Heimlich Maneuver

What is the Heimlich maneuver?

The Heimlich maneuver is a first-aid method for choking. Choking is when a person can’t breathe because food, a toy or another foreign item is blocking their throat or windpipe (trachea). Another name for the Heimlich maneuver is abdominal thrusts. You can use it in different ways on adults and children.

How does the Heimlich maneuver work?

Dr. Henry Heimlich invented the Heimlich maneuver in 1974. Dr. Heimlich discovered that the remaining air in a person’s lungs could be used to free (dislodge) a foreign object from their esophagus using quick, upward thrusts under their ribcage.

At first, the Heimlich maneuver didn’t catch on with the medical community. The backslap method remained the most popular first-aid choking treatment for another 10 years. Eventually, the Heimlich maneuver caught on for use in conscious adults. Healthcare providers still recommend backslaps (back blows) for infants, and they recommend CPR for unconscious adults, children and infants.

When should you use the Heimlich maneuver?

You should use the Heimlich maneuver if a person is conscious and choking. You can usually tell a person is choking if they can’t speak, breathe or cough. Ask the person, “Are you choking?” They may be able to cough but can’t speak to ask for help. Sometimes, their breathing and speaking become weaker and weaker until only gasping sounds come out. People often use the universal choking symbol — holding your hands up and clutching your throat.

If a person is able to speak, cough or breathe, don’t attempt the Heimlich maneuver. Encourage the person to keep coughing. Sometimes a strong cough can free the foreign object. Only perform the Heimlich maneuver if a person’s life is in danger.

How do you perform the Heimlich maneuver?

To perform the Heimlich maneuver, follow these steps:

• Stand behind the person and put your arms around their belly (abdomen).
• Make a fist with one hand and clasp your other hand tightly around it.
• Place the thumb side of your fist just below their ribcage and about two inches above their belly button (navel).
• Sharply and quickly thrust your hands inward and upward five times.
• Repeat this process until you free (dislodge) the object stuck in their windpipe, or the person becomes unconscious. If the person becomes unconscious, start CPR.

Can you perform the Heimlich maneuver on toddlers and children?

You can perform the Heimlich maneuver on toddlers and children. If the child is younger than 5 years old or weighs less than 45 pounds (20 kilograms), you should alter the method slightly. First, you should kneel behind the child to get down to their level. Then, you should use less forceful thrusts than the typical Heimlich maneuver requires.

Can you perform the Heimlich maneuver on babies?

Healthcare providers don’t recommend the Heimlich maneuver for use on infants 12 months or younger. Instead, you should use backslaps (back blows) on babies.

To perform this method, follow these steps:

1. Turn the infant face down with their chest resting on your forearm or thigh. Make sure their head is lower than their body.
2. Using the heel of your hand, strike the infant between their shoulder blades five times. The strikes should be firm but not so hard that you cause injury.
3. Check the infant’s mouth and remove any visible objects.
4. If their airway remains blocked, turn the infant face up with their head down. Using your second and third fingers, give five inward and upward chest thrusts about ½ to 1^½ inches into the infant’s breastbone (sternum).
5. Check the infant’s mouth for visible objects again. Repeat this process until you free (dislodge) the object or the infant becomes unconscious. If the infant becomes unconscious, start CPR.

How do you perform the Heimlich maneuver on pregnant people or those with obesity?

People who are pregnant or have obesity can receive the Heimlich maneuver in a slightly altered way. Instead of thrusting on their abdomen, you should place the thrusts on their breastbone (sternum).

How do you do the Heimlich maneuver on yourself?

If you’re alone and choking, you can try to free the item by performing the Heimlich maneuver on yourself.

To perform this method, follow these steps:

1. Make a fist with one hand and clasp your other hand tightly around it.
2. Place the thumb side of your fist just below your ribcage and about two inches above your belly button (navel).
3. Sharply and quickly thrust your hands inward and upward five times.
4. Repeat this process until you free (dislodge) the object.

You can also try leaning over a railing, chair or table edge. Then, sharply and quickly thrust your upper abdominal area against the edge.

Who shouldn’t receive the Heimlich maneuver?

Infants shouldn’t receive the Heimlich maneuver. In addition, if a person is unconscious, they shouldn’t receive the Heimlich maneuver. Instead, you should perform CPR.

What are the risks of the Heimlich maneuver?

Healthcare providers consider the Heimlich maneuver a safe and quick method to save lives. You don’t have to have any medical knowledge or training to perform the Heimlich maneuver. But if you don’t perform the Heimlich maneuver correctly, you can do serious harm.

If you aren’t able to dislodge the foreign object after the first few sets of thrusts, problems can occur. The most common complications of the Heimlich maneuver are broken ribs and holes in the gastrointestinal tract. Other rare abdominal complications can happen, but in a life-or-death situation, providers still recommend performing the Heimlich maneuver.

How can I prevent my child from choking?

Young children are at a high risk of choking. To prevent your child from choking:

• Keep small objects and other hazards out of their reach.
• Cut their food into small pieces.
• Be especially careful with round foods, like hot dogs, nuts and grapes.
• Don’t let them have hard candy.
• Supervise your child while they’re eating and playing.

A note from Cleveland Clinic

When someone can’t breathe because of a blockage (obstruction) in their upper airway, seconds count. You could save a life by performing the Heimlich maneuver. You don’t have to have any medical training to perform it, but it’s a good idea to know the steps in case the situation ever arises. You may even need to use it on yourself one day. The Heimlich maneuver can be a life-saving rescue technique, but you should only use it if the person can’t breathe and they’re still conscious.