The Heimlich maneuver, also known as abdominal thrusts, is a first-aid technique used to treat upper airway obstruction by foreign objects. It involves forceful compression of the abdomen to create an artificial cough, increasing intrathoracic pressure to expel the blockage. When alone and choking, immediate self-rescue is necessary because brain damage can occur within minutes without oxygen. This article details methods for safely and effectively performing this maneuver on yourself.
Recognizing Severe Airway Obstruction
Before attempting self-rescue, confirm the obstruction is severe rather than mild. Mild choking allows the person to cough forcefully or speak, indicating air movement. Severe airway obstruction is characterized by the inability to cough, speak, or inhale any air, leading to a silent struggle.
The universal distress signal for choking is clutching both hands to the throat, indicating a complete blockage. This lack of air exchange requires immediate, forceful intervention to prevent rapid unconsciousness. The maneuver aims to generate a pressure greater than 16 mmHg in the lungs to dislodge the foreign body. This high pressure forces the air out, acting as a propulsive column for the object.
Performing the Heimlich Maneuver Using a Fixed Object
Using a sturdy, fixed object—like a chair back, counter edge, or railing—is the most effective method for self-administering the Heimlich maneuver due to the mechanical advantage it provides. The leverage allows for a greater and more focused upward force compared to using only muscular strength. Select a stable, waist-height object with a rounded edge that will not move or tip over when forceful pressure is applied.
Position yourself so the object is directly in front of your upper abdomen, between the navel and the bottom of the ribcage. Clench one hand into a fist and place the thumb side against your body, just above this point. This placement targets the subdiaphragmatic region, which is necessary to compress the lungs and force the diaphragm upward.
Lean forward over the fixed object, pressing your fist and upper abdomen forcefully against the edge. Use the object as a lever to drive the fist inward and upward rapidly. Execute distinct, sharp thrusts, aiming toward your diaphragm with maximum speed, rather than simply leaning.
Repeat the inward and upward thrusts in rapid succession until the obstruction is dislodged and expelled. The force must compress the air remaining in the lungs, creating a sudden and powerful exhalation to clear the airway. This method harnesses the rigidity of the fixed object to apply the necessary pressure.
Performing the Heimlich Maneuver Without an Object
If a suitable fixed object is not accessible, the maneuver can be performed using only your hands and body momentum. Make a tight fist with one hand and place the thumb side against your abdomen, slightly above the navel and below the ribcage. Cover the fist with your other hand to reinforce the structure and apply even pressure.
Lean forward rapidly, dropping your body down over your fist while simultaneously driving the fist inward and upward. This utilizes your body’s weight and momentum to generate force against the diaphragm. The motion should be a quick, distinct pull directed toward the back of your head, not just a push into the stomach.
Repeat these forceful, self-administered abdominal thrusts until the foreign body is ejected. The force must rapidly increase the pressure in the chest cavity, imitating a violent, artificial cough.
After successfully clearing the airway, seek prompt medical attention regardless of the method used. A healthcare professional should examine you for potential internal injuries, such as damage to abdominal organs or rib fractures, which can occur from the necessary force of the thrusts.