What is the Heimlich maneuver?

Indications and Procedures

The Heimlich maneuver is an emergency technique, introduced in 1974 by Henry J. Heimlich, that guides a rescuer through a set of manipulative procedures to prevent suffocation when a victim’s airway (windpipe) becomes blocked by food, water, or other foreign material. The maneuver lifts the diaphragm and forces enough air from the lungs to create an artificial cough. This cough intends to move the obstructive foreign body from the windpipe in order to resume normal and functional breathing (ventilation).

The Heimlich maneuver should be performed only if a choking victim cannot speak, cough, or breathe. Several indications may signal such a situation: frantic gestures to the throat, a face that turns blue in color because of lack of oxygen, and the production of loud noises in an attempt to take in breaths of air.

Before attempting the Heimlich maneuver, permission in the form of an affirmative nod or gesture should be given by a conscious victim to the intended administrator of the maneuver. When performing the technique, the rescuer is usually positioned behind the sitting or standing victim, with his or her arms around the victim’s waist. The rescuer makes a fist with one hand and places that hand, with the thumb toward the victim, just above the victim’s navel or below the rib cage and above the waist. The free hand should clasp the fisted hand tightly. Then, in a series of sharp thrusts upward and inward, the rescuer attempts to develop enough air pressure in the airway to force the lodged foreign object back up the trachea. The procedure may have to be repeated several times before the foreign object is expelled. Once the airway is cleared, the victim should start coughing and/or regain normal breathing. In cases when breathing is not resumed, then cardiopulmonary resuscitation (CPR) may have to be administered. In more serious choking cases in which the airway is
not cleared of the obstruction, a small incision to the windpipe called a tracheostomy
may have to be completed.

Uses and Complications

In addition to choking victims, the Heimlich maneuver may be administered to asthmatics and drowning victims. While it can be performed on all people, modifications should be adapted when executed upon infants (it is not recommended for infants less than one year old), children, and very obese, pregnant, or unconscious adults. The Heimlich maneuver may also be self-administered.

The Heimlich maneuver is one of the best courses to follow for the prevention of asphyxiation during a choking episode, but it does come with several precautions. In addition to modifications depending on the age and situation of the victim, incorrect administration of the Heimlich maneuver by incorporating techniques such as chest thrusts, back slaps, and abdominal thrusts can cause bruised ribs, broken bones, damage to internal organs, and even death. If all the guidelines are effectively followed by the administrator, however, then the victim should feel little or no bodily discomfort and should recover quickly.

Bibliography

Chillag, Shawn, Jake Krieg, and Ranjana Bhargava. "The Heimlich Maneuver: Breaking Down the Complications." Southern Medical Journal 103, no. 2 (February 2010): 147–150.

"Choking: First Aid." Mayo Clinic, October 13, 2011.

“Heimlich Maneuver.” In Everything You Need to Know About Medical Treatments. Springhouse, Pa.: Springhouse, 1996.

"Heimlich Maneuver." MedlinePlus, July 16, 2011.

Icon Health. Heimlich Maneuver: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References. San Diego, Calif.: Author, 2004.

Subbarao, Italo, et al., eds. American Medical Association Handbook of First Aid and Emergency Care. Rev. ed. New York: Random House Reference, 2009.

Tintinalli, Judith E., ed. Emergency Medicine: A Comprehensive Study Guide. 6th ed. New York: McGraw-Hill, 2004.

White, R. D. “Foreign Body Airway Obstruction: Considerations in 1985.” Circulation 74, no. 6, pt. 2 (1986): IV60–62.