How to deal with choking on food or foreign objects using the Heimlich maneuver: What you need to know

Choking due to severe upper airway obstruction caused by a foreign object, with signs of inability to speak, cough, or breathe adequately. The choking person often suddenly clutches the neck, grunting, hoarseness...

American doctor Henry J. Heimlich invented the first aid technique for choking on a foreign body in the airway, so people named this technique after him.

Contraindications of the Heimlich maneuver.Absolute contraindications: Children under 1 year of age are contraindicated for the Heimlich maneuver (other methods are used in younger children). Relative contraindications: Children < 20 kg (usually < 5 years) should receive only moderate thrusts and back blows. Obese patients and women in late pregnancy should receive chest thrusts rather than abdominal thrusts.

Complications of the Heimlich maneuver

Rib injuries, internal organ damage if performed in the wrong position or too hard.

Note: This rapid rescue maneuver is performed immediately whenever the person is choking. Sudden, significant force is appropriate for these maneuvers. However, clinical judgment is required to avoid excessive force that could cause injury.

The Heimlich maneuver is well known and widely used. However, chest thrusts and back blows can produce higher airway pressures. Multiple maneuvers may be used if the initial maneuver fails to dislodge the obstruction.

Position for the Heimlich maneuver

Determine if there is a serious airway obstruction. A hand clutched at the throat is a common distress signal of a serious airway obstruction. If the choking person nods yes and cannot speak, cough, or breathe adequately, this suggests a serious airway obstruction and requires maneuvers to clear the airway. Abdominal thrusts (Heimlich maneuver). Wrap both arms around the patient's midsection. Place one hand in a fist and place it midway between the navel and sternum. The other hand grasps the fist. Push the fist hard and upward by pulling both arms back and up. Repeat the thrusts quickly 6 to 10 times, if necessary.

Chest Push:Wrap both arms around the patient's midsection. Clench one hand into a fist and place it on the lower half of the sternum. Grasp the fist with the other hand. Pull both arms back forcefully to deliver a powerful inward thrust. Repeat the thrust quickly 6 to 10 times, if necessary.

Back Pat:Wrap one arm around the person's waist to support the upper body; a small child may be placed across your legs. Bend forward at the waist, about 90 degrees if possible. Using the heel of your other hand, deliver five quick, firm blows between the person's shoulder blades.

Common mistakes with the Heimlich maneuver:Do not attempt the Heimlich maneuver if the choking person can speak, cough forcefully, or breathe fully. In obese patients and women in late pregnancy, use chest thrusts instead of abdominal thrusts.

If you are choking on a foreign object and are alone, or have no one to help, do the following:

- Make a fist with one hand, and with the thumb facing in, place it at the diaphragm - below the ribs and above the navel.

- Push inward and upward until the foreign object is expelled.

- If this maneuver is not possible or does not work on a solid object, such as a table or chair. Place your hands next to the diaphragm and push in and up. Move back and forth to create thrust.

- Repeat until the foreign object is expelled./.