Abdominal thrusts

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The Heimlich maneuver

The Heimlich Maneuver, also known as abdominal thrusts, is a first aid procedure for clearing an obstructed airway. It is an effective life-saving measure in cases of choking.

Dr. Henry Heimlich has also promoted it as a treatment for drowning and asthma attacks. Recent articles indicate Dr. Heimlich used fraudulent case reports and dubious evidence to promote the maneuver for both drowning and asthma.

The Heimlich maneuver is named after Henry Heimlich, who first described it in 1974. However, Edward A. Patrick, MD, PhD (http://patrickinstitute.org/press_release.htm), has claimed to be the uncredited co-developer of the maneuver.


Performing the Heimlich maneuver

Briefly, a person performing the Heimlich maneuver uses their hands to exert pressure on the bottom of the diaphragm. This compresses the lungs and exerts pressure on any object lodged in the trachea, hopefully expelling it. This amounts to an artificial cough. (The victim of an obstructed airway, having lost the ability to draw air into the lungs, has lost the ability to cough on their own.)

Even when performed correctly, the Heimlich maneuver can injure the person it is performed on. The Heimlich maneuver should never be performed on someone who can still cough, breathe, or speak. Those wishing to learn and perform the Heimlich maneuver should take first aid training from a qualified instructor. Reading the Wikipedia is not a substitute for first aid training. Moreover, since the Wikipedia may be altered by anyone at anytime, this article may not even be accurate. For a more thorough disclaimer, see the link at the bottom of this page.

Indications that someone is choking

  • The person can not speak or cry out.
  • The person's face turns blue from lack of oxygen.
  • The person desperately grabs at his or her throat.
  • The person has a weak cough, and labored breathing produces a high-pitched noise.
  • The person does all of the above, then becomes unconscious.

On a standing or seated victim

Before attempting the Heimlich maneuver on a conscious adult, one should ask the victim "Are you choking?" If the victim can reply verbally, you should not interfere, but should instead monitor the situation to make certain they continue being able to respond verbally. Do not attempt the Heimlich maneuver if the person is coughing and able to reply, even if the reply is a request to do so. A strong cough can dislodge the object, whereas the Heimlich maneuver can make it more difficult to dislodge.

You should not call for help while the victim is able to respond verbally, as the help may attempt the Heimlich maneuver maneuver. Only if the victim is unable to reply verbally should the Heimlich maneuver be attempted.

The person giving the Heimlich maneuver stands behind the victim and wraps their arms around the victim's sides, underneath the victim's arms. One hand is made into a fist and placed, thumb side in, flat against the victim's upper abdomen, below the ribs but above the navel. The other hand grabs the fist and directs it in a series of upward thrusts until the object obstructing the airway is expelled. The thrusts should not compress or restrict the ribcage in any way.

If the victim loses consciousness, call for help.

On an unconscious victim

If the victim is unconscious or loses consciousness, yell for help before proceeding.

If the victim is unconscious, lying down, or too obese for the first aid provider to wrap their arms around, the person giving the Heimlich maneuver positions rolls the victim onto their back and straddles the victim's hips. The heel of one hand is positioned against the victim's upper abdomen as described above. The other hand covers the fist, and, as above, directs it in a series until the victim's airway is clear.

On oneself

A person may perform the Heimlich maneuver on themselves using the same procedure described above. One hand is balled into a fist and placed against their upper abdomen, while the other hand grabs the first and directs it in a series of upward thrusts until the airway is clear.

A person may also perform the Heimlich on themselves by leaning their upper abdomen against a fixed object (such as the back of a chair) and repeatedly thrusting their body downward against the object until they expel the obstruction.

On an infant

To perform the Heimlich maneuver on a child less than one year old, the child is positioned on their back. The first aid provider kneels at the child's feet and places the index and middle fingers of one hand together against the upper abdomen of the child, below the rib cage and above the navel. These fingers are covered with the index and middle fingers of the other hand. The top hand then repeatedly presses the fingers of the lower hand upward and into the child's abdomen, until the airway is clear. This must be done gently. Using the same force as would be used on an adult victim could result in injury to the child.

After the airway is clear

After the obstructing object or liquid has been expelled from the airway, it is possible, especially if the victim was unconscious to begin with, that the victim may not resume breathing on their own. Continuing the Heimlich maneuver will not restore breathing. Artificial respiration or CPR must be used for the this purpose.

A medical advice is necessary after a Heimlich maneuver:

  • when the person breathes back: it may be necessary to have a medical evaluation due to possible secondary trauma;
  • when the person does not breathe: to get a paramedic or a medical team for medicalised resuscitation (the phone call should be made before beginning the CPR);

see Call for help.

External links

fr:Méthode d'Heimlich it:Manovra di Heimlich nl:Heimlichmanoeuvre ko:하임리히법 tl:Heimlich maneuver


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