Health Library Choking Rescue Procedure (Heimlich Maneuver)From Healthwise

Choking is usually caused by food or an object stuck in the windpipe. For tips to avoid choking, see preventing choking.

A person who is choking cannot talk, cough, or breathe, and may turn gray or blue. The Heimlich maneuver can help get the food or object out.

WARNING: Do not try the Heimlich maneuver unless you are sure the person is choking.

If a person older than 1 year is choking:

• Stand or kneel behind the person and wrap your arms around his or her waist. If the person is standing, place one of your legs between his or her legs so you can support the person if he or she faints.
• Make a fist with one hand. Place the thumb side of your fist against the person's belly, just above the belly button but well below the breastbone. See picture A.
• Grasp your fist with the other hand. Give a quick upward thrust into the belly. This may cause the object to pop out. You may need to use more force for a large person and less for a child or small adult. See picture B.
• Repeat thrusts until the object pops out or the person faints.

Medical Illustration Copyright © 2002 Nucleus Medical Art, Inc. All rights reserved. www.nucleusinc.com

Picture A

Picture B

Call 911 or other emergency services if the person faints. Then:

• Start CPR (cardiopulmonary resuscitation) if you know how. See CPR in the topic Dealing With Emergencies.
• Each time the airway is opened during CPR, look for an object in the mouth or throat. If you see an object, remove it.
• Do not do any more Heimlich thrusts.
• Keep doing CPR until the person is breathing on his or her own or until help arrives.

If you choke while you are alone, use your fists to do thrusts on yourself. Or lean over the back of a chair and press hard to pop out the object.

If a baby younger than 1 year is choking:

• Put the baby facedown on your forearm so the baby's head is lower than his or her chest.
• Support the baby's head in your palm, against your thigh. Don't cover the baby's mouth or twist his or her neck.
• Use the heel of one hand to give up to 5 back slaps between the baby's shoulder blades. See picture C.
• If the object does not pop out, support the baby's head and turn him or her faceup on your thigh. Keep the baby's head lower than his or her body.
• Place 2 or 3 fingers just below the nipple line on the baby's breastbone and give 5 quick chest thrusts (same position as chest compressions in CPR for a baby). See picture D.
• Look for an object in the baby's mouth. If you can see one, remove it. Then give 2 rescue breaths. To give rescue breaths:
  • Place one hand on the baby's forehead, and tilt the baby's chin up to keep the airway open.
  • Then place your mouth over the baby's mouth and nose and slowly blow air in until the baby's chest rises.
  • Between breaths, remove your mouth, take a breath, and watch for the baby's chest to fall.
• If the object does not come out with these steps, call 911 or other emergency services.
• Continue with back slaps, chest thrusts, looking for the object, and rescue breaths until the baby coughs up the object and starts breathing on his or her own, or until help arrives.

Picture C

Medical Illustration Copyright © 2002 Nucleus Medical Art, Inc. All rights reserved. www.nucleusinc.com

Picture D

• Dealing With Emergencies
• Swallowed Objects

Author:	Jan Nissl, RN, BS	Last Updated: May 1, 2008
Medical Review:	Adam Husney, MD - Family Medicine Patrice Burgess, MD - Family Medicine
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