How to Do the Heimlich

The Heimlich maneuver is the common name for abdominal thrusts, which are used to dislodge an item from a choking victim's trachea. The Heimlich is used when sweeping the throat is not enough to get the object out, and the victim can't breath. Care must be exercised when performing the maneuver, because it can injure the victim even when performed correctly. If you come across someone who is choking and they need help, here is how to do the Heimlich:

Difficulty: Moderately Easy

Instructions

1. Asses the Situation
   
   Before you leap into action, you want to be sure the victim is choking. Otherwise, performing this move can harm the person, possibly grievously, if they don't need it.
   
   Check to see if the person is conscious by telling them your name and asking if they are choking. They should respond either by nodding, or by giving the international sign for choking – that is, crossing your arms across your chest and placing your palms on your neck, as if you were choking yourself. Once you've confirmed they are choking, tell them to stay calm in a reassuring voice, and let them know that you are going to perform the Heimlich maneuver to dislodge the item from their throat. It is very important you let them know what you are about to do; otherwise, the victim may respond frantically when you started the maneuver, which can harm you and cause further harm to themselves.
   
   If they are unconscious and you did not physically see them begin to choke, you will need to confirm there is an object lodged in their airway. If they are already laying on the floor, open their mouth by moving their lower jaw downwards, and look inside to see if an object is clearly visible. If it is, you can assume they are choking and move to the next step. If not, you may want to perform a finger sweep to see if you can feel anything in their throat before you do the Heimlich.

2. Call for Help
   
   If there are other people with you and the victim, instruct someone to call 9-1-1 immediately while you begin the Heimlich. If you are alone, start the Heimlich for one minute before you pick up the phone and call 9-1-1 yourself. It is important to administer at least one minute of care before summoning help if you are alone; that one minute can make all the difference in whether that person lives or dies.

3. Perform a Finger Sweep
   
   Open the victim's mouth by holding the bottom of their jaw in your hand and gently moving it downwards. Then, take two fingers – your index and your middle – and place them inside the victim's mouth. Move your fingers back into their throat area, starting at the left side, and slowly sweep your fingers to the right while moving them forward. If you can feel the object, you may be able to remove it just by doing a finger sweep. If the object is too far back to retrieve it with your fingers, do not force your fingers any further down the throat. Doing so can cause the object to move farther down the trachea, which will make the situation worse and possibly lead to you not being able to dislodge the object by doing abdominal thrusts.

4. Get the Victim Into Position
   
   If the victim is about your size, you should be able to do the Heimlich maneuver while standing up. Instruct the person to stand in front of you, or hold them in front of you yourself. Make a fist with one hand, and reach your arm around the victim. Place your fist against the victim's abdomen, aiming for the bottom of the diaphragm, located just beneath the ribcage. You can feel where the ribcage ends, and you may be able to feel a small bone underneath; place your fist there, but be aware that too much pressure can cause that bone to crack. Reach your other hand around the other side of the victim, and wrap in around your fist.

5. Start Doing the Heimlich
   
   Place some pressure on the area where your hands are, and begin to push in and up quickly in a thrusting manner. This causes the body to move in the same manner as a cough, which should expel the object. Continue thrusting quickly, by pushing in and up, over and over, until you hear the victim begin to cough. Coughing means breathing, and is a sign that the object has come out. Confirm the object was remove from the airway by asking the person to speak, and then locating the object if it flew out of the victim's mouth. Be prepared to catch the victim after they expel the object or begin coughing; they may fall afterwards.
   
   If the victim becomes unconscious at any time during the maneuver, or is unconscious before you get to them, try to hold them up while continuing to do the Heimlich, if you can. If there are other people in the room, enlist their help to hold the victim up while you continue. When the victim is slumped over, their airway is further blocked, and the abdominal thrusts may be of no use, or they may even cause the object to push further back into the trachea. If you are alone, you can use a chair for assistance by pushing them up against the chair and holding them up while you do the thrusts.

6. Get the Victim to the Hospital
   
   If you have not already summoned help, get the victim to an emergency room immediately after dislodging the object. While they may act and feel fine, there's a good chance there may have been damage done while you were performing the Heimlich, and there is also a chance that the choking may have caused damage, as well. The sooner the victim is checked out, the better their chances for a full recovery become.
   
   If paramedics arrive while you are in the middle of doing the abdominal thrusts, continue to do them until a paramedic tells you to stop and they will take over.