The Heimlich maneuver is a life-saving technique that can be used when someone is choking due to an obstruction in their airway. It is a simple yet effective method that can be performed by anyone, even without medical background or training. Knowing how to perform the Heimlich maneuver is a fundamental skill that can make the difference between life and death in emergency situations.
Choking is a common hazard, often caused by food getting lodged in a person’s throat, blocking the air flow and making it difficult or impossible to breathe. In such critical moments, using the Heimlich maneuver can quickly dislodge the object, restoring the person’s ability to breathe. This crucial skill should be part of everyone’s knowledge, as it can be used to save not only the lives of strangers, but also those of friends and family members.
In the following sections, we will discuss the steps to properly perform the Heimlich maneuver, including how it can be adapted for adults, children, pregnant individuals, and even oneself. With this vital information, readers will be well-equipped to act decisively and effectively in the face of a choking emergency.
Identifying Choking Signs
Cannot Speak
When an individual is choking, one of the most evident signs is the inability to speak. This occurs because the object lodged in the throat or windpipe is preventing air from flowing through, and thus, the person cannot produce sound.
Coughing
Coughing is another common sign of choking. It may begin as a forceful cough in an attempt to dislodge the object obstructing the airway. If the individual can still cough, it’s crucial to encourage them to continue, as it may help remove the blockage.
Loss of Consciousness
In more severe choking cases, the restricted airflow may lead to a loss of consciousness. If a person loses consciousness while choking, it is important to act quickly and call 911 or your local emergency number immediately.
Red Cross-Recommended Signs of Choking
The American Red Cross suggests looking for the following signs to identify if someone is choking:
- Holding the throat with one or both hands
- Universal Distress Signal: Clutching the throat with the thumb and index finger, forming a “C” shape
- Difficulty breathing or making high-pitched noises while inhaling
- Bluish skin due to lack of oxygen
- Inability to cough effectively or at all
Keep in mind that these signs of choking may vary, and not all individuals will display every symptom. However, being aware of these common indicators and acting quickly may help save someone’s life.
Performing Heimlich Maneuver on Different Populations
Conscious Adults
To perform the Heimlich maneuver on a conscious adult who is choking:
- Stand behind the person and wrap your arms around their waist.
- Make a fist with one hand and place the thumb side against the person’s abdomen, slightly above the navel.
- Grasp the fist with the other hand, and perform quick, inward and upward thrusts until the object is expelled or the person can breathe again.
Children
For children over one year old, the procedure is similar to that for adults:
- Kneel behind the child, wrap your arms around them, and position your hands in the same manner as for adults.
- Perform abdominal thrusts until the object is expelled or the child can breathe again.
Infants
The Heimlich maneuver is not recommended for infants under one year old. Instead, perform back blows and chest thrusts:
- Hold the infant face-down over your forearm, supporting their head and neck.
- Deliver five back blows between the infant’s shoulder blades with the heel of your other hand.
- Turn the infant face-up and place two fingers at the center of their breastbone.
- Perform five quick chest compressions.
- Repeat the back blows and chest thrusts until the object is expelled, or the infant can breathe.
Pregnancy
For pregnant individuals or people with a large abdomen, perform chest thrusts instead of abdominal thrusts:
- Stand behind the person and wrap your arms around their chest.
- Place your fist on the person’s sternum, in the middle of their chest.
- Perform quick, inward thrusts until the object is expelled or the person can breathe again.
Obese Individuals
In the case of obese individuals, the Heimlich maneuver may need to be adjusted:
- Stand behind the person and wrap your arms around their waist, adjusting your position to accommodate their size.
- Locate the navel and place your fist slightly above it, as with a standard Heimlich maneuver.
- Perform inward and upward thrusts until the object is expelled or the person can breathe again.
When performing the Heimlich maneuver, it is important to keep in mind the risks associated with the procedure, such as bruising, broken ribs, or damage to internal organs. However, it can be a life-saving technique during a choking emergency.
Steps for Heimlich Maneuver
Make a Fist
- Stand behind the choking person and wrap your arms around their waist
- Make a fist with one hand, placing the thumb side against the person’s stomach, slightly above their navel
Abdominal Thrusts
- Grasp your fist with your other hand
- Perform quick, inward, and upward thrusts into the person’s stomach
- Continue to perform abdominal thrusts until the object is expelled or the person starts breathing again
Chest Thrusts (for pregnant persons or those who cannot receive abdominal thrusts)
- Stand behind the person, placing one of your arms under their armpit and across their chest
- Place the other hand in the middle of the person’s chest
- Perform quick, inward and backward thrusts using the heel of your hand
Back Blows
- Support the person’s upper body by wrapping one arm around their waist and leaning them forward at the waist at about 90 degrees
- Use the heel of your other hand to deliver five firm back blows between the person’s shoulder blades
- This can be done alternatively with the Heimlich maneuver
Procedure Repeating
- If the choking person remains conscious and still has an obstruction, continue alternating between abdominal thrusts (or chest thrusts if applicable) and back blows until the obstruction is cleared or medical help arrives
| Actions | Target Group | Instructions |
|---|---|---|
| Abdominal Thrusts | Adults and Older Children | Quick, inward, and upward thrusts |
| Chest Thrusts | Pregnant Persons and Those Who Cannot Receive Abdominal Thrusts | Inward and backward thrusts |
| Back Blows | All Choking Persons | Firm blows between shoulder blades |
Remember, it is crucial to act quickly and accurately when performing the Heimlich maneuver or any other first-aid technique. If possible, have someone call emergency services while you perform the necessary steps to help the choking person.
Heimlich Maneuver When Alone
Choking can be a life-threatening situation, and knowing how to perform the Heimlich maneuver on yourself is crucial if you’re alone when it happens. Here, we discuss two methods to quickly and effectively perform abdominal thrusts to dislodge the object blocking your airway.
Using a Chair
- Find a stable chair without wheels or cushioning.
- Position yourself behind the chair with the back of the chair facing you.
- Place the top edge of the chair against your abdomen, slightly above the navel.
- Lean forward and press your abdomen firmly against the chair edge.
- Use a quick, inward and upward motion to apply pressure.
- Repeat these abdominal thrusts until the object is dislodged.
Using a Countertop
- Locate a sturdy countertop, such as in the kitchen or bathroom.
- Stand facing the countertop edge.
- Place your hands on the countertop for support.
- Position your abdomen against the edge, slightly above the navel.
- Lean forward and push your abdomen into the edge with a quick, inward, and upward motion.
- Continue performing these abdominal thrusts until the object blocking your airway is dislodged.
Practicing the Heimlich maneuver on a regular basis can help you become familiar with the technique, preparing you to act quickly in an emergency situation. While abdominal thrusts can be a lifesaving intervention for someone who is choking and alone, it is essential to seek medical attention after such an event to ensure there are no remaining complications.
First Responder Actions and Associations
American Heart Association Recommendations
The American Heart Association (AHA) recommends the Heimlich maneuver as the primary method for assisting a choking person. If the victim is conscious and able to cough, encourage them to continue coughing to expel the object. If the person is unable to cough, follow these steps:
- Stand behind the choking person and wrap your arms around their waist.
- Make a fist with one hand and place it slightly above the person’s navel.
- Grasp your fist with your other hand, and apply quick, upward and inward thrusts until the object is dislodged or the person starts to breathe on their own.
CPR
If the choking victim becomes unconscious, lower them to the ground and begin CPR. Administer the following steps:
- Position the heel of one hand in the center of the chest.
- Place your other hand on top of the first hand, interlocking fingers.
- Give 30 compressions, pressing hard and fast.
- Open the airway by tilting the person’s head back and lifting their chin.
- Check for the foreign object and remove it if visible.
- Provide two rescue breaths, and then continue with compressions.
Remember to recheck for the object and clear the airway after every 30 chest compressions.
Contacting Emergency Services
It is crucial to call emergency services as soon as possible if a person is choking and unable to breathe or if they lose consciousness. While waiting for the professionals, a first responder should continue to administer the Heimlich maneuver or CPR, depending on the situation. Always follow the guidance of the American Heart Association and remain calm to ensure the best possible outcome for the choking victim.
Understanding Unconscious Choking Victims
When dealing with unconscious choking victims, it’s crucial to act swiftly and correctly to increase their chances of survival. In this section, we’ll discuss the necessary steps to address such situations, focusing on chest compressions and foreign object removal.
Chest Compressions
Chest compressions are a vital component of Cardiopulmonary Resuscitation (CPR) and useful in helping unconscious choking victims. When an individual is unconscious and not breathing, begin CPR immediately. If possible, have someone call for emergency medical assistance. To perform chest compressions:
- Lay the victim down on their back on a hard and flat surface.
- Kneel beside them, positioning your shoulders above their chest.
- Place the heel of one hand on the center of their chest, then place your other hand on top of the first while interlocking your fingers.
- Keep your arms fully extended and your elbows locked. Use your upper body weight to press down firmly and quickly, compressing the chest about 2 inches (5 cm) deep.
- Allow the chest to return to its normal position, then repeat the compression with a rate of 100-120 compressions per minute.
Foreign Object Removal
If you suspect the unconscious individual is choking, it’s essential to clear their airway while providing CPR. After 30 chest compressions, you can attempt to remove the foreign object. Here’s how to perform a foreign object removal:
- Tilt the victim’s head back gently to open their airway.
- Perform a finger sweep by carefully inserting your index and middle fingers into their mouth, moving along the inside of the cheek, and sweeping towards the center of the throat.
- If you feel or see the obstructing object, remove it using a pincer grip with your fingers.
- If the object is not visible or reachable, continue CPR and let professionals handle the situation when they arrive.
Remember, acting quickly and effectively is critical when addressing life-threatening situations like unconscious choking victims. By ensuring you have knowledge of the proper procedures, such as CPR, chest compressions, and foreign object removal, you can increase the chances of saving someone’s life.