Life-Saving Skills: Mastering the Heimlich Maneuver for Adults and Children

Choking is a terrifying experience, and knowing how to respond can be the difference between life and death. The Heimlich maneuver, also known as abdominal thrusts, is a first-aid procedure used to dislodge an object blocking a person’s airway. This comprehensive guide will provide detailed instructions on how to perform the Heimlich maneuver effectively on adults, children (over one year old), and infants (under one year old). It will also cover important distinctions, precautions, and what to do when the maneuver is unsuccessful.

Understanding Choking: Recognizing the Signs

Before diving into the technique, it’s crucial to recognize the signs of choking. When someone’s airway is blocked, they may exhibit the following:

• Universal Choking Sign: Clutching at the throat with one or both hands.
• Inability to speak or cough: They may struggle to make any sound or have a weak cough.
• Difficulty breathing or noisy breathing: They may be gasping for air or making a high-pitched sound.
• Bluish skin, lips, or fingernails (cyanosis): This is a sign of oxygen deprivation and indicates a severe situation.
• Loss of consciousness: In severe cases, the person may become unresponsive.

It’s important to distinguish between a mild airway obstruction, where the person can cough forcefully and talk, and a severe obstruction, where they can’t. If someone can cough forcefully, encourage them to keep coughing. Don’t interfere unless the obstruction becomes severe. If the person is exhibiting signs of a severe obstruction, then you should proceed immediately with the Heimlich Maneuver.

Performing the Heimlich Maneuver on an Adult or Child (Over 1 Year Old)

When performing the Heimlich maneuver on an adult or child over one year old, follow these step-by-step instructions:

1. Assess the situation and ensure safety: Quickly determine if the person is indeed choking and if they cannot speak, cough, or breath. Also, ensure the scene is safe before you start to help. If someone else is present, ask them to call for emergency services immediately while you perform the Heimlich maneuver.
2. Position Yourself: Stand behind the person. Make sure they are also standing if possible, or sitting if they can’t stand.
3. Form a Fist: Make a fist with one hand. Place the thumb side of your fist against the person’s abdomen, slightly above their navel and below the rib cage. Avoid putting your fist on their ribs.
4. Grasp Your Fist: Grasp your fist with your other hand. This is to help you apply stronger pressure to the abdominal area.
5. Perform Abdominal Thrusts: Give a quick, forceful inward and upward thrust into the abdomen. Each thrust should be a distinct and separate movement. Try to visualize lifting them up from the inside. Avoid squeezing their ribs.
6. Repeat: Repeat the abdominal thrusts until the object is dislodged or the person becomes unresponsive. Aim for 5 thrusts in quick succession at a time.
7. Check After Each Set: After each set of 5 thrusts, assess the situation again. Check if the person is now able to breathe, speak, or cough effectively. Check if the object has been expelled. If they are still choking, continue to alternate between the 5 abdominal thrusts and assessment until the object is dislodged.
8. If the person becomes unresponsive: If the person becomes unconscious, carefully lower them to the ground, call for emergency services or ensure someone else has done so, and begin chest compressions (CPR). Do not attempt to continue the Heimlich maneuver once the person is unconscious. Instead, focus on chest compressions. You can still try to look into the airway for foreign objects after each cycle of chest compressions, but only if it can be done safely, and quickly.

Important Considerations for Children:

• Adjust Force: For children, use less force when giving abdominal thrusts. Use the amount of force needed for their size and fragility.
• Kneel if necessary: If the child is smaller than you, kneel behind them to make the thrusts more effective and to ensure you are not using too much force.
• Avoid Chest Thrusts on Children: Do not give chest thrusts on an infant. If performing chest thrusts on a larger child they must be done with great care, and only if the abdominal thrusts are not working.

Performing the Heimlich Maneuver on a Pregnant Woman or an Obese Person

The standard Heimlich maneuver may not be appropriate for pregnant women or obese individuals. In these cases, chest thrusts should be used instead:

1. Position Yourself: Stand behind the person.
2. Form a Fist: Make a fist with one hand.
3. Position Your Fist: Place the thumb side of your fist on the center of their chest, in the middle of the sternum (breastbone). Avoid the lower part of the sternum which may puncture.
4. Grasp Your Fist: Grasp your fist with your other hand.
5. Perform Chest Thrusts: Give quick, forceful chest thrusts, pulling the chest inward and sharply. These thrusts should be directed inwards and slightly upwards.
6. Repeat: Repeat the chest thrusts until the object is dislodged or the person becomes unresponsive. Aim for 5 thrusts in quick succession at a time.
7. Check After Each Set: After each set of 5 thrusts, assess the situation again. Check if the person is now able to breathe, speak, or cough effectively. Check if the object has been expelled. If they are still choking, continue to alternate between the 5 chest thrusts and assessment until the object is dislodged.
8. If the person becomes unresponsive: If the person becomes unconscious, carefully lower them to the ground, call for emergency services or ensure someone else has done so, and begin chest compressions (CPR). Do not attempt to continue the Heimlich maneuver once the person is unconscious. Instead, focus on chest compressions. You can still try to look into the airway for foreign objects after each cycle of chest compressions, but only if it can be done safely, and quickly.

Performing the Heimlich Maneuver on an Infant (Under 1 Year Old)

The Heimlich maneuver is performed differently on infants. Abdominal thrusts are not recommended for infants as they can cause injury. Instead, use a combination of back blows and chest thrusts:

1. Assess the situation: Check if the infant is indeed choking and cannot cry, breathe, or cough forcefully. If the infant is able to cough or cry, then you should let the infant cough as that is the most effective way to clear an airway obstruction.
2. Position the Infant: Hold the infant face down along your forearm, resting on your thigh. Support their head and jaw with your hand, making sure their head is lower than their chest.
3. Deliver Back Blows: Using the heel of your other hand, give 5 firm back blows between the infant’s shoulder blades. Use a firm but controlled force.
4. Turn the Infant: Carefully turn the infant face up, supporting their head and neck with one hand and resting them on your other forearm and thigh.
5. Deliver Chest Thrusts: Place two fingers in the center of their chest, just below the nipple line. Give 5 quick and sharp chest thrusts, about 1.5 inches in depth. Do not push into the abdomen.
6. Repeat Back Blows and Chest Thrusts: Continue alternating between 5 back blows and 5 chest thrusts until the object is dislodged or the infant becomes unresponsive. Check after each set of 5 back blows and 5 chest thrusts to see if the airway is clear and the infant can breathe or cry.
7. If the infant becomes unresponsive: If the infant becomes unconscious, call for emergency services or ensure someone else has done so, and begin chest compressions (CPR). Do not continue the back blows or chest thrusts if the infant is unconscious. You can still look into the airway for foreign objects after each set of chest compressions, but only if it can be done safely, and quickly.

What to Do If the Heimlich Maneuver Fails

If the Heimlich maneuver is unsuccessful, you may have to consider the following:

• Call for Emergency Services: If you haven’t already, call for emergency services as soon as you recognize the person is choking. If possible, you can continue with the Heimlich maneuver while waiting for them to arrive.
• Continue the Maneuver: Keep trying the Heimlich maneuver as long as the person is conscious, alternating between the thrusts and assessment. If the thrusts are failing, make sure your technique is correct and that you are using the correct position on the body for the person you are helping.
• Perform Chest Compressions if Unresponsive: If the person becomes unresponsive, lower them to the ground carefully and start chest compressions (CPR). Remember that this should only be performed if the person is unconscious. You can try and look into the airway during the pauses in compression but do not stop chest compressions to do so unless you are able to remove a foreign object immediately.

Prevention is Key

While knowing how to perform the Heimlich maneuver is crucial, preventing choking is equally important:

• Cut food into small pieces: Especially for young children and the elderly.
• Supervise children when they are eating: Don’t let them run or play while eating.
• Avoid letting children play with small objects: These can easily be swallowed.
• Encourage careful eating: Chew food thoroughly.
• Avoid alcohol consumption while eating: This can impair swallowing.
• Consider appropriate food choices for individuals who have difficulty swallowing (dysphagia): Some medical conditions can impair the act of swallowing which will increase the risk of choking on regular foods.

Conclusion

The Heimlich maneuver is a life-saving technique that everyone should know. By understanding how to perform it correctly on adults, children, and infants, you can be prepared to respond in a choking emergency. Regular training, such as first aid classes, can help reinforce these skills and improve your confidence in your ability to act quickly and effectively. Remember, prompt and correct action can save a life. Practice the maneuver regularly and always prioritize prevention methods to minimize the risks of choking. In a real-life emergency, calm and immediate action is crucial.