the spine directly

This technique is recommended for conscious adults and children over one year old who are choking and unable to clear the obstruction by coughing. If back blows do not clear the airway, abdominal thrusts (Heimlich maneuver) or chest thrusts (for pregnant or obese persons) should follow

. In summary, the responder should give back blows with the heel of the hand between the choking person’s shoulder blades while the person is bent forward at the waist