The Heimlich maneuver is a life-saving first-aid technique used to clear an airway obstruction caused by a foreign object. This method helps prevent life-threatening oxygen deprivation during choking. It can be performed without special equipment.
Identifying a Choking Emergency
Recognizing the signs of a choking emergency is the first step in providing aid. A person choking may display a panicked expression and often clutches their throat, the universal sign for choking. They might be unable to speak, cough effectively, or breathe, indicating a severe airway blockage. Other indicators include strained or noisy breathing, high-pitched squeaking sounds, or a silent cough. Skin, lips, or nails may turn blue or gray as oxygen diminishes.
The Mechanism of Action
The Heimlich maneuver works by creating an artificial cough, leveraging the air already present in the lungs. Upward and inward abdominal thrusts compress the diaphragm, a dome-shaped muscle beneath the lungs. This increases intrathoracic pressure within the chest cavity. The surge of pressure forces residual air rapidly upwards through the trachea. This powerful expulsion dislodges the foreign object from the airway.
Performing the Heimlich Maneuver
Adults
To perform the Heimlich maneuver on an adult, stand behind the person and wrap your arms around their waist. Make a fist with one hand, grasp it with the other, and place it just above the person’s navel and below the ribcage. Deliver five quick, upward, and inward thrusts. Continue these thrusts until the object is dislodged or the person becomes unconscious.
Children
For children, kneel behind them and use less forceful thrusts, adjusting the pressure to their smaller size. The hand placement remains similar, just above the navel.
Pregnant Individuals or Those with Obesity
For pregnant individuals or those with obesity, abdominal thrusts are not recommended. Instead, perform chest thrusts. Place your hands at the base of the breastbone, just above the lowest ribs, and deliver sharp inward thrusts.
Self-Heimlich
If you are alone and choking, you can perform the maneuver on yourself by placing your fist above your navel and thrusting inward and upward. Alternatively, you can lean over a firm surface like a countertop or chair and press your upper abdomen against it.
After the Maneuver
Once the foreign object is dislodged, it is important to assess the person’s condition. Encourage them to breathe deeply and calmly. Even if the object is cleared and the person appears fine, seeking medical attention is advisable to check for potential internal injuries, such as bruising, cracked ribs, or organ damage, which can occur from the forceful thrusts. If the choking episode was severe or prolonged, or if there is persistent difficulty breathing, chest pain, or a lingering cough, immediate medical evaluation is recommended.
If the object is not dislodged and the person becomes unresponsive, lower them gently to the floor. Immediately call emergency services if not already done, and begin cardiopulmonary resuscitation (CPR). Continue cycles of chest compressions and rescue breaths, checking the mouth periodically for the object.