When a child is choking and coughing hard, what should you do as a bystander?

Depends: Infant and child CPR will give you the best guidelines on what to do in the instance that a child is choking and/ coughing hard. If you have a child, work with a child, have child visitors in your household, it is imperative that you learn bls, basic life support. You can find classes at your local hospital, many community programs and the american red cross chapter nearest you.