Emergency Medicine: Choking – the Heimlich Maneuver

Do You Know What to do if Someone Is Choking?

How to Know if Someone Choking Needs Your Help

The universal sign for choking is hands clutched to the throat. If the person doesn’t give the signal, look for these indications:

• -Inability to talk
• -Difficulty breathing or noisy breathing
• -Inability to cough forcefully
• -Skin, lips and nails turning blue or dusky
• -Loss of consciousness

The Heimlich maneuver is an emergency technique for preventing suffocation when a person’s airway (windpipe) becomes blocked by a piece of food or other object.

It can be used safely on both adults and children, but most experts do not recommend it for infants less than one year old. You can also perform the maneuver on yourself. If the person has stopped breathing and you have dislodged the object from the windpipe, CPR may need to be performed.

The Heimlich Maneuver

To perform the Heimlich Maneuver on an infant:

1. Place the infant face down across your forearm (resting your forearm on your leg) and support the infant’s head with your hand. Give four forceful blows to the back with the heel of your hand. You may have to repeat this several times until the obstructing object is coughed out.

2. If this does not work, turn the baby over. With two fingers one finger width below an imaginary line connecting the nipples, give four forceful thrusts to the chest to a depth of one inch.

You may have to repeat this several times until the obstructing object is coughed out.

To perform the Heimlich Maneuver on yourself:

1. Place a fist slightly above your navel.

2. Grasp your fist with the other hand and bend over a hard surface – a countertop or chair will do.

3. Shove your fist inward and upward.

4. If you do not have the strength or the object is not coming out, find the corner of a table or chair and push your body upward and inward.

If choking is occurring, the Red Cross recommends a “five-and-five” approach to delivering first aid:

• First, deliver FIVE back blows between the person’s shoulder blades with the heel of your hand.
• Second, perform FIVE abdominal thrusts (also known as the Heimlich Maneuver).
• Third, alternate between FIVE back blows and five abdominal thrusts until the blockage is dislodged.

To perform the Heimlich Maneuver on someone else:

1. Stand behind the person. Wrap your arms around the waist. Tip the person forward slightly.

2. Make a fist with one hand. Position it slightly above the person’s navel.

3. Grasp the fist with the other hand. Press hard into the abdomen with a quick, upward thrust ? as if trying to lift the person up.

4. Perform a total of five abdominal thrusts, if needed. If the blockage still isn’t dislodged, repeat the “five-and-five” cycle.

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