Choking Prevention: Training Guidelines for Care Staff

Mealtimes should be safe and enjoyable, but for people with difficulty swallowing, they can also carry significant risks. 

According to the National Safety Council (NSC), choking on food or other objects is the fourth-leading cause of accidental injury or death in the United States. Studies have shown that people with intellectual and developmental disabilities are nearly 11 times more likely to die from respiratory-related conditions, often linked with difficulties swallowing (dysphagia), choking, and aspiration. 

Choking emergencies develop in seconds. Proper training helps ensure care staff have the confidence and practical skills to intervene. Below are the core training practices to implement across your agency.

Ensure Staff Are Trained in Choking Prevention

Train staff…

• To recognize warning signs that someone may be aspirating or choking. This can include grabbing at the neck or throat, gagging, gasping for air, wheezing, face turning red, abruptly leaving the table, or running into another room.
• On CPR and first aid upon hire and at regular intervals. Consider having staff practice CPR using a weighted mannequin, or practice moving a mannequin from a chair or bed to the floor to simulate real-life situations. Ensure staff are trained on choking interventions for people who use wheelchairs.
• On choking prevention upon hire and provide refresher training. Include staff education on dysphagia.
• On “right to risk” scenarios regarding people’s access to food. Ensure staff understand the importance of implementing safeguards, including approved restricted access to foods and beverages, as outlined in plans of care for people who have a history of choking, are at risk of choking, require modified food or liquid consistencies, have poor dental health/are missing teeth, or have medical conditions, including a diagnosis of Prader-Willi syndrome or dysphagia.
• In a timely manner on newly created or modified plans of care.
• To be prepared for the possibility of vomit, blood, or other bodily fluids when responding to a choking emergency.

Whenever possible, provide in-person instruction and hands-on demonstration to help staff feel confident in implementing the strategies shown. 

And be sure to track compliance! Document the training provided and keep documentation organized and accessible to help you identify staff who have not been trained or who may need refreshers.

Equipping your team with proactive strategies and hands-on emergency training ensures quick, decisive action when every second counts. For complete protocols, mealtime assessments, and ready-to-use care templates, explore the Justice Center’s full Choking Prevention Toolkit.

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