critical care medicine
How To Do the Heimlich Maneuver in the Conscious Adult or Child
Step by Step Description of Heimlich Maneuver
Determine if there is severe airway obstruction Look for signs such as inability to speak, cough, or breathe adequately. Look for hands clutching the throat, which is the universal distress signal of severe airway obstruction. Ask: “Are you choking?” If the person can speak and breathe, encourage them to cough but do not initiate airway clearance maneuvers; instead, arrange medical evaluation. If the choking person nods yes or cannot speak, cough, or breathe adequately,that suggests severe airway obstruction and the need for airway clearance maneuvers. Treat the choking conscious adult or child Stand directly behind the choking adult or kneel behind a child. Begin with abdominal thrusts for people who are not pregnant or obese; do chest thrusts for obese patients and women in late pregnancy. Alternate between sets of abdominal thrusts (Heimlich maneuver), chest thrusts, and back blows as needed to relieve the obstruction. Continue until obstruction is removed or advanced airway management is available. start Cardiopulmonary Resuscitation (CPR) in Adults (CPR). After each set of chest compressions, look inside the patient's mouth before giving rescue breaths and remove any visible obstruction that can be reached. Do not do blind finger sweeps. Abdominal thrusts (Heimlich maneuver): Encircle the patient’s midsection with your arms. Clench one fist and place it midway between the umbilicus and xiphoid. Grab the fist with the other hand (see figure Abdominal thrusts with victim standing or sitting (conscious) ). Deliver a firm inward and upward thrust by pulling with both arms sharply backward and upward. Rapidly repeat the thrust 6 to 10 times as needed. Chest thrusts: Encircle the patient’s midsection with your arms. Clench one fist and place it on the lower half of the sternum. Grab the fist with the other hand. Deliver a firm inward thrust by pulling both arms sharply backward. Rapidly repeat the thrust 6 to 10 times as needed. Back blows: Wrap one arm around the waist to support the patient's upper body; small children can be laid across your legs. Lean the person forward at the waist, about 90 degrees if possible. Using the heel of your other hand, rapidly deliver 5 firm blows between the person's shoulder blades. 