Choking incidents can escalate quickly, demanding immediate action. Knowing how to respond effectively can be crucial in such situations. The Heimlich maneuver, a widely recognized first-aid technique, utilizes abdominal thrusts to clear airway obstructions. This guide provides a comprehensive walkthrough of the Heimlich maneuver, drawing upon expert advice from Dr. Wendy Macias-Konstantopoulos, an emergency medicine physician at Mass General Brigham.
Calling for Help and Assessing the Situation
The first step in any choking emergency is to dial 911. If someone else is present, one person should call for help while the other initiates first aid. Crucially, the Heimlich maneuver is not appropriate if the person can still talk, cough, or breathe. Encourage coughing if these signs are present. If the person cannot breathe, talk or cough, or displays the universal choking sign, begin by delivering five sharp back blows between the shoulder blades using the heel of your hand.
Before starting the Heimlich, check to make sure the person isn't breathing, talking or coughing. (iStock)
Performing the Heimlich Maneuver
If back blows are unsuccessful, proceed with the Heimlich. Stand behind the choking individual (kneel if it's a child) and wrap your arms around their torso. Make a fist with one hand and cover it with the other. Position your hands between the person's navel and rib cage.
Deliver inward and upward thrusts to the diaphragm. This action expels air from the lungs, potentially dislodging the obstruction. Repeat these thrusts up to five times. If choking persists, alternate between five back blows and five abdominal thrusts until the airway is clear or medical assistance arrives.
If the person is exhibiting the universal choking sign, it is best to begin administering the Heimlich. (iStock)
Place your fist above the belly button and below the rib cage when administering the Heimlich. (iStock)
For pregnant or obese individuals, administer five chest thrusts to the breastbone instead of abdominal thrusts.
Heimlich for Infants
The Heimlich is not suitable for infants under 12 months. If a baby is choking, position them face down along your arm or thigh, ensuring their head is lower than their body. Deliver up to five firm (but not injurious) back blows. If this fails, switch to chest thrusts. Hold the baby face up, supporting their head and neck. Place two to three fingers on their breastbone and perform five sharp downward and upward chest compressions, about one inch deep.
Recommended Heimlich maneuvers vary between adults and children. (iStock)
Self-Administering the Heimlich
If choking alone, you can perform the Heimlich on yourself. Position your fists above your navel and thrust inward and upward. Alternatively, bend over a hard surface like a chair back or countertop and thrust your abdomen against it.
If you are choking and you’re alone, the same Heimlich technique can be performed on yourself. (iStock)
If you can't speak, texting 911 is an option in many areas.
Parents and caregivers should exercise caution with foods that pose choking risks for children, such as popcorn, nuts, grapes, hot dogs, and hard candies. Cutting food into small pieces and supervising mealtimes are essential preventative measures.
