Heimlich Maneuver: Emergency Choking First Aid

What Is the Heimlich Maneuver?

The Heimlich maneuver is a first-aid method for choking that you can use on adults and children. Another name for the Heimlich maneuver is abdominal thrusts, because it involves thrusting into the abdominal area. It’s a quick and life-saving method, but you should only use it on conscious people who can’t breathe on their own. When someone can’t breathe because of a blockage (obstruction) in their upper airway, seconds count. You could save a life by performing the Heimlich maneuver.

The Heimlich maneuver works by using the reserve of air in the lungs to dislodge objects from the esophagus through a quick upward thrust under the ribcage. This technique has become one of the most recognized emergency procedures worldwide, taught in basic life support and advanced cardiac life support classes. However, it’s important to understand that while this maneuver can be life-saving and is generally safe to perform, serious intra-abdominal harm can occur if performed incorrectly.

History of the Heimlich Maneuver

The Heimlich maneuver was introduced in 1974 by Dr. Henry Heimlich after proving his theory that the reserve of air in the lung could serve to dislodge objects from the esophagus by quick upwards thrust under the ribcage. At first, the Heimlich maneuver didn’t catch on with the medical community. The backslap method remained the most popular first-aid choking treatment for another 10 years. The American Red Cross (ARC) and the American Heart Association (AHA) continued to promote backslaps for ten years after the introduction of the Heimlich maneuver.

Eventually, the Heimlich maneuver caught on for use in conscious adults. Today, healthcare providers still recommend backslaps (back blows) for infants, and they recommend CPR for unconscious adults, children and infants. The technique has become the standard emergency response for conscious choking victims unable to clear their airways on their own.

When Should You Use the Heimlich Maneuver?

You should use the Heimlich maneuver if a person is conscious and choking. You can usually tell a person is choking if they can’t speak, breathe or cough. Ask the person, “Are you choking?” They may be able to cough but can’t speak to ask for help. Sometimes, their breathing and speaking become weaker and weaker until only gasping sounds come out.

Signs of Choking

People often use the universal choking symbol — holding your hands up and clutching your throat. The universal choking sign is the main indication for the Heimlich maneuver. This sign consists of the inability to speak, breathe, or cough while holding both hands up to one’s own throat.

When NOT to Use the Heimlich Maneuver

If a person is able to speak, cough or breathe, don’t attempt the Heimlich maneuver. Encourage the person to keep coughing. Sometimes a strong cough can free the foreign object. Only perform the Heimlich maneuver if a person’s life is in danger. The only accepted indication for the abdominal thrust maneuver is that of the conscious choking adult from a lodged supra-laryngeal foreign body. Although initially reported to help with asthma and drowning patients, the Heimlich maneuver has not proven to help with these diagnoses.

How to Perform the Heimlich Maneuver

Healthcare providers consider the Heimlich maneuver a safe and quick method to save lives. You don’t have to have any medical knowledge or training to perform the Heimlich maneuver. Follow these steps to perform the technique correctly:

Step-by-Step Instructions

Step 1: Position Yourself Stand behind the choking person and wrap your arms around their upper abdominal region.

Step 2: Locate the Correct Position Place your fist about two inches above the person’s belly button and below the rib cage. The thrusts must be executed over the epigastric region just below the ribcage and directed upwards towards the head of the patient.

Step 3: Create a Fist Make a fist with one hand and wrap the other hand tightly over the fist.

Step 4: Deliver Thrusts Deliver five sharp midline thrusts inward and upward. Pull the clenched fist sharply and directly backward and upward under the rib cage.

Step 5: Repeat Continue alternating five back blows and five abdominal thrusts until the obstruction is cleared or emergency help arrives.

Special Considerations

If the patient is pregnant, the thrust maneuver can be performed over the sternum instead of the abdomen. For 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.

Potential Complications

Ever since the introduction of the Heimlich maneuver, cases of harm inflicted by the forceful displacement of the diaphragm and sudden increase in intrathoracic pressure have driven numerous studies and reviews. Although this maneuver is considered life-saving and generally safe to perform, serious intra-abdominal harm can ensue from incorrect technique and unusually vigorous application.

Common Complications

If you aren’t able to dislodge the foreign object after the first few sets of thrusts, problems can occur. The most common complications of the Heimlich maneuver are broken ribs and holes in the gastrointestinal tract. Other rare abdominal complications can happen, but in a life-or-death situation, providers still recommend performing the Heimlich maneuver. However, if you don’t perform the Heimlich maneuver correctly, you can do serious harm.

What to Do After the Heimlich Maneuver

After the obstruction is removed, have the person examined by a physician as soon as possible. Even if the choking victim appears to be breathing normally, they should receive medical evaluation to ensure no internal injuries occurred and to confirm complete clearance of the airway.

If the person is not breathing after the obstruction is removed, begin CPR if necessary. Listen for breathing and watch for the 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). Continue this sequence uninterrupted until the obstruction is removed or advanced life support is available.

Performing the Heimlich Maneuver on Yourself

The Heimlich maneuver is a first aid procedure used when a person is choking. If you are alone and you are choking, you can try to dislodge the thing in your throat or windpipe by performing the Heimlich maneuver on yourself. Self-administered abdominal thrusts is also a clear signal to rescuers that a person is choking.

Self-Help Technique

To perform the Heimlich maneuver on yourself, place a fist slightly above your navel. Grasp your fist with the other hand and press hard into your abdomen with a quick, upward movement. You can repeat this motion 6 to 10 times, or until the object dislodges. Alternatively, you can lean over a hard surface, such as a countertop or back of a chair, and press your abdomen against it with a quick, upward movement to generate the necessary pressure.

Prevention of Choking

While knowing how to perform the Heimlich maneuver is important, prevention is always better than emergency response. Young children are at a high risk of choking. To prevent your child from choking, supervision is critical during meals and playtime. Be aware of common choking hazards such as small toys, hard candies, nuts, grapes, hot dogs, and other small foods that could become lodged in the airway.

General Choking Prevention Tips

For adults, choking prevention includes eating slowly and chewing food thoroughly before swallowing, avoiding talking or laughing with a full mouth, and being particularly cautious when consuming foods that are known choking hazards. For elderly individuals or those with swallowing difficulties, modified food textures and careful monitoring during meals can significantly reduce choking risk.

Frequently Asked Questions

Q: Do I need medical training to perform the Heimlich maneuver?

A: No, you don’t need any medical training to perform the Heimlich maneuver. However, it’s helpful to learn the proper technique beforehand through first-aid classes or instructional resources. Being prepared can make the difference in an emergency situation.

Q: Can the Heimlich maneuver be used on infants?

A: No, the Heimlich maneuver is not recommended for infants. Healthcare providers recommend back blows for infants under one year of age. The technique can be used on children older than one year and adults.

Q: What if the Heimlich maneuver doesn’t work?

A: If the Heimlich maneuver is unsuccessful after the first few sets of thrusts, continue attempting the maneuver while also calling emergency services (911 in the United States). Have someone nearby call for help if you are alone with the choking victim.

Q: Can the Heimlich maneuver cause injury?

A: While serious injuries from the Heimlich maneuver are uncommon, they can occur if the technique is performed incorrectly or with excessive force. Possible complications include broken ribs and internal organ damage. However, in a life-threatening choking situation, the benefits outweigh the risks.

Q: Should I use back blows along with the Heimlich maneuver?

A: Yes, many emergency response guidelines recommend alternating between five back blows (delivered between the shoulder blades with the heel of your hand) and five abdominal thrusts until the obstruction is dislodged or help arrives.

Q: What is the difference between the Heimlich maneuver and CPR?

A: The Heimlich maneuver is specifically designed to clear an airway obstruction caused by a foreign body, while CPR (cardiopulmonary resuscitation) is used to maintain circulation and oxygenation when a person’s heart has stopped beating or they are not breathing. Both are important life-saving techniques for different emergency situations.

Key Takeaways

The Heimlich maneuver is a critical first-aid technique that can save lives when performed correctly on conscious choking victims. Remember that you only need to use it if the person cannot speak, cough, or breathe. If a person is able to cough or speak, encourage them to continue coughing as this may naturally dislodge the object.

Always ensure the person receives medical evaluation after the obstruction is removed, even if they appear to be breathing normally. When in doubt during a choking emergency, it’s better to attempt the Heimlich maneuver than to wait for professional help to arrive, as every second counts in these life-threatening situations.

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Author

Sneha TeteBeauty & Lifestyle Writer

 

Sneha is a relationships and lifestyle writer with a strong foundation in applied linguistics and certified training in relationship coaching. She brings over five years of writing experience to renewcure,  crafting thoughtful, research-driven content that empowers readers to build healthier relationships, boost emotional well-being, and embrace holistic living.

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