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First Aid for Choking: Heimlich Maneuver – Adult Choking / Infant Choking

Choking is a common medical occurrence and typically does not require emergency intervention. Rescuers should initiate care in cases of severe choking such as when a person is unable speak, makes the universal choking sign, or is turning blue. When witnessing someone believed to be in severe choking you should ask them if they are okay. If they are unable to respond, initiate care without delay.

In adults the most effective way to relieve severe choking is to deliver abdominal thrusts by performing the Heimlich maneuver.

The Heimlich maneuver uses abdominal thrusts to place pressure on the diaphragm simulating a coughing reflex in the choking victim to help expel the object. To perform the Heimlich maneuver stand behind the victim and wrap your arms around their abdomen. Create a fist with one hand and place the thumb side against the victim’s stomach above the belly button but below the rib cage. Place your other hand over the fist and thrust inward, hard and fast, until the victim begins breathing or goes unconscious.

IF the victim goes unconscious and falls to ground, begin the steps of CPR with one exception. When opening the airway, look and see if you see an object inside the victims airway. If you see an object and you feel comfortable you may perform a finger sweep to attempt to remove the object. If you do not see something, are uncomfortable, or think you are unable to sweep the object out – do not attempt a finger sweep. Continue CPR until professional help arrives.

The Heimlich maneuver can be applied to any person or child who is unable to stand. For children you should kneel down to perform abdominal thrusts.

Choking Relief for Infants: Choking relief for infants must be modified from the methods used on adults due to their small size. To relieve severe choking in an infant, place the child face down on your arm while supporting the head with the palm of the hand. Perform 5 back slaps, striking the infant between the shoulder blades, with sufficient force to attempt to dislodge the object. Turn the child over and perform 5 chest compressions with the two finger chest compression technique. Repeat 5 back slaps and 5 chest compressions until the infant begins breathing normally or goes unconscious.

If the infant become unconscious, begin the steps of CPR with one exception. When opening the airway, look and see if you see an object inside the victims airway. If you see an object and you feel comfortable you may perform a finger sweep to attempt to remove the object. If you do not see something, are uncomfortable, or think you are unable to sweep the object out – do not attempt a finger sweep. Continue CPR until professional help arrives.

Pregnant & Large Adults: For persons who are pregnant or of large size, choking relief may have to be modified. Chest thrusts may be used instead of abdominal thrusts when faced with these situations. Hand technique should be the same with placement being moved to the middle of the chest on top of the sternum.

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