Performing The Heimlich Maneuver

WHAT YOU SHOULD KNOW:

  • The Heimlich maneuver is a procedure you can use to help someone who is choking. Choking happens when food or another object blocks the airway, making it hard to breathe. The airway is the tube that goes from your lungs to your nose and mouth. With the Heimlich maneuver, air is pushed out of a person's lungs, making him cough. The force of the cough may then move the object out of his airway. This will clear the person's airway, and allow him to breathe. Young children like to put things in their mouths, which increases their risk for choking. Older people also have an increased risk as the muscles in their airway weaken with age.

  • Food, coins, and small toys are the most common things that can block a person's airway. An unconscious person can choke on his own tongue or dentures. Liquids, such as milk and water, can also block an airway and is more common in infants. When someone has a blocked airway they may grab at their throat, and have trouble breathing and speaking. A person's face may turn blue from a lack of oxygen. The Heimlich maneuver can be used on adults and children over one year of age. It should only be done on someone who is awake and unable speak. Knowing when and how to do the Heimlich maneuver may help save someone's life.

AFTER YOU LEAVE:

Ask for information about where and when to go for follow-up visits:

For continuing care, treatments, or home services, ask for more information.

How to know if someone is choking:

Conditions such as a stroke or a heart attack can cause a person to stop breathing. These conditions are treated differently than a blocked airway. Signs that a person has a blocked airway and is choking include:

  • Color changes, such as the face turning blue from a lack of oxygen.

  • Grabbing of the throat.

  • Not being able to cough forcefully.

  • Trouble speaking or not being able to speak at all.

  • Trouble breathing.

  • Wheezing (high-pitched sound) or a whistling sound when breathing.

When to give the Heimlich maneuver:

The Heimlich maneuver may be given to a choking person who is conscious (awake) and unable to talk. When you see someone who appears to be choking, first ask him, "Are you choking?" If he nods yes, ask him calmly, "Can you speak?" If he can speak, this means his airway is only partly blocked. Tell him to continue breathing and try to cough forcefully to remove the object stuck in his airway. If he begins vomiting, lay him on his side to prevent the object from totally blocking his airway. If a person is choking and cannot speak, have someone call 911 for help. You may do the Heimlich maneuver on him until help arrives.

Doing the Heimlich maneuver on another adult or child:

  • With the person standing or sitting, stand closely behind him and wrap your arms around his waist. Bend the choking person slightly forward at his waist.

  • Make a fist with one of your hands. Place the thumb side of your fist against the middle of the person's abdomen (stomach). Your fist should be between his navel (belly button) and the lowest part of his ribs. Do not put your fist on his breastbone or ribs. It is very easy to break bones in this area, or hurt the person's abdomen or chest.

  • Put your other hand over your fist. Using both hands, press your fist into the person's abdomen with a quick inward and upward thrust (push). Use less force on a small child than you would on a bigger adult.

  • Repeat the quick thrusts until the object comes out. If the object does not come out, the person is at risk of becoming unconscious. If the choking person becomes unconscious, lay him on the floor on his back. You may need to start rescue breathing or CPR (cardiopulmonary resuscitation). Rescue breathing may help a person start breathing, and CPR may help their heart start beating again. Have someone call 911 and stay with him until caregivers arrive. Ask your caregiver for more information about rescue breathing and CPR.

  • If the person is very overweight or pregnant, wrap your arms around them under their armpits. Place your fist on the center of their breastbone. Be sure your fist is not low on the breastbone, or off to one side of the ribs. Place your other hand over the fist, and do quick pushes. Do this until the object comes out of their mouth, or they become unconscious.


Helping a choking infant:

For infants less than one year old, you may do the following:

  • Pick the child up. You may stand, or sit in a chair.

  • Hold the child face down, with his head slightly lower than his feet. Support his jaw and head with your hand. Support his weight with your knee if you are sitting, and on your forearm if you are standing.

  • Give up to five blows on his upper back, between his shoulder blades. Use the heel of your free hand to do this. If you see an object come out of the child's mouth, stop the back blows. If the object does not come out, go on to the next step.

  • Sandwich the child between your arms and hands, and turn him over onto his back. Support his head and neck with your hand. The child's head should be held slightly lower than his feet. Support his weight on your knee if you are sitting, and on your forearm if you are standing.

  • Give up to five chest thrusts using two fingers. Your fingers should be placed on the lower half of his breastbone. Be sure your fingers are not off to one side, or at the bottom of his breastbone. If you see an object come out of his mouth, stop giving the chest thrusts. If the object does not come out, go on to the next step.

  • Repeat all steps until the object comes out of the infant's mouth. If the infant becomes unconscious, begin CPR and have someone call 911. Ask your caregiver for more information about performing CPR on infants.


Doing the Heimlich maneuver on yourself:

If you are choking and you are alone, you may have to do the Heimlich maneuver on yourself. If you can breathe and talk, cough hard until you are able to spit out the object. If you cannot talk or cough, and are having trouble breathing, do the following:

  • Dial 911. Leave the line open if you cannot get the object that you are choking on out. You may be able to spit out the object, but you may have damaged your airway, chest, or abdomen.

  • Make a fist with one hand. Place the thumb side of your fist against the middle of your abdomen. Your fist should be between your navel and the lowest part of your ribs. Do not put your fist on your breastbone or your ribs.

  • Put your other hand over your fist. Press your fist into your abdomen with a quick inward and upward push. Repeat the quick pushes until you are able to spit out the object.

  • If you cannot get the object out, press your upper abdomen over any hard, blunt (not sharp) surface. The back of a chair, side of a table, or porch railing may work. You may need to do many hard, fast pushes against the surface to clear your airway.

Things that may happen after getting the Heimlich maneuver:

The Heimlich maneuver can be done safely on adults and children over one year of age. Doing the Heimlich maneuver on infants less than a year old may cause harm to their body. Adults and children may throw up or have abdominal pain after getting the Heimlich maneuver. If not done properly, the Heimlich maneuver may cause a person's ribs to fracture (break). Rarely, the Heimlich maneuver may harm a person's organs that can cause bleeding or infection. Eye damage may occur, and fluid or air may enter the lungs making it hard to breathe. Anyone who has had the Heimlich maneuver done on them should see their caregiver to check for injuries.

Preventing an airway from getting blocked:

  • Avoid giving medicine in tablet form to children less than four years of age.

  • Cut food into small pieces.

  • Chew food slowly and well.

  • Do not give foods such as peanuts and popcorn to small children, or anyone who cannot chew well.

  • Do not let young children play with toys small enough to put in their mouths. Always be aware of warnings on toys that say they may be a choking hazard.

  • Do not talk or laugh while chewing and swallowing food.

For more information:

  • American Academy of Pediatrics
    141 Northwest Point Boulevard
    Elk Grove Village , IL 60007-1098
    Phone: 1- 847 - 434-4000
    Web Address: http://www.aap.org
  • American Heart Association
    7272 Greenville Avenue
    Dallas , TX 75231-4596
    Phone: 1- 800 - 242-8721
    Web Address: http://www.heart.org
  • Centers for Disease Control and Prevention
    1600 Clifton Road
    Atlanta , GA 30333
    Phone: 1- 404 - 6393311
    Phone: 1- 800 - 3113435
    Web Address: http://www.cdc.gov

CONTACT A CAREGIVER IF:

  • You cannot stop throwing up.

  • You have a sore throat or trouble swallowing.

  • You have questions or concerns about your condition, treatment, or care.

SEEK CARE IMMEDIATELY IF:

  • You cannot see clearly, or see floating specks or bright flashes of light.

  • You have worsening pain in your chest or abdomen.

  • You have trouble breathing.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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