Performing the Heimlich maneuver and what to do when it doesn’t work

1 Sep 2017 Health Care

Performing the Heimlich maneuver and what to do when it doesn’t work

Every year millions of people die due to choking. In fact, choking has been listed as the fourth leading cause of unintentional deaths. Luckily, there is a simple technique that anyone can use to expel objects that are stuck in someone’s airway. It is called the Heimlich maneuver or abdominal thrust. Bellaire ER here shows how to perform the Heimlich maneuver and what to do in case it does not work.

When a person is choking, first allow them to try and dislodge the object from their airway on their own. This is always the first step and not immediately resorting to abdominal thrust procedure. First, ask the person if they can speak. If they can, then that means the air exchange is quite good, and they can get the object out with some forceful coughing. If they are unable to speak, that is when you can proceed to do the Heimlich maneuver.

Performing on a person of normal size
The Heimlich maneuver is handled differently depending on the person it is being performed on. For an average sized person, you should lean them forward and using the heel on your hand, deliver five back blows on the section between the victim’s shoulder blades. That should get the object out. If it does not, then you can perform the Heimlich thrust. This involves the following steps:
• Stand behind the victim then wrap your arms around their waist.
• Once you have wrapped your arms around the victim, ensure that the hand that is closest to the stomach of the victim is made into a fist and your thumb’s knuckle is positioned between the bottom of the victim’s rib cage and their belly button. It should be pressing in that position.
• Once you are set in that position, squeeze and thrust your hands simultaneously inwards and upwards. Do this repetitively until the object that is obstructing the victim’s airway pops out of the victim’s mouth.

This technique is only applicable if the victim is an adult or a child who is above one year.

Heimlich maneuver for a pregnant woman victim

Employing the standard procedure that is usually conducted on a normal person to a pregnant woman can be harmful to the fetus and the victim herself. As such, a modified approach of the Heimlich maneuver is employed for women who are expectant. For this case, deliver the five back blows to the lady just like the standard procedure and observe whether the object blocking their airway can come out. If the object fails to pop out and you have to do the thrust, ensure that when wrapping your hands around the pregnant victim, they should be a little higher as compared to where they would be when performing the same procedure on a normal person. Your thumb’s knuckle should be positioned at the breastbone base just above the section where the lowest ribs join.
Heimlich maneuver on an obese person
For effectiveness, perform the procedure the same way you would perform on a pregnant woman. Your hands should be a bit higher and just under the breastbone.
Heimlich maneuver for a baby victim
Babies are more likely to be choked by objects given that they like putting things in their mouth. For a baby who is more than one year old, the same procedure that is done on a normal person can be performed on them. If the baby is less than one year old, the approach has to be adjusted a bit. For them, give them five firm but gentle back thumps. Then while sitting down, let their arms rest on your thigh. Hold them on your forearm while facing down and use your palm to support their head. You need to be careful not to twist their neck or cover their mouth. Once you have attained this position, give the baby five gentle thumps on their back. The force and gravity will force the object out.
If the object fails to come out, hold the baby on your forearm face-up with the head being a bit lower than the rest of the body. You then have to use two or three of your fingers to give quick chest thrusts to get the object out.
Self-administering of Heimlich maneuver
In case you have to do the procedure on yourself:
• Place your thumb below your rib cage and just above your navel like you would do when performing the procedure on someone else.
• Use your other hand to grab your fist and press it on that spot with a quick movement upwards.
• Another alternative is for you to lean over a chair, rail or the edge of a table thrust your upper abdomen against the edge.
If the maneuver doesn’t work
In case neither of these procedures work on the victim, it is important that you call 911 immediately. In fact, any case of choking should be reported, and paramedics called immediately to assess whether other medical complications could arise due to the choking.

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