How to Do the Heimlich Manoeuver

  • Choking because of an obstructed airway is a leading cause of accidental death.
  • If a choking person is not coughing or is unable to speak, perform the Heimlich maneuver immediately.
Notes: 
  • Adults, children and infants must always be conscious when being treated for choking.
  • If the subject becomes unresponsive perform CPR.
  • Helping a choking infant (1 year old or less) is done differently than helping a child or an adult.
    • The Heimlich maneuver is used on a child or an adult.
    • Back blows and chest thrusts are used on a choking infant.
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First Aid for a Choking, Conscious Adult
Step 1.  Determine if the person can speak or cough.  If not, proceed to the next step.
  • Ask the choking person to stand if he or she is sitting.
  • Place yourself slightly behind the standing victim.
  • Reassure the victim that you know the Heimlich maneuver and are going to help.
  • Place your arms around the victim's waist.
  • Make a fist with one hand and place your thumb toward the victim, just above his or her belly button.
  • Grab your fist with your other hand.
  • Deliver five upward squeeze-thrusts into the abdomen.
  • Make each squeeze-thrust strong enough to dislodge a foreign body.
  • Understand that your thrusts make the diaphragm move air out of the victim's lungs, creating a kind of artificial cough.
  • Keep a firm grip on the victim, since he or she can lose consciousness and fall to the ground if the Heimlich maneuver is not effective.
  • Repeat the Heimlich maneuver until the foreign body is expelled.
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Step 2.  Perform an abdominal thrust (Heimlich Maneuver) repeatedly until the foreign body is expelled.
Step 3.  A chest thrust may be used for markedly obese persons or in late stages of pregnancy.
  • If the adult or child becomes unresponsive perform CPR.
  • If you see an object in the throat or mouth, remove it.
 
First Aid for a Choking, Conscious Child - (1-8 years old)

The procedure for clearing an obstructed airway is the same for children and adults.
Step 1.  Determine if the person can speak or cough.  If not, proceed to the next step.
  • Ask the choking person to stand if he or she is sitting.
  • Place yourself slightly behind the standing victim.
  • Reassure the victim that you know the Heimlich maneuver and are going to help.
  • Place your arms around the victim's waist.
  • Make a fist with one hand and place your thumb toward the victim, just above his or her belly button.
  • Grab your fist with your other hand.
  • Deliver five upward squeeze-thrusts into the abdomen.
  • Make each squeeze-thrust strong enough to dislodge a foreign body.
  • Understand that your thrusts make the diaphragm move air out of the victim's lungs, creating a kind of artificial cough.
  • Keep a firm grip on the victim, since he or she can lose consciousness and fall to the ground if the Heimlich maneuver is not effective.
  • Repeat the Heimlich maneuver until the foreign body is expelled.
Step 2.  Perform an abdominal thrust (Heimlich Maneuver) repeatedly until the foreign body is expelled.
Step 3.  A chest thrust may be used for markedly obese children
  • If the adult or child becomes unresponsive perform CPR.
  • If you see an object in the throat or mouth, remove it.
 
 

How Do You Help a Choking, Conscious Infant?

Step 1.  Determine if the infant can cry or cough. If not, proceed to next step.
 
  • Pick the infant up.
  • You will be turning the infant over to do chest thrusts and back blows. You may sit down in a chair or you may stand to do this. Sitting may make you feel more stable, especially if the infant feels heavy.
  • Position and hold the infant face down, with the head slightly lower than the feet. Support the infant's jaw and head with your hand. Support the weight of the infant on your knee if you are sitting. Support him on your forearm if you are standing.
  • Give up to 5 back blows on the upper back between the shoulder blades. Use the heel of your free hand to do this. If you see an object come out of the infant's mouth at any point, stop giving the back blows.
  • Sandwich the infant between your hands and turn the infant over on to his back. Support the infant's head and neck with your hand. The head should be held slightly lower than the feet. Support the weight of the infant on your knee if you are sitting. Support him on your forearm if you are standing.
  • Give up to 5 chest thrusts (pushes) using 2-3 fingers. Your fingers should be placed on the lower half of the breastbone. Be sure your fingers are not off to one side, or at the bottom of the breastbone. If you see an object come out of the infant's mouth at any point, stop giving the chest thrusts.
  • Keep giving 5 back blows followed by 5 chest thrusts. Do this until you see an object come out of the infant's mouth, or the infant becomes unconscious.
Step 2.  Give 5 back blows.
Step 3.  Give 5 chest thrusts.
 
Step 4.  Repeat steps 2 & 3 above until effective or the infant becomes unconscious. If the infant becomes unresponsive, perform CPR - if you see an object in the throat or mouth, remove it.
 
  • If the infant becomes unconscious, you should perform CPR immediately.

How Do You Do the Heimlich Maneuver on Yourself?

If you are by yourself and you are choking, you may have to do the Heimlich maneuver on yourself. If you can breathe and talk, cough hard until you are able to spit out the object. If you cannot talk or cough, and are having trouble breathing, do the following steps:
  • Make a fist with one hand.
  • Place the thumb side of your fist against the middle of your abdomen just above the belly button. Do not put your fist on your breastbone or your ribs.
  • Put your other hand over your fist. Press your fist into your abdomen with a quick upward push. Continue to repeat the quick pushes until you can spit out the object.
  • If you cannot get the object out of your airway, press your upper abdomen quickly over any hard surface. The back of a chair, side of a table, or porch railing works well. You may need to do several hard, fast pushes against the surface to clear your airway.
  • Dial 911 on the telephone and leave the line open if you cannot get the object that you are choking on out.
  • You may be able to spit out the object, but you may have damaged your airway, chest, or abdomen. Call your caregiver and tell them what happened. They may want you to go to the hospital to be checked.
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Tips:
  • If a victim is coughing strongly or able to talk, let the person try to expel the foreign body using his or her own efforts.
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  • If the choking victim displays a weak or ineffective cough, this indicates that air exchange is minimal and that you should start the Heimlich maneuver.
  • Teach your family the universal choking sign - clutching the throat. Encourage everyone you know to become familiar with this sign and use it when choking.
  • An adult, child or infant may become unconscious (unable to waken) because something they have choked on has blocked their airway.

Warnings:
  • If the subject becomes unconscious, you must perform CPR immediately.
  • To avoid breaking bones, never place your hands on the victim's breastbone or lower rib cage when performing the Heimlich maneuver.
  • If choking persists, call 911 immediately.