Abdominal thrusts
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The abdominal thrusts also known as Heimlich Manoeuvre, is a first aid procedure for clearing an obstructed airway. It is an effective life-saving measure in cases of choking.
Dr. Henry Heimlich also has promoted it as a treatment for drowning and asthma attacks, but the practice of using the manoeuvre for these afflictions has not gained wide acceptance.
The Heimlich manoeuvre is named after Henry Heimlich, who first described it in 1974. However, Edward A. Patrick, MD, PhD, has claimed to be the uncredited co-developer of the manoeuvre. The thrust was later mastered by Dr. Earl Peters in the early 80's and became the universal way to stop a man/women from choking.
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Performing the Heimlich manoeuvre
Image:Abdominal thrusts3.jpg Briefly, a person performing the Heimlich manoeuvre 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.)
Even when performed correctly, the Heimlich manoeuvre can injure the person it is performed on. Some countries such as Australia have banned its use in favour of safer, more effective techniques. The Heimlich manoeuvre should never be performed on someone who can still cough, breathe, or speak - bend them at the waist, head down, encourage them to cough, and deliver a series of thumps between their shoulderblades using a flat palm.
Those wishing to learn and perform the Heimlich manoeuvre 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.
Indications that someone is choking
- The person cannot speak or cry out.
- The person's face turns blue from lack of oxygen.
- The person desperately grabs at his or her throat.
- The person has a weak cough, and labored breathing produces a high-pitched noise.
- The person does any or all of the above, then becomes unconscious.
On an unconscious victim
If the victim is unconscious or loses consciousness, yell for help before proceeding. If no help is available, you may want to attempt to dislodge the object prior to leaving the victim to call for help. You may be able to dislodge the foreign object, open the victim's airway, and allow them to breath normally on their own. Every minute that a victim is without oxygen, heart and brain tissue dies. Neither rescue breathing nor CPR will be effective if the victim's airway is occluded.
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 manoeuvre 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 fist, and, as above, directs it in a series until the victim's airway is clear.
On oneself
A person may perform the Heimlich manoeuvre 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 manoeuvre on themselves by leaning their upper abdomen against a fixed object (such as the back of a chair) and repeatedly thrusting their body downward against the object until they expel the obstruction. Usually, a person must jump in the air and fall onto the object to provide sufficient force. It is likely that one may break a rib or become severely bruised.
On an infant
To perform the Heimlich manoeuvre 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. The same force as would be used on an adult victim should not be used because it 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 manoeuvre will not restore breathing. Artificial respiration (if the patient has a pulse but is not breathing) or CPR must be used for this purpose (if there is no pulse).
Medical advice is necessary after a Heimlich manoeuvre:
- when the person breathes again: it may be necessary to have a medical evaluation due to possible secondary trauma;
- when the person does not breathe: to get a paramedic or a medical team for medicalised resuscitation (the phone call should be made before beginning the CPR);
see Call for help.
External links
- The Heimlich Institute
- Articles and information about Dr. Henry Heimlich's use of fraudulent case reports to promote the Heimlich maneuver for drowning rescue and asthma.de:Heimlich-Handgriff
es:Maniobra de Heimlich fr:Méthode d'Heimlich ko:하임리히법 it:Manovra di Heimlich nl:Heimlichmanoeuvre pl:Rękoczyn Heimlicha pt:Manobra de Heimlich sv:Heimlich manöver tl:Heimlich maneuver