Upper-airway obstructions account for about 3,000 deaths in the United States each year. Slapping someone who is choking on the back is not as effective as abdominal thrusts, sometimes called the Heimlich maneuver.
Most people have probably seen this maneuver illustrated on posters in restaurants, and ideally everyone should know how to do it. It is best to learn it in a first aid or CPR class. Classes are offered by the American Heart Association and the American Red Cross.
Immediate Care for Choking
In general terms, here is what you should do if someone is choking. If he can still breathe and speak, wait a moment to see if he can dislodge the obstruction on his own. If he can’t breathe (or only with difficulty), speak, or cough (or only weakly) and is clutching his throat, do the following while someone else calls 911 or the Emergency Medical Service.
- Stand behind the choking person and wrap your arms around his or her waist. Tip the person forward slightly.
- Make a fist with one hand. Place your fist with the thumb against the abdomen between the breastbone and navel, slightly above the person’s navel.
- Grab the fist with the other hand and thrust quickly and firmly upward into the abdomen. Repeat until the food or object is dislodged.
The above maneuver should not be used for babies less than a year old. Instead, do the following:
- Hold the baby along your forearm or arm, positioning the body so that the head is lower than the feet.
- With the heel of your hand, deliver four firm blows between the baby’s shoulder blades.
- If this doesn’t stop the choking, turn the baby over and use your forefinger to deliver four quick upward thrusts to the chest.
- If the baby is still choking, open the mouth and move the jaw and tongue to look for an object in the throat. If you can see the object, try to gently remove it using a sweeping motion with your little finger. (Only do this if you can see the object; otherwise, inserting your finger in the child’s throat may push the object further in or trigger a gag reflex.)
Keep repeating all of the above steps until the object is dislodged. If the baby doesn’t begin to breathe at that point, apply mouth-to-mouth resuscitation.
Performing Heimlich on Yourself
The do-it-yourself Heimlich maneuver is a good thing for everyone to know, in case choking occurs when no one is around. Make a fist and place the thumb side against your abdomen, slightly above the navel. With the other hand, grasp the fist and press it in and upward with quick, sharp thrusts.
Another method: press your abdomen forcefully against the back of a chair, table, sink, or railing. Repeat until air is forced through the airway and the food is expelled.
For More Information
- American Red Cross
- American Heart Association