How to Perform the Heimlich Maneuver in 6 Different Situations

by Brett & Kate McKay on August 15, 2011 · 52 comments

in Manly Skills, Survival

You’re in a restaurant enjoying a dinner with friends, when all of a sudden you hear a woman shriek: “He’s choking!”

You calmly excuse yourself from the table and dash with effortless cool towards the source of the loud yell. You find a man with a look of terror in his eyes, gripping his throat, indicating that something is lodged within. You politely ask the distraught woman to step aside. You place your arms around the choking man’s abdomen and give two deft inward thrusts. A scallop shoots out of the man’s mouth and lands conveniently in a trash can. The restaurant bursts into applause.

You heartily pat the man on the back and say something witty to lighten things up. You stroll back to your friends’ table, sit down, and pick up the conversation right where you left it. “What were you saying about the true meaning of The Old Man and the Sea, John?”

At least that’s how we imagine we’d handle a situation if we saw someone choking. More likely though, you’d probably stand there havy cavy, not sure what to do. Because even though most have heard the phrase Heimlich maneuver countless times, and seen it dramatized just as many, a lot of folks really don’t know exactly what to do beyond putting their arms around the person and squeezing somehow. And if you do know precisely how to do it, you may only be familiar with the technique used on an average person.

So today’s the day you’re finally going to commit this important and potentially lifesaving skill to memory, and not only that, learn how to do it in six different situations–on an average person, an obese person, a baby, a pregnant woman, a dog, and even yourself. Bet you never thought about giving the Heimlich to your pooch did, you? Well now Fido can sleep easy at night, with visions of gristly bones dancing in his head.

First: Assess the situation and allow the person to try to dislodge the object on his or her own

This is the first step for all six situations: If you see someone who might be choking, don’t bust out the Heimlich right away. He might not need it. First, ask the person if he can speak. If he can speak, it means he still has good air exchange and might be able to get the object out of his throat on his own with some coughing. Ask him to try to cough the object out.

If the person can’t speak, makes high-pitched sounds when he talks or coughs, or it looks like he’s not breathing, it’s Heimlich time.

1. How to Perform the Heimlich Maneuver on a Regular-Sized Person

First thing you want to do is have someone call 911. If the person becomes unconscious, you’re going to need help.

The Red Cross recommends using the “five-and-five” approach to help a choking person. Here’s how it works:

Give five back blows. Lean the victim forward and deliver five back blows between their shoulder blades with the heel of your hand.

Perform five Heimlich thrusts. If the back blows didn’t get the object out, it’s time to perform the Heimlich:

1. Stand behind the victim and wrap your arms around his waist.

2. Bring your hands together, with the hand closest to the victim’s stomach made into a fist. The knuckle of your thumb should be our positioned and pressed between the victim’s bellybutton and the bottom of his rib cage.

The knuckle of your thumb should be positioned and pressed between the victim's bellybutton and the bottom of their rib cage.

3. Simultaneously squeeze and thrust your hands inwards and upwards. Repeat this action until the obstruction pops out like the cork from a bottle.

Repeat the five-and-five until the food or object is expelled or the person becomes unconscious. If the latter happens, hopefully the medics will be close at hand.

This technique can be used on adults and children one year old or older.

2. How to Perform the Heimlich Maneuver on a Pregnant Woman

Using the standard Heimlich maneuver can harm the fetus growing inside of a pregnant woman. We don’t want to do that, so we’re going to need to use a modified version of the Heimlich.

Do the usual five back blows. When you perform the thrusts, position your hands a little bit higher than you would with the normal Heimlich. The knuckle of your thumb should be positioned and pressed at the base of the breastbone, just above the joining of the lowest ribs.

3. How to Perform the Heimlich Maneuver on an Obese Person

Same way as you’d do it on a pregnant woman. Place your hands a bit higher, right under the breastbone.

4. How to Perform the Heimlich Maneuver on a Baby

One of the things I’ve learned about babies since having Gus is they like to put things in their mouth. If they can pick it up, it’s going in their mouth. Pen? In the mouth. Penny? Mouth. iPhone? Right in the mouth. So choking has been a big concern of mine. It’s also gone up even more since Gus has started eating solid foods. I’m afraid he’ll stuff a fistful of puffs in his mouth and start choking. So learning how to perform the Heimlich maneuver on a baby has been a priority for me. Here’s how it’s done.

For babies who are one year old or younger do the following:

Give the baby five gentle, yet firm back thumps. Sit down and rest your forearm on your thigh. Hold the baby face-down on your forearm. Support the baby’s head with your palm, but make sure you don’t cover the baby’s mouth or twist its neck.  Here’s how it should look:

Source WebMD

Proceed to give the baby five gentle, yet firm back thumps. The combination of gravity and the blows should be enough to dislodge the object.

Perform baby thrusts. If the object still hasn’t come out after administering the thumps,  hold the baby face-up on your forearm, keeping the baby’s head lower than her body. Place 2 or 3 fingers just below the baby’s breastbone and give 5 quick chest thrusts like so:

Source WebMD

Repeat the back blows and thrusts until the object is dislodged.

5. How to Perform the Heimlich Maneuver on Yourself

You’re sitting at home in your favorite man chair while eating a steak and watching Bridge Over the River Kwai. Right at the movie’s climatic explosion you start choking on a piece of gristle. No one is around. What do you do?

While you can’t give yourself the five back blows, you can still perform the Heimlich thrusts on yourself.

1. Make a fist and place your thumb below your rib cage, just above the navel as you would when performing the Heimlich on someone else.

2. Grasp your fist with your other hand. Press it into the area with a quick upward movement.

3. If that doesn’t work, you can also lean over a table edge, chair, or railing. Quickly thrust your upper belly area (upper abdomen) against the edge, like this:

Source A.D.A.M

If you can’t get the gristle out of your throat, don’t worry. You died while eating a steak and watching one of the best war movies ever made. What a way to go.

6. How to Perform the Heimlich Maneuver on a Dog

It’s bound to happen sometime. Your pooch swallows a bone and starts choking. Lucky for you the Heimlich maneuver works on dogs, and you can take action to save your best friend.

Make sure your dog is really choking. Dogs eat weird stuff all the time and get things caught in their throat. Usually with some coughing and hacking, they can dislodge the object themselves. If your dog can cough effectively, leave him alone and let him do his thing. When he hacks up whatever was bothering him, give him a reassuring pat on the head.

If your dog doesn’t cough, but is instead pawing at his face, throat, and generally acting panicked, he might need some help getting whatever is stuck in his gullet out.

Check the mouth. Look inside your dog’s mouth for the obstruction. If you can see it, try to pull it out with your fingers. Don’t confuse the small bones in a dog’s throat for the foreign object. Pulling those will injure your dog.

Give your dog back blows. Just as you would with a human, give your canine friend five sharp blows on the back between the shoulder blades. You can try raising his hind legs above his head while doing this in order to put gravity on your side.

Doggy Heimlich maneuver. The back blows didn’t work and Baxter is still choking. Time to begin the doggy Heimlich maneuver.

Nothing going on here. Just a man giving his dog the Heimlich.

1. Stand behind your dog and grasp him around the waist.

2. Place your fist just below the ribcage and give five quick thrusts.

3. Take your dog to the vet even if you get the object out. He’ll need to be examined to see if there were any internal injuries.

Have you ever performed the Heimlich maneuver on someone? How about on a dog? Share your experiences and tips with us in the comments. 

{ 52 comments… read them below or add one }

1 Jesse H. August 15, 2011 at 11:40 pm

I’ve never had to perform the Heimlich on someone, but I am certainly glad that I know how to now – especially for a pregnant woman, considering the wrong information – as it tends to happen with medical situations – can lead to further injury. I’m very glad I know this information now! Thank you, Brett & Kate!

2 Darrin August 15, 2011 at 11:46 pm

Nice, informative, useful article. But I can’t help feeling for the guy who was assigned the task of illustrating the doggie Heimlich maneuver.

3 Curtis August 15, 2011 at 11:51 pm

When you are performing the heimlich on someone via the breastbone you don’t want to go too close to the bottom of the sternum otherwise you risk snapping off the xyphoid process. Admittedly this is less of a concern at the time if you’re choking to death. Keep in mind that what the heimlich maneuver is doing is forcing the diaphragm and thus the pleural cavity (the cavity holding the lungs) to contract and force out the obstruction.

If the victim goes unconscious then you want to begin cpr immediately with the change of checking the mouth for the foreign object before you give breaths.

4 Dom August 16, 2011 at 12:48 am

Great article. Being a former Boy Scout I learned to do the Heimlich some time ago, but I only learned to do it on the average Joe and myself. Now I’m glad to know how to perform it on a pregnant woman, a baby, and a dog (you never know…).

I guess it’s an effective system, but I just can’t help but think that it won’t work when I need to use it. I guess I’m just thinking that way because I’ve never actually had to use it (thankfully).

As Brett and Kate asked in the article, has anyone ever had to perform the Heimlich?

5 Julito August 16, 2011 at 2:48 am

Great article. I’ve only had to perorm the Heimlich once before, on my younger sister, and it really is a great system-after two thrusts, the obstruction was cleared.
Luckily, she is of average build, because otherwise I wouldn’t have known what to do. Now I know how to take care of anyone who may be choking, which makes me feel a lot better for my future spouse and children (and pooch, of course!).

6 Ben Carpenter August 16, 2011 at 3:38 am

I was out to dinner with my lovely girlfriend at a swanky French restaurant in California when a woman started yelling hysterically. Her baby had inhaled a particularly large chunk of steamed carrot, and couldn’t breathe. Luckily, I’ve been CPR/First Responder certified for years, and keep my certification current. I performed the back blows, and out popped a carrot. It was great to see the baby start crying and flailing, since that meant she was okay. The woman was so relieved (obviously) and offered to pick up my bill. I declined (my better half and I had eaten quite well and had a substantial bill), but her gratified looks and words were more than enough.

Although the restaurant comped our meal, so that was nice (as were the “my hero” kisses from my lady later in the evening).

7 Dan August 16, 2011 at 6:42 am

I actually have performed the Heimlich on my dog. She was kinda gasping but freaking out, not coughing, so I tried getting a hold of her, and as luck would have it, I caught her round the waist as she was running down stairs (even luckier, my stairs have a flat bit before turning back on themselves, so there was no risk of her falling down them!) and did the job. Then went to sit down coz it’s among the more intense things I’ve done in my life, but at least it works. Where did I learn it? Eddie Izzard :D “Hoocha hoocha hoocha – lobster!”

8 Louis August 16, 2011 at 7:14 am

I’ve had the Heimlich Maneuver performed on me. In a fit of greed, I stuffed too many peanuts in my mouth. Fortunately a friend who knows the move was nearby, saw my plight and squeezed the offending nut out. I am a lifeguard and trained in wilderness first aid but I never even thought about doing the move to myself. I’ll always be grateful to Matt.

Later that summer, my wife had a case of whooping cough (go figure) and could not breath. While not an obstruction-based breathing problem, it was the only thing I could think of to help her. To my relief, it worked.

I don’t know that we are both alive today because of the Heimlich, but I give it a lot of credit. Thanks for the article.

9 Ryan August 16, 2011 at 8:21 am

I’ve never used the Heimlich Manoeuvre myself, but having just completed a First Aid at Work course, and working at a large college, I may well need to at some point. One factor they stressed when using it is that the casualty MUST be assessed by a medical professional afterwards. There have been cases of people dying from internal bleeding after having the Heimlich performed on them.

10 Steven Gebo August 16, 2011 at 9:35 am

Great article Brett & Kate. I’ve never had to perform the Heimlich, but being an EMT I’ve gone through CPR (which includes the Heimlich) certification many times. I think it’s great for all people to know how to perform these techniques. The only thing that I’ve learned differently from this article (because MA trains their EMTs to the American Heart Association standards rather than Red Cross) is to not include back blows on adult patients as it can actually lodge the object deeper into the airway. This article shows both sides of this controversy (http://inhomecpr.com/in_home_cpr_news/choking-emergency-the-heimlich-maneuver-or-back-blows/). While I’ll leave it up to the reader to decide, I would recommend only performing back blows if you can get the patient bent over enough to have gravity working on your side, as is the case in babies.

On a similar note, I think you should write an article on the American Heart Association’s new CPR standards for lay rescuers. The AHA now recommends that bystanders now perform only chest compressions, as rescue breaths have only a limited effectiveness, and bystanders would be more likely to act with a simpler CPR technique.

11 Luis August 16, 2011 at 11:27 am

Thanks for the link Steven. After a brief research I think back thrusts are more effective, seeing as the one that said that Heimlich maneuvers were the ONLY way to go was Heimlich himself… In any case, Heimlich maneuvers are not widely supported in other countries contrary to the US.

12 James August 16, 2011 at 12:06 pm

This is one of the few articles you’ve written that I hope I never need to test out or use. Great read, especially since I did not know the proper hand placement.

13 Kevin August 16, 2011 at 1:27 pm

Regarding the baby Heimlich maneuver when it says below the breast-bone can you be more specific? The illustration points to an area I didn’t expect. In the illustration it look like you press below the manubrium while the text makes me think to press below the sternum near the xiphoid process.

14 Cory B.A. Ok August 16, 2011 at 1:45 pm

My wife had an opportunity to excersize her skills last year at the Dentist’s office. The grandmother of the child was screaming at the kid and sticking her car keys down his throat so he wouldn’t bite her finger! My wife strolled over, picked the blue kid up, and saved the day. I was proud…..but a little jealous I wasn’t there to be the hero.

15 Damian August 16, 2011 at 2:18 pm

I had to perform the Heimlich on my brother I was 10 and he was 5 I just learned it in school. We were watching cartoons and he was jumping up and down eating a chewable vitamin, he started choking without hesitation I did the Heimlich, after 3 or 4 thrust it was out. He was crying from choking and mad at me like what did you just do, he was trying to push me away when I was doing the Heimlich.

16 Andrew August 16, 2011 at 2:26 pm

@ Kevin.

You should never press on the xiphoid process while doing the Heimlich on anyone, as breaking it can cause serious internal damage to the victim. For an infant, you should give position your fingers in the center of the chest, along the nipple line. The illustration is correct, even though the description is a little unclear on that point. It’s worth noting that the Heimlich thrusts on an Obese or pregnant individual are also termed “chest thrusts” on occasion.

17 Jack McGowan August 16, 2011 at 3:02 pm

I was eating a big juicy steak with a former Marine at a Cattlemans restraunt one Saturday night many many moons ago when it happened to me. All of a sudden, I realized there was a chunk of steak stuck in my throat. I couldnt breathe, talk or make a sound with my mouth to warn anyone what was happening. My friend and I were looking at each other right in the eye and I guess he could see the panic in my eyes as I stood up. He immediately jumped up, spun me around, put his arms around me, picked me up a little and back down with a sudden stop and a squeeze. The chunk of steak came flying out of my mouth and hit the floor like a cork out of a cork gun. Dennis just saved my life, no doubt. I caught my breath, sat back down, picked up the chunk of steak that almost killed me, put it back on my plate, chewed it until my jaws got tired and swollowed it. I felt like I just got the wind knocked out of me by that cow, but he didnt win.

18 Alex Devlin August 16, 2011 at 3:03 pm

@Andrew

So are you saying that doing this on a kid or a pregnant woman you would put your hands on their chest right between their nipples and then push in? I also thought from reading the article that you would, on a baby at least, feel down just below their ribcage until you’re below the bones and then press in quickly. The way you are saying it makes it sound like you would push on their chest/ribs. I really need to look into taking a first aid course I think so I can understand how to do things like this and cpr. I “thought” I knew what to do in an emergency, but now I’m wondering how many other people thought that too and when the time came they had no idea or it was ineffective.

One of the problems I have with a few of these kinds of articles on the web is they don’t explain it enough when it comes to the technique. Sometimes a simple picture and a few lines aren’t enough for me to actually get what they are trying to teach.

Thanks for everyone’s advice though on these kinds of articles and comments. Reading the article is one thing, reading about peoples experiences in the comments after is what helps the penny drop for me on most of them though.

19 enric August 16, 2011 at 3:03 pm

Just a funny note. The Heimlich manoeuvre cannot be called liked that any more due to copyright issues with the Heimlich family so now it’s called “Abdominal thrusts”, just in case you get sued because of your article… enjoy! :)

20 Will August 16, 2011 at 5:07 pm

Great article. I personally, as a kid, remember 2 distinct times having the Heimlich performed on me when I was choking (I know right, twice? thought you’d learn the first time).

Love the doggy Heimlich! I’ve got a Great Dane and lots of objects that are probably ok for some smaller dogs could choke him, and he’s been choking before but dealt with it himself. Glad to know I can help now, if it gets bad.

21 Dan August 16, 2011 at 6:19 pm

When my daughter was almost two years old she started choking on a piece of food. I was napping in another room, but suddenly heard my wife screaming “she’s choking”! It’s a blur in my memory, but my wife recounts that I strolled into the kitchen all casual-like, knelt down to child height, and silently performed a sort of one-handed heimlich thrust on the girl (right hand in a fist on her stomach and left hand on her back) until the obstruction came loose. I then walked out into the backyard, where I remember being overcome with the post-emergency-adrenaline shakes.

22 Nick D August 16, 2011 at 6:44 pm

The Bridge ON The River Kwai

(bridge OVER was the book’s title)

23 Jabberwock August 16, 2011 at 7:00 pm

People are always keen to talk about the Heimlich because it’s somehow more “heroic”, but the article should really be called “how to save someone from choking”, and there should be more detail on back-blows. I want to emphasise that you should ALWAYS try Back-blows FIRST. Do not just leap straight to the Heimlich. Back-blows performed properly with the heel of the hand, from the middle of the back between the shoulder blades aiming toward the head with the patient slightly bent over, are all that is usually necessary. My father was a medical officer in the Navy for more than twenty years and never had to use the Heimlich on a person who was choking, though he did save men from choking several times by performing the back-blows routine. Furthermore, do not assume that simply because you have seen a “how-to” article on the Internet that you now know how to perform the Heimlich. If you do ever perform the Heimlich on someone, you must get them to a hospital immediately, even if they feel fine, as you may have caused internal injuries.

24 Vegemite Sammy August 16, 2011 at 9:57 pm

http://bit.ly/qEhO3h
Stephen Dean, Assistant CEO, St John Ambulance, Queensland, Australia: “In the US, they still advocate the Heimlich Manoeuvre for choking but in Australia, we believe the evidence shows it is dangerous and so our guidelines don’t promote it.”

25 Andrew August 17, 2011 at 12:50 am

@ Alex

The theory for the heimlich maneuver is that, by compressing the lungs, you force whatever air is trapped inside outward, forcing the object out with the trapped air. The reason why you press on the chest for an infant is because their ribcage isn’t fully developed, so you can actually compress their lungs through their chest w/o breaking any ribs (which you can’t do for an adult, hence the need to go under the diaphragm and press up; an abdominal thrust) Also, for any unconscious choking victim, you would always give chest compressions (but not back blows) and rescue breaths

I’d highly recommend taking a Red Cross CPR course. I’m a lifeguard, so I need to have an up-to-date CPR for the Professional Rescuer, but I think everyone should take at least a civilian-level CPR course. They do a much better job of teaching this stuff than any online article could since they use practice dummies for you to make sure your technique is good. (for example, there’s a very specific way that you administer the back blows and chest compressions for a choking baby, but I’m pretty sure most people don’t see it from this article)

26 David W August 17, 2011 at 11:43 am

This stuff is no joke. I did the heimlich on a boss of mine a few years ago. She was choking on a sandwich and water and no one knew what to do.

So I walked around the corner and pumped that junk out of her throat. It was intense. But real. And everyone should know how to do this.

27 David August 17, 2011 at 12:38 pm

And folks, if you are choking, you should put your hands up to your throat a few times like you are choking yourself so people can know what the problem is. That is the universal choking symbol

Great article, thanks

28 Chris August 17, 2011 at 3:18 pm

As expected there are a few( varied (and sometimes conflicting) opinions on what to do and how to do it here already. Hopefully my .02 adds some value…

When performing the Heimlich… I mean abdominal-thrusts… or rather J-thrusts… or whatever it’s being called this week a lot of people focus on what to do up front but there’s two really important points about what you do behind the patient that make all the difference between a successful save and a foiled attempt:

1.) Place 1 foot between their legs (ideally your thigh is against their bum), and the other foot behind you. You should look roughly like you’ve just taken a step forward (feet about hip width apart, not too wide or right behind each other). You are going to be doing a *lot* of pulling (if you’re not cracking ribs, you’re not doing it right) and this will help ensure they stay vertical instead of on top of you.

2.) Squeeze right up against their back and put one side of your face between their shoulders (duck down if you have to unless you’re clearly a head taller than them *after* you’ve wrapped your arms around their waist).

If there’s a space between you and them most of your squeezing force will go into closing the gap instead of ejecting the object. This is bad. No space means it all goes into turning that object into a projectile instead of their last supper.

Also (perhaps more importantly) if you don’t put your head against them the first thing their head is going to do when you give them a squeeze is whip back and smack you in the face. Best case this hurts like a bitch and impedes your lifesaving efforts (making you look less the hero and more the idiot). Worst case you knock yourself out ending your lifesaving efforts and possibly hurting yourself seriously in the process.

Height & size are obviously a factor since everybody varies, however a very small person can still be quite successful with a larger patient if they make good use of the above two points (remember, physics is your friend).

I echo previous comments on emergency services immediately following any of these actions. The patient has just: been deprived of oxygen for some time, probably had some ribs cracked, possibly had the Xyphoid Process (http://en.wikipedia.org/wiki/Xyphoid_process) broken, and may have internal bleeding. Each are *internal* injuries and can exhibit zero external symptoms until it’s too late. You can’t force them into the ambulance but if they refuse tell them you’ll pick up their dinner as it might be their last. Between your (perhaps dramatic response) and the EMTs logic may prevail. If not let Darwin do his thing.

With regards to the high-pitched sounds (http://en.wikipedia.org/wiki/Stridor): if a patient has any amount of air exchange (meaning partially not fully obstructed airway) it’s better to allow them to try to dislodge the foreign object themselves. All of my training has been “until no air can pass, don’t touch them b/c chances are you’ll make it worse”.

Finally, and this might be a bit obvious but I’ve seen enough people forget to make it worth saying: talk to the patient(!), get consent(!) and tell them what you are doing. These people are distressed and if they see some guy running up to them with his arms open trying to get behind them they’re going to be more likely to try to fend you off with their last few seconds of consciousness then let you bear-hug them prison-style until you explain what the heck you’re doing.

29 DanT August 17, 2011 at 4:48 pm

I have actually done it twice. A few years back, my wife and I were at our cabin upnorth and she got a piece of steak lodged in her throat. I grabbed her, put my fist just under her sternum and gave her (2) pops and the piece of steak came flying out.

While in a restaurant, this past spring, an elderly (I know, so am I) lady came running up to the counter where I was sitting in an obvious panic mode. Another patron, who was sitting behind me, grabbed her and started squeezing her from behind but he didn’t have his hands positioned properly and they were too high, just under her boobs. He squeezed her a few times and then stopped. I asked the woman if she was OK and she shook her head no and was frantically moving her hands. I grabbed her from behind and gave her a forceful pop and must have dislodged her steak. She immediately tried to get out of my grasp and walked back to her table and commenced eating her steak and eggs without saying another word! Her lady breakfast companion eventually came over to the other guy and myself and thanked us but the victim never said a word.

30 Jaime August 17, 2011 at 11:49 pm

I like how everyone in the restaurant applauds you as a hero for saving the guy. In real life it doesn’t work that way.
Back around 1986, I lived in a poor section of California. An Asian family lived next door. One day they frantically banged on my door. I opened the door and in broken English they asked to use my phone to get an ambulance. I then noticed they were holding a limp young child that had definitely turned blue. I didn’t waste time trying to explain myself – even figured I was to late anyway. I just grabbed the child, held her upside down, and whacked her hard on the abdomen. A lego log popped out her mouth and she started breathing again. I then handed the child back to them.
The rest of the time I lived there, those people looked and treated me like I was demon possessed. When I left or arrived at the apartment and they were outside, they would quickly grab their kids and scurry back inside. Admittedly, I am not a very nice person, but I still feel punished by the one truly good deed that I did in my early life.

31 Patrick August 18, 2011 at 2:11 am

I actually performed the Heimlich almost exactly as described above. I was attending a fraternity alumni event in Dallas, sporting a tuxedo I might add, when a woman at our table began to choke. Her husband tried, but was unable to perform the maneuver. I calmly asked him to step aside, and cleared the obstruction with a single upward thrust. As the woman collected herself she exclaimed, “Thank you! Thank you young man!” I returned to my date as if nothing had happened, and the man bought me a drink. I felt especially manly for days. Chalk one up for high school health class, this is decidedly essential man knowledge.

32 Adam August 18, 2011 at 12:05 pm

I just went through an EMT class this summer and we were told to only perform the Heimlich when the person has a “completely obstructed” airway, i.e. no choking sounds or talking, etc. For partially obstructed airways EMT’s are instructed to encourage the patient to cough as forcefully as they can, take vital signs, and transport.

33 Mrs. Peel August 18, 2011 at 5:09 pm

So true, Adam. I choked on a hard candy mint as a child, and while actively coughing, my concerned family members turned me upside down and began smacking my back. Not helpful, though they frightened me so much that I ended up swallowing the thing whole.

34 Matt B August 18, 2011 at 10:54 pm

I learned the heimlich through a Red Cross course about ten years ago. several years after I had learned (and far after my license expired!), a relative was choking. Without thinking, I started using the Heimlich (although to my discredit, I had forgotten to use backblows!). after 2 or 3 thrusts, the object was expelled, and she was fine

The reason I am writing is simply to assure those of you who have doubts about whether you can do it that, in fact, you can. Learn as much as you can, but the most important thing is to take action!

35 Andy August 19, 2011 at 2:01 am

Interesting piece on why it’s never been taught or used in Australia.
http://www.abc.net.au/rn/healthreport/stories/2009/2634253.htm

36 Allen August 19, 2011 at 7:29 am

Wow! I had no clue that you could do the Heimlich Maneuver on a dog. Now If my big buddy can’t get that bone out of his mouth I know I can possibly save his life. Love AOM keep the great articles coming

37 Artimid August 20, 2011 at 5:49 am

Very informative. I am always glad to see more of this sort of thing. I was very glad that the first thing that was suggested was basically to ask, “Are you choking?” and if they reply you don’t mess with them, let them get it out on their own. It can be hard to watch, but don’t just bust this move out.

Also, as David stated, everyone should know the universal sign for choking as placing your hands on your throat until someone notices. This is what saved my mother before (she had it done on her twice in her life so far that I know of), the first was at a family gathering and someone saw her sign, the other was at a doctors office where the doctor was actually wondering why her eyes were “bugging out” and turning dark red. >_< So yes, this is important to know.

Also, the chair method? If you have a very overweight person, you can do the same thing for them. Lean them over a chair with either your hand or theirs and perform the example of performing the technique on yourself. This makes up for the fact that you might not be able to put your arms around them. Very good article, and one that equips each reader with another tool to possibly save someone in trouble. :)

38 David Collins August 22, 2011 at 11:38 am

Gents,

I would like to make the offer to instruct and certify any gentlemen who are members of the art of manliness in the Art and Science of the Cardio Pulmonary Resuscitation of Adults, Children, and infants. For those who live in the new york tri-state area, are are interested in learning Please feel free to email me and I will try to set up a date and time for those who are interested to meet and train. I will donate my time, and arrange to provide certifications to those who want them, at the cost my training center charges me as the instructor for the printing of the cards ($10). All other cost associated with the training will be gratis. Each gentlemen would be responsible for his own transportation to the event.

Respectfully,
David Collins
davidacollins@mac.com

39 Len August 22, 2011 at 2:09 pm

I once performed the maneuver on myself, when I inhaled a piece of the (excellent) chili I was eating at my favourite Mexican restaurant. I was reading a pretty funny book at the table and started laughing. Next thing I knew, I had breathed out laughing and breathed in chili.

I followed first aid classes years ago, so I had once known the basics of the move, but it’s not something that most people have experience of, day-to-day. But as the only customer at the restaurant, and with the staff all in the back preparing to close up for the night, the only real option I had was to get out of trouble on my own. I placed my hands as shown and hup. Two hits and out it came. The margarita I used to wash down the rest of chili never tasted so good.

40 Mike August 23, 2011 at 2:40 am

To add to Chris’ #1 point, make sure that the knee between their legs is slightly bent. The way that I was taught is that this leg is also there to slide the person to the ground if they loose consciousness. If that knee is locked, their weight might overextend your knee.

41 Glenn of California November 17, 2012 at 9:51 am

I have to wonder if the Australians use an alternative rescue method?
“I’d like to dislodge that obstruction mate but first you’re going to have to show me some convincing scientific proof it works better than me just watching you choke to death.”

42 Jacki November 26, 2012 at 2:28 pm

My husband is a big guy and I have had to do this two and attempted a third time…I wasn’t able to get my arms around him so my son-in-law was able to.. My daughter has said if this was to happen again I could lay him on the floor and straddle him and do the maneuver. do you agree?
I look forward to hearing from you.
Jacki.
Ps. I love ur sight and always scroll down till I find URS!!!!!

43 Lora White November 27, 2012 at 10:17 pm

I did one on my mother, and i had never done it before, but i seemed to do everything right, that was listed above. And my mother is ok. and it was dislodged. The only time i had seen it done was on T,v., i guess that’s where i learned it.

44 Mary December 3, 2012 at 5:26 pm

I had to use the heimlick maneaver on my son who was at the time 4years old. He was choking on a banana. I saw it on a show I use to watch. Called E.R. and it saved my child life. Three thurst and it came.

45 Debbie December 10, 2012 at 11:21 am

I am 42 and have choked 4 times in my life. I know….crazy huh? Lucky me!! : ) Believe me, its NO fun and to be honest it has even affected what I will eat now. There are certain foods that I love that I will not eat. I try to focus on things like yogurt, oatmeal, cream of wheat, and even some baby foods. It is an absolutely terrifying experience and I wouldn’t wish it on my worst enemy. Of all the times I choked only one time did someone perform the Heimlich on me. The Heimlich is also a terrifying thing to go through. One commenter mentioned how her brother was fighting her off while she was doing the Heimlich on him and that is exactly what I was doing!! It hurts to have this done because it really is done with a lot of force if the item doesnt come out right away. I’ve even heard during my EMT training that sometimes people will break a rib while doing the maneuver if the item will not dislodge. The theory being its easier to deal with a broken rib (so long as it doesnt puncture a lung!!) than to choke to death. All 4 times I couldnt breath at all in or out nor speak nor make any sound. Two of the times I had to slam my hands on a table repeatedly to get someones attention. The first time I choked I was playing cards with my brother and step father. They were drinking alcohol and I had been eating chips. I suddenly realized I couldn’t breath and instantly panicked. It always seems to happen when you have no breath in your lungs. I think sometimes when people think about “choking” just in general they think you have this big gust of air in your lungs like your going to hold your breath however, in my case anyhow, it has always happened when I had no air to begin with (as if you exhale almost all of the air in your lungs and THEN begin to choke). I thought it strange because you would think you would automatically reach for your throat but I kept putting my hands on my chest as if to reach for my lungs. The 1st time I choked with my brother and step father, my brother looked at me and said “she’s just joking around!” and continued doing whatever he was doing, so I pounded on the table harder, he finally came over and starts rubbing my back “you okay?” I shaking my head back and forth finally he says to my step father “I think shes really in trouble!” so he came over and performed the maneuver on me. I began panicking even more thinking that since it was hurting so much that he was doing it wrong plus he was drinking. He repeated the thrusts over and over and nothing was happening. I remember all I was doing was trying to get away because of how uncomfortable it was. Finally a very small airway was set free, I could get air in but barely and I was making these really strange noises, my whole body was shaking like crazy but eventually I was able to clear a sufficient airway and it felt so good to just “breath”. That was the first time I choked and although each time its been absolutely terrifying that first time was the worst. I really thought I was going to die.

46 CPR Courses Winnipeg December 14, 2012 at 1:13 am

Its is a good idea have a break and get CPR traning because CPR traning is very necessary for everyone and ready for emergency.

47 John Perkins December 31, 2012 at 12:52 pm

It’s often articles like this that drive us to being more emergency prepared in all aspects. I became CPR trained a a couple years ago.

48 crystal February 3, 2013 at 1:15 am

I had to perform the heimlich on my 16 month old…just as explained…and it worked well! he stuffed too many pieces of soft food down his throat (safe foods of course)…heimlich worked and he was well! thanks for the info on dogs! I hope that people know that you should not be feeding your dogs poultry bones…they splinter

49 Steve February 18, 2013 at 9:00 pm

Yes, I successfully performed heimlich twice on my 10 year old Jack Russell terrier and finished up with mouth-to-snout resuscitation. My fault that I’d allowed the jumping fool a swiss cheese 0.5 inch cubed. Poor dog immediately began running in circles, jumped onto the bed and eventually collapsed onto the floor from my wife’s side of the bed–flaccid! My spouse thought this a hilarious new parlor trick and damn near turned blue from laughing. The dogs tongue was deeply cyanotic. Went through upper abdominal thrusts without result, attempted mouth to snout (unable to move air-obviously still obstructed). Mouth-to-snout did get my wife’s attention though. I know it’s not taught anymore but I resorted to finger sweep at the full depth of my index finger and was able to remove about 1/3 of cube and mouth to snout successfully expanded chest with resultant passive expiration. Dog resumed spontaneous stertorous respirations then obstructed again. Repeated abdominal thrust without success and learned important lesson. Do not finger sweep until dog unconscious and flaccid. This was not a reflex bite; he was pissed. Was able to again hook portion of cheese at extreme tip of reach and this time roll out of glottis and mouth. A couple more puffs and respiration resumed. Dog became responsive within seconds and settled down to a resp rate of about 60/min(suspect negative pressure pulmonary edema) which resolved overnight. With a Jack Russell one never knows if they’re “all there” or not, but he does seem to know his name and can still play a dead Ole Miss Rebel.

50 Jason February 24, 2013 at 2:18 am

As a cashier, I successfully performed the Heimlich maneuver on a toddler. The hispanic parent slapped her child on the back a few times, then she waited.

To my horror, I watched as the toddler’s face turned to the color of a bright red tomato. Luckily, I have recently successfully completed the Emergency Care Basic Life Support course by the EMTA (www.minutesmeanlife.com). I am glad I took that course. It took me 7 abdominal thrusts on the child until the object came out.

The class I took advises against giving back blows, unless you are dealing with an infant in which case you pick the baby up like a football just like what is shown in this article above.

Other schools might be teaching 5 back slaps to 5 abdominal thrusts, but I’m not sure.

By the way, the the xyphoid process is found only in males, not in females. Breaking the xyphoid wouldn’t kill a person, it would just be very painful. Choking does kill 3000 people per year however.

51 Evan August 15, 2013 at 10:55 pm

I came close to needing to use the Heimlich on my son, luckily the fifth back blow dislodged the big wad of noodles he decided he didn’t need to chew!

52 Jonathan December 18, 2013 at 12:26 pm

Great article! I have known how to perform the basic Heimlich for a time now, but I feel more confident now.

When I was a small child, probably 6 or 7 years old, I got a whole grape stuck in my throat. My mother immediately Heimlich-ed me and the grape went flying across the room. I have since then realized that attempting to inhale whole grapes is not the wisest method of eating them.

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