Heimlich Maneuver

1. See Also
   1. Heimlich Maneuver for Infants
   2. Obstructed Airway
   3. Advanced Airway
   4. Rapid Sequence Intubation
   5. Endotracheal Intubation Preparation
   6. Endotracheal Tube
   7. Endotracheal Intubation Preoxygenation (and Apneic Oxygenation)
   8. Direct Laryngoscope
   9. Video Laryngoscope
   10. Endotracheal Intubation
   11. Extraglottic Device (e.g. Laryngeal Mask Airway or LMA)
   12. Tactile Orotracheal Intubation (Digital Intubation)
   13. Nasotracheal Intubation
   14. Cricothyrotomy
   15. Needle Cricothyrotomy
2. Indications
   1. Foreign Body Aspiration with airway obstruction in children and adults
3. Precautions
   1. Do not perform heimlich if patient can cough or speak
4. 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
5. 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