Heimlich Maneuver: When It’s Indicated & How to Perform

Heimlich Maneuver: When It's Indicated & How to Perform

Man giving a woman the Heimlich maneuver

The Heimlich maneuver is a lifesaving, emergency response performed on someone who is choking. The method is meant to dislodge food or another object that is blocking a person’s airway. Choking can happen at any age as children can choke on a toy or food and adults are likely to choke on food or breathing in fumes. There are red flags that signal someone is choking, and different techniques for intervention depending on the individual’s age and level of consciousness.

Signs That Someone is Choking

There are certain behaviors that someone exhibits when they are choking and unable to breathe. A person who is choking may display an inability to:

  • Speak
  • Cough
  • Make noise
  • Breathe

What causes choking?

Choking is caused when a piece of food, object or liquid becomes lodged in the throat and blocks the airway.

Common objects that children choke on:

  • Popcorn
  • Candy
  • Pencil erasers
  • Hot dogs
  • Chewing gum
  • Peanuts
  • Cherry tomatoes
  • Whole grapes
  • Large pieces of fruit
  • Large pieces of vegetables

Adults generally choke when they swallow food without properly chewing or when they swallow while laughing or drinking.

The Red Cross Organization has outlined the appropriate steps to take when someone is choking. These guidelines are laid out depending on age and the persons level of consciousness. The first step is to check out the scene and determine if the person is injured or ill. For children and infants, consent must be attained from the parent or guardian.

For Conscious Choking

The Individual Cannot Cough, Speak, Cry or Breathe

  1. For an adult, child and infant, start with five back blows.
  2. Give five abdominal thrusts (give chest thrusts for an infant).
  3. Repeat steps 1 and 2 until the:
    • Object is forced out.
    • Person can cough forcefully or breathe.
    • Person becomes unconscious.

If the person becomes unconscious, gently lower them to the ground and give CARE for unconscious choking, beginning with looking for the object. Also, confirm that 9-1-1 has been called.

For Unconscious Choking

The Individual Appears to be Unconscious/ Non-Responsive

  1. For an adult, check responsiveness by tapping their shoulder and asking, “Are you okay?”
  2. If no response, call 9-1-1. Roll the person face-up if they are face-down.
  3. Tilt the head and lift the chin, quickly checking for a breath (gasps do not equal breathing).
  4. If No Breathing: Begin CPR. If Breathing: maintain open airway and monitor.

Chest Does Not Rise with Rescue Breaths

  1. Retilt the head and give another rescue breath.
  2. If chest continues to not rise, give 30 chest compressions.
  3. Look for and remove and object if it can be seen.
  4. Give 2 rescue breaths and determine if the chest is rising. If no rise, repeat steps 2 through 4. If chest does rise, check for breathing.

Adult CPR: No Breathing

  1. Give 30 chest compressions. Push hard in the middle of the chest at least 2 inches deep and at least 100 compressions per minute.
  2. Give 2 rescue breaths. Tilt the head back and lift the chin up. Pinch the nose shut and make a complete seal over the person’s mouth. Blow for about 1 second to make the chest rise. If chest does not rise, retilt the head and give another rescue breath.
  3. Do Not Stop. Continue CPR until:
    • The person shows signs of recovery, such as breathing.
    • An AED is ready to use.
    • Emergency Personnel arrive and can continue with care.
    • You are too exhausted to continue.
    • The scene becomes unsafe.

If an AED is available, follow the easy automated instructions to use the device.

How to Perform the Heimlich Maneuver on a Child

When a child between the ages of one and twelve are choking, there are special considerations to take and steps to follow when performing the Heimlich maneuver. Children may turn grey or blue due to an obstructed airway with the inability to talk, couch or breathe.

If the child is unconscious, start CPR.

If the Child is Conscious but Not Breathing:

  1. Get the Child into Position. With the child facing down on your forearm with their body supported on your thigh. Keep the child’s torso higher than the head.
  2. Give Forceful Blows. Use the heel of your hand to thump the child in between the shoulder blades up to five times.
  3. Turn the Child Over. Turn the child face up and keep supporting the head and neck. If the object is not out yet, continue to step 4.
  4. Press the Chest. Place the child on a firm surface (can be your forearm). Put two to three fingers in the center of the child’s breastbone and push quickly up to five times. Repeat until the object comes out. If the child continues to not breathe and is unconscious, open the airway by putting your thumb in the child’s mouth and grasping the lower incisors or gums. Look for the object then but do not do a finger sweep as you could further lodge the object deeper into the child’s throat.
  5. If Needed, Start Child CPR. Please find a reference for proper administration of child CPR.

How to Perform the Heimlich Maneuver on Yourself

If you find yourself choking and you remain conscious, locate a stable surface such as a table or chair. Press against your abdomen in the same place you would on another person (below the chest bone and above the navel). Thrust your body inward and upward in a quick motion. Continue until the object is dislodged.

While it is frightening to be in a situation where someone is choking, providing some sort of intervention is better than nothing. The least one can do is call 9-1-1 and try to practice the skills documented here that were obtained from prestigious medical websites such as the Red Cross, Healthline and WebMd. There are many educational videos online as well for visual learners.

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