Iowa Specialty Hospital

Choking and the Heimlich Maneuver

May 27, 2022

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Each year on June 1st, National Heimlich Maneuver Day recognizes this life-saving technique which uses abdominal thrusts to force air from the lungs. That forced air expels an object on which someone is choking. Dr. Henry J. Heimlich created this life-saving procedure in 1974.  “The Heimlich Maneuver” is also referred to as “Abdominal Thrusts.” 

You should only use the Heimlich Maneuver if a person is choking and his or her life is endangered by a windpipe obstruction. Choking is signaled by the inability to speak, cough or breathe, and may result in a loss of consciousness, even death. Always avoid using excessive force in employing the Heimlich Maneuver to avoid injuring the ribs or internal organs. Given the potentially life-or-death nature of the situation, always use your best judgment.

In the event of an adult choking, the American Heart Association offers these guidelines:  

 

Conscious Adult

  • In the event of choking, rescuers should take action if they see signs of severe airway obstructions. This includes poor air exchange and increased breathing difficulty, a silent cough, or if the person is unable to speak or breathe.
  • To differentiate between a mild airway obstruction and severe airway obstruction, the rescuer should ask the person, “Are you choking?” If the victim nods yes, assistance is needed. Choking is also often indicated by the universal distress signal of hands clutching the throat.
  • If the person can speak, cough or breathe, do not interfere.
  • If the person cannot speak, cough or breathe, give abdominal thrusts known as the Heimlich Maneuver.
    • To employ the Heimlich Maneuver:
      • Reach around the person’s waist.
      • Position one clenched fist above the navel and below the rib cage.
      • Grasp your fist with your other hand.
      • Pull the clenched fist sharply and directly backward and upward under the rib cage six to 10 times quickly.
  • In case of obesity or late pregnancy, give chest thrusts.
  • Continue until either the obstruction is relieved or advanced life support is available. In either case, the person should be examined by a physician as soon as possible.

 

Unconscious Adult

  • Position the person on his or her back with their arms by their side.
  • Shout for help. Call 911 or the local emergency number as soon as possible.
  • Perform a finger sweep to try to remove any foreign body from their mouth. Only remove an object you can see and easily remove.
  • Listen for breathing and watch for their chest to rise and fall.
    • If the person is not breathing, perform rescue breathing.
    • If unsuccessful, give six to 10 abdominal thrusts (the Heimlich Maneuver).
      • To perform abdominal thrusts on an unconscious person, kneel over the person and place the heel of one hand on the person’s abdomen, slightly above the navel.
      • Next, place your other hand on top of the first.
      • Press into the abdomen with quick, upward thrusts.
  • Repeat the above sequence: Perform finger sweep, attempt rescue breathing, perform abdominal thrusts, until you are successful.
  • Continue until either the obstruction is removed or advanced life support is available. When successful, have the person examined by a physician as soon as possible.
  • After the obstruction is removed, begin CPR, if necessary.

 

If you're choking and you're alone:

  • Don't panic; if possible, take slow breaths.
  • Call 911 or the local emergency number immediately (even if you cannot speak); the dispatcher should be able to recognize that an emergency is occurring.
    • If you're using a land-line, in some areas, he or she may then be able to trace the call and send emergency personnel to you. (Cell phone calls may not be traceable to your exact location.)
  • If available, lean over the back of a chair and press hard on your abdomen and chest to expel the object. You can also attempt to use your fists to give yourself abdominal thrusts (Heimlich Maneuver). 
    • To employ the Heimlich Maneuver:
      • Position one clenched fist above the navel and below the rib cage.
      • Grasp your fist with your other hand.
      • Pull the clenched fist sharply and directly backward and upward under the rib cage six to 10 times quickly.
  • In case of obesity or late pregnancy, give chest thrusts.
  • Continue until either the obstruction is expelled or advanced life support is available. In either case, you should be examined by a physician as soon as possible.

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