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Abdominal thrusts

The Heimlich maneuver, also known as abdominal thrusts, is a first aid procedure for clearing an obstructed airway. It has been promoted as a life-saving measure in cases of choking, and also as a treatment for an asthma attack when medication is unavailable or ineffective. It was also used for drowning, but this is no longer advised.

Briefly, a person performing the Heimlich maneuver uses their hands to exert pressure on the bottom of the diaphragm. This compresses the lungs and exerts pressure on any object lodged in the trachea, hopefully expelling it. This amounts to an artificial cough. (The victim of an obstructed airway, having lost the ability to draw air into the lungs, has lost the ability to cough on their own.)

The Heimlich maneuver is named after Henry Heimlich, who first described it in 1974.

Performing the Heimlich maneuver

Especially when performed incorrectly, the Heimlich maneuver can injure the person it is performed on. The Heimlich maneuver should never be performed on someone who can still cough, breathe, or speak. Those wishing to learn and perform the Heimlich maneuver should take first aid training from a qualified instructor. Reading the Wikipedia is not a substitute for first aid training. Moreover, since the Wikipedia may be altered by anyone at anytime, this article may not even be accurate. For a more thorough disclaimer, see the link at the bottom of this page.

On a standing or seated victim

The person giving the Heimlich maneuver stands behind the victim and wraps their arms around the victim's sides, underneath the victim's arms. One hand is made into a fist and placed, thumb side in, flat against the victim's upper abdomen, below the ribs but above the navel. The other hand grabs the fist and directs it in a series of upward thrusts until the object obstructing the airway is expelled. The thrusts should not compress or restrict the ribcage in any way.

On oneself

A person may perform the Heimlich maneuver on themselves using the same procedure described above. One hand is balled into a fist and placed against their upper abdomen, while the other hand grabs the first and directs it in a series of upward thrusts until the airway is clear.

A person may also perform the Heimlich on themselves by leaning their upper abdomen against a fixed object (such as a railing or the back of a chair) and repeatedly thrusting their body downward against the object until they expel the obstruction.

On an unconscous victim

If the victim is unconscious, lying down, or too obese for the first aid provider to wrap their arms around, the person giving the Heimlich maneuver positions rolls the victim onto their back and straddles the victim's hips. The heel of one hand is positioned against the victim's upper abdomen as described above. The other hand covers the first, and, as above, directs it in a series until the victim's airway is clear.

On an infant

To perform the Heimlich maneuver on a child less than one year old, the child is positioned on their back. The first aid provider kneels at the child's feet and places the index and middle fingers of one hand together against the upper abdomen of the child, below the rib cage and above the navel. These fingers are covered with the index and middle fingers of the other hand. The top hand then repeatedly presses the fingers of the lower hand upward and into the child's abdomen, until the airway is clear. This must be done gently. Using the same force as would be used on an adult victim could result in injury to the child.

After the airway is clear

After the obstructing object or liquid has been expelled from the airway, it is possible, especially if the victim was unconscious to begin with, that the victim may not resume breathing on their own. Continuing the Heimlich maneuver will not restore breathing. Artificial respiration or CPR must be used for the this purpose.

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