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Choking - adult or child over 1 year - Treatment

Alternative Names

Heimlich maneuver - adult or child over 1 year

First Aid:

How to perform the Heimlich maneuver:

First ask, "Are you choking? Can you speak?" DO NOT perform first aid if the person is coughing forcefully and able to speak -- a strong cough can dislodge the object.
Stand behind the person and wrap your arms around the person's waist.
Make a fist with one hand. Place the thumb side of your fist just above the person's navel, well below the breastbone.
Grasp the fist with your other hand.
Make quick, upward and inward thrusts with your fist.
Continue these thrusts until the object is dislodged or the victim loses consciousness.

IF THE PERSON LOSES CONSCIOUSNESS

Lower the person to the floor.
Call 911 or the local emergency number or tell someone else to do so.
Begin CPR.
If you see something blocking the airway, try to remove it.

FOR PREGNANT OR OBESE PEOPLE

Wrap your arms around the person's CHEST.
Place your fist on the MIDDLE of the breastbone between the nipples.
Make firm, backward thrusts.

After removing the object that caused the choking, keep the person still and get medical help. Anyone who is choking should have a medical examination. Complications can occur not only from the choking, but also from the first aid measures that were taken.

Do Not:

DO NOT interfere if the person is coughing forcefully, able to speak, or is able to breathe in and out adequately. However, be ready to act immediately if the person's symptoms worsen.
DO NOT try to grasp and pull out the object if the person is conscious.

Call immediately for emergency medical assistance if:

Seek medical help right away if you find someone unconscious.

When the person is choking:

Tell someone to call 911 or the local emergency number while you begin first aid/CPR.
If you are alone, shout for help and begin first aid/CPR.

After the object is successfully dislodged, the person should see a doctor because complications can arise.

In the days following a choking episode, contact a doctor immediately if the person develops:

Persistent cough
Pneumonia
Wheezing

These could be signs that the object entered the lung instead of being expelled.

Choking first aid - adult or child over 1 year - series

Reviewed last on: 7/16/2011
Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, Washington, Clinic. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Manno M. Pediatric respiratory emergencies: Upper airway obstruction and infections. In: Marx J, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009: chap 166.

Thomas SH, Brown DFM. Foreign bodies. In: Marx J, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009: chap 57.

Hauda WE II. Pediatric cardiopulmonary resuscitation. In: Tintinalli JE, Kelen GD, Stapczynski JS, Ma OJ, Cline DM, eds. Emergency Medicine: A Comprehensive Study Guide. 6th ed. New York, NY: McGraw-Hill; 2004:chap 14.

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