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Can you perform the Heimlich maneuver if needed?


Choking can happen unexpectedly to anyone, including yourself, family members, friends, or strangers. Being trained in the Heimlich maneuver enables you to respond quickly and confidently in such situations, providing immediate aid until professional help arrives. You may come across choking incidents in public places like restaurants, parks, or workplaces. By being equipped with the knowledge and skills to perform the maneuver, you can step up to assist someone in distress and potentially prevent a tragedy from occurring. As GSS Health and Consultation, we would like to contribute to the awareness of the June 1st, Heimlich maneuver with this article.

What’s happening?

You are having dinner at the restaurant. There is a sudden noise at the next table. You have seen people shouting in a hurry around an old lady coughing violently while standing with her hands on her throat.

It is important to recognize and be able to assist someone with an airway obstruction due to a foreign body. An individual in distress from a compromised airway is likely to use the universal sign for an airway obstruction, which is for the individual to grab his or her neck with both hands. Just like the woman in the story. 

Foreign bodies can cause partial or complete obstruction. Common causes of airway obstruction by foreign body include:

Choking on food is one of the most common causes of airway obstruction. Small, hard, or poorly chewed food items, such as nuts, seeds, popcorn, or chunks of meat, can get stuck in the throat and block the airway.

Young children are particularly prone to inhaling small objects such as buttons, beads, coins, or toy parts. These objects can become lodged in the airway and cause obstruction.

In some cases, food or liquid can be accidentally inhaled into the airway instead of going into the esophagus. This can happen during eating or drinking, especially if someone is laughing, coughing, or talking while swallowing.

Airway obstruction can occur during dental or medical procedures if instruments, devices, or materials accidentally enter the airway. Examples include broken dental instruments, dislodged dental crowns, or medical equipment accidentally misplaced.

Trauma to the face, neck, or chest can cause airway obstruction if it results in swelling, bleeding, or displacement of tissues that block the airway.

In cases of drug overdose, particularly with sedatives or opioids, individuals may experience loss of consciousness and relaxation of the muscles in the throat, leading to airway obstruction without foreign body.

With a partial airway obstruction, air exchange may be adequate or inadequate. If the victim is able to speak, cough, and exchange air, then he or she should be encouraged to continue spontaneous efforts. Obtain assistance, such as activation of the local ambulance system. Do not interfere with the patient’s attempts to cough or expel the foreign body and do not perform a blind finger sweep. 

Just watch the victim carefully! 

At this stage, the patient can expel the foreign body with the help of airway protective reflexes such as coughing.

Let’s hope so, but vice versa.

If the obstruction in the airway continues, the patient’s condition will worsen gradually, she will lose consciousness and even her heart will stop. This condition is time sensitive. 

If air exchange becomes inadequate as indicated by the inability to speak, increased difficulty breathing, weak and ineffective cough, worsening stridor or cyanosis, immediate medical attention is required.

Inadequate air exchange from a severe partial or a complete airway obstruction should be managed the same way. In an unconscious person, the presence of airway obstruction may be ascertained by noting inadequate airflow and poor chest rise with efforts to ventilate.

The victim’s inability to cope with this situation on her own is no longer breathless, quiet, not coughing, and worsening of consciousness.

Meanwhile is there anything you can do?

Maneuvers used to relieve foreign body obstructions include the Heimlich maneuver, chest thrusts, and the finger sweep. In a conscious individual, the obstructed airway (Heimlich) maneuver is the recommended maneuver in most adults for relieving airway obstruction due to a solid object. It is not useful for liquids. In an unconscious individual suspected of having an aspirated foreign body and in whom the foreign body is visualized, the recommended first step is the finger sweep. A blind finger sweep is no longer recommended as it may worsen airway obstruction by pushing an unseen object into an even less favorable position. Otherwise, in an unconscious patient, the recommended sequence is to perform the obstructed airway maneuver up to five times, open the mouth and perform a finger sweep if a foreign body has become visible, and then attempt to ventilate. This sequence may be repeated as often as needed until the patient recovers or additional assistance arrives.

Heimlich Maneuver

Subdiaphragmatic abdominal thrusts or the Heimlich maneuver is a first-aid procedure used to treat upper airway obstruction caused by a foreign body.

The Heimlich maneuver was initially introduced in 1974 by Dr. Henry Heimlich after proving his theory that the reserve of air in the lung could serve to dislodge objects from the esophagus by quick upwards thrust under the ribcage.

In the 1960s, choking on food, toys, and other objects was the sixth leading cause of accidental death in the United States. According to the National Safety Council’s statistics, foreign-body airway obstruction is the fourth leading cause of unintentional death, resulting in 5,051 documented deaths in 2015. In children under the age of 16, foreign body airway obstruction is still one of the leading causes of accidental deaths. Due to the prevalence and rapidity of unconsciousness and death associated with choking, all persons, including those outside of the health field, should have a basic understanding of how to care for a choking victim. Simple maneuvers taught to lay-people, such as the Heimlich maneuver, have been proven to save lives.

Basic Life Support (BLS) skills are designed to provide immediate care to individuals experiencing life-threatening emergencies, such as cardiac arrest, choking, or severe injuries. By learning BLS, you gain the ability to perform critical interventions that can potentially save someone’s life until advanced medical help arrives. Today, Heimlich maneuver is commonly taught during basic life support and advanced cardiac life support (ACLS) classes.

If we go back to our question in the title;

Can you perform the Heimlich maneuver if needed?

In order to say yes with peace of mind, the best thing to do is to take a basic life support course and try the Heimlich maneuver, which is a part of it, on a model before a human.

I should tell before I forget

The choking old lady is alive today, because there is someone in the restaurant who can perform the Heimlich maneuver.

Below you can find the steps of the Heimlich maneuver and the steps of the European Resuscitation Council Basic Life Support Guideline 2021 Foreign Body Airway Obstruction Management

To perform the Heimlich maneuver on an adult or child who is conscious and choking, follow these steps:

  • Stand behind the person and wrap your arms around their waist.
  • Make a fist with one hand and place the thumb side against the person’s upper abdomen, just above the navel and below the ribcage.
  • Grasp your fist with your other hand and give quick inward and upward thrusts to the abdomen, using enough force to dislodge the object causing the choking.
  • Perform the thrusts in a series of quick, upward motions, as if you were trying to lift the person upward.
  • Avoid pressing on the person’s ribcage or lower chest area to prevent injury.
  • If you are unable to reach around the person, you can perform the maneuver by pressing your fist against a hard surface such as a table or chair back.
  • Repeat the thrusts until the person can breathe or until medical help arrives.
  • If the person becomes unconscious while performing the Heimlich maneuver, lower them gently to the ground and immediately begin CPR (cardiopulmonary resuscitation) starting with chest compressions.

It is important to note that these instructions are meant for informational purposes only. If you find yourself in a situation where someone is choking, it is crucial to seek immediate medical attention and call your local emergency number for assistance. Proper training in first aid and BLS is recommended to handle emergency situations effectively.

According to European Resuscitation Council Basic Life Support Guideline 2021, Foreign Body Airway Obstruction Management

  • Suspect choking if someone is suddenly unable to speak or talk, particularly if eating.
  • Encourage the victim to cough.
  • If the cough becomes ineffective, give up to 5 back blows:
  • Lean the victim forwards.
  • Apply blows between the shoulder blades using the heel of one hand
  • If back blows are ineffective, give up to 5 abdominal thrusts:
  • Stand behind the victim and put both your arms around the upper part of the victim’s abdomen.
  • Lean the victim forwards.
  • Clench your fist and place it between the umbilicus (navel) and the ribcage.
  • Grasp your fist with the other hand and pull sharply inwards and upwards.
  • If choking has not been relieved after 5 abdominal thrusts, continue alternating 5 back blows with 5 abdominal thrusts until it is relieved, or the victim becomes unconscious.

If the victim becomes unconscious, start chest compression