The Heimlich Maneuver

A Response to Choking


Choking is the seventh leading cause of accidental death. It doesn't have to be that way, because choking can be stopped using the Heimlich maneuver. This life-saving technique was developed by Dr. Henry Heimlich in 1974 and is credited with saving thousands of lives since then.

When and How To Use the Heimlich Maneuver

Don't interfere with a possible choking victim who is coughing forcefully. Coughing may be all that is needed to dislodge the blockage. But if the person looks alarmed, grasps his or her throat, can't cough, talk or breathe, appears to be turning blue or the veins on the head or neck are swollen, here's what to do:
1. Have someone call for medical help while you stand behind the choking person and put your arms around him or her. If the victim is sitting, bend your knees and waist behind the chair to circle both the victim and chair.

2. Clench your fist and place it with your thumb inward just above the navel, below the breastbone and between the rib cage. lIf a choking victim is pregnant or extremely obese place your fist on the chest instead of on the abdomen.)

3. Grasp your fist with your other hand and, bending your elbows, pull both hands toward you with a quick upward and inward thrust. Repeat these thrusts until the blockage is dislodged. Stop if the choking person becomes unconscious.

If the Choking Person Becomes Unconscious...

A. Place the victim on his or her back and use your index finger like a hook to dislodge anything in the victim's mouth that might be blocking the airway. (Don't try this on a child or infant.) Be careful not to force an object deeper into the airway.

B. If this doesn't work, administer rescue breathing for two full breaths.

C. If the victim doesn't regain consciousness, perform the Heimlich maneuver as adapted for a victim on his or her back:
  • Straddle the victim's thighs.
  • Position the heel of one hand just above the victim's navel.
  • Cover that hand with your other hand, interlacing fingers.
  • Keeping your arms straight, rapidly press the abdomen inward and upward until the foreign matter is expelled, but not more than ten times.

If this doesn't work, repeat steps A through C for as long as necessary. Infants and young children require special techniques, which are taught by the Red Cross, the YMCA and many community agencies.

Necessary Actions

Choking victims may feel embarrassed and try to leave the room. If they do, they may black out without anybody around, so perform the Heimlich maneuver as soon as you've determined someone is choking. In only four minutes, choking can cut off enough oxygen to the brain to cause permanent damage, even if they survive the incident. And any choking victim who is able to breathe again should still be examined by a doctor as soon as possible since the abdominal thrusts can damage the liver and other internal organs.

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