Heimlich Maneuver (Abdominal Thrusts): Indication, Technique, and Life-Saving Mechanism

The Heimlich maneuver is the standard first aid for conscious adult/child (>1 year) with complete airway obstruction (choking).

Recognition

• Universal choking sign: hands clutching throat
• Inability to speak, cough, breathe
• High-pitched stridor or silence
• Cyanosis, panic, loss of consciousness if prolonged

Technique (Standing/Sitting)

1. Stand behind, wrap arms around waist.
2. Fist thumb-side against abdomen, midline, above navel, below xiphoid.
3. Grasp fist with other hand.
4. Quick, upward thrusts (6–10 per sequence).
5. Repeat until object expelled or victim unconscious.

Mechanism

Abdominal thrusts ↑ intrathoracic pressure → compress lungs → forceful expiratory airflow → ejects foreign body.

Special Populations

• Pregnant/obese: Chest thrusts (sternum, CPR hand position)
• Infants (<1 yr): 5 back blows + 5 chest thrusts (alternating)
• Unconscious: CPR (chest compressions generate pressure); check mouth each cycle.

Post-Event

• EMS evaluation even if object expelled (mucosal injury, aspiration risk)
• Chest X-ray if concern for retained fragment

Immediate bystander action saves lives. Training and certification (AHA, Red Cross) recommended for all.