II. Indications

  1. Foreign Body Aspiration with airway obstruction in children and adults

III. Precautions

  1. Do not perform heimlich if patient can cough or speak

IV. Management: Conscious Patient

  1. Stand behind patient and wrap hands around waist
  2. Make a fist with one hand
    1. Place thumb side against patient's Abdomen
  3. Place fist midline over naval (well below xiphoid)
  4. Grasp fist with other hand
  5. Press into patient's Abdomen with quick upward thrust
    1. Each thrust should be distinct
    2. Each thrust intended to expel foreign body
  6. Repeat thrusts until:
    1. Foreign body is expelled
    2. Patient becomes unconscious

V. Management: Unconscious Patient

  1. Perform 6-10 abdominal thrusts per cycle (5 for child)
    1. Straddle patient's thighs
    2. Place heel of one hand against patient's Abdomen
      1. Position midline above navel (well below xiphoid)
    3. Place second hand directly on top of his first hand
    4. Press into Abdomen with quick upward thrusts
  2. Check for foreign body
    1. Adult: Sweep deeply into mouth to remove debris
    2. Child
      1. Do NOT perform a blind finger sweep
      2. Remove foreign body ONLY if visualized
  3. Open airway and attempt to ventilate

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