What is the Heimlich Maneuver and How is it Applied?

The Heimlich maneuver is a first aid method used in choking situations. It can be applied to adults and children to remove a substance that is obstructing the airway and preventing breathing. The Heimlich maneuver involves applying pressure to the abdominal area. It is a quick life-saving technique, but it is not used in every emergency choking situation. The Heimlich maneuver is only performed on conscious individuals who cannot breathe on their own. The maneuver is named after the doctor who developed it and involves applying a quick, upward pressure below the chest to expel a foreign object from the esophagus. The Heimlich maneuver is the primary first aid method used to resolve choking. Choking occurs when a person's throat or windpipe (medically known as the trachea) is blocked by a toy, food, or another foreign object, preventing them from breathing. The Heimlich maneuver is applied differently in adults and children.

When Should the Heimlich Maneuver be Used?

The Heimlich maneuver should be used when the person experiencing upper airway obstruction is struggling to breathe due to a foreign object. In other words, if the person is choking and cannot take in air, the Heimlich maneuver can be applied. A person who is choking due to a foreign object will be unable to speak, may try to cough, and will be unable to breathe. The Heimlich maneuver is used when the airway obstruction (airway obstruction) is severe and the person's life is at risk.

In some cases, applying the maneuver can do more harm than good. For example, if the choking person can speak, cough forcefully, or breathe sufficiently, the Heimlich maneuver and even other airway techniques should not be used. If the person has lost consciousness, meaning they do not respond when spoken to and their eyes are closed, the Heimlich maneuver should also not be applied. The maneuver is only used when the person is conscious and choking at the same time.

Generally, it is possible to recognize that a person cannot speak, breathe, or cough based on their gestures. If you notice these signs, you can understand that the person is choking. You can ask the person, "Are you choking?" Sometimes the choking person may cough but cannot speak or ask for help due to insufficient breath. Occasionally, breathing and speaking may become progressively weaker and can be heard. Due to airway obstruction, the person's speech will weaken until only breathing sounds are heard. The universal choking sign, in which a person raises their hands and grasps their throat, is often used to indicate the situation.

Once you are sure the person is choking, if they can speak, cough, or breathe, the Heimlich maneuver should not be used. It is usually preferred to encourage the person to continue coughing. Sometimes, a strong cough can dislodge the foreign object from the airway. It is healthier to use the Heimlich maneuver only when the person’s life is in danger.

How to Perform the Heimlich Maneuver?

After learning when to use the Heimlich maneuver, the next step is typically understanding how to perform it. The technique for performing the Heimlich maneuver depends on the person it is being applied to. The following groups require different steps when performing the Heimlich maneuver:

• A person who is not pregnant,
• Children,
• A pregnant woman or the person performing it on themselves.

Regardless of who the Heimlich maneuver is applied to, the individual should still receive medical attention afterward. The purpose of medical assistance is to ensure that no physical damage has occurred to the throat or airways after the Heimlich maneuver and the choking incident.

Steps for the Heimlich Maneuver for Non-Pregnant Adults:

1. Ensure the person is standing.
2. Position yourself behind the person.
3. Lean the person forward and deliver five back blows with the palm of your hand.
4. Then, stand behind the person and wrap your arms around their abdomen.
5. Make a fist with one hand and grasp it with the other hand.
6. Place the thumb side of your fist just below the ribcage and approximately 5-6 centimeters above the belly button.
7. Quickly and forcefully thrust your hands inward and upward five times.
8. Repeat these steps until the object is expelled from the airway or the person can breathe on their own or cough.
9. If the person loses consciousness, begin CPR (Cardiopulmonary Resuscitation).

Alternatively, if the person cannot stand, the person performing the maneuver should sit on the person’s waist, facing their head, and attempt the inward and upward thrusts as they would standing.

Evaluating Whether the Heimlich Maneuver is Needed:
It’s important to assess whether the person actually needs the Heimlich maneuver. If the choking person is conscious and coughing, they may be able to dislodge the foreign object themselves. The Heimlich maneuver is only applied if the person is conscious and the airway is obstructed due to a foreign object.

Heimlich Maneuver for Children:
The Heimlich maneuver can also be applied to children. If the child is under 5 years old or weighs less than 45 kilograms, the technique is slightly modified. The person performing the maneuver should kneel behind the child to be at their level, and apply less forceful thrusts than in the adult version.

Heimlich Maneuver for Pregnant Women:
Pregnant women who are choking can also benefit from the Heimlich maneuver. Unlike in non-pregnant adults, the person performing the maneuver must place their hands around the person’s ribcage (sternum) and slightly higher than the torso. If the person is unconscious, the Heimlich maneuver should not be performed. Instead, the person performing the maneuver should first lay the person on their back and attempt to clear the airway by sweeping the object out with their fingers. If they cannot remove the object, CPR should be started.

Performing the Heimlich Maneuver on Yourself:
If you are alone and choking, you can perform the Heimlich maneuver on yourself. If you notice that your airway is blocked by a foreign object, follow these steps:

1. Make a fist with one hand and wrap your other hand tightly around it.
2. Place the thumb side of your fist just above your navel and below your ribcage.
3. Grasp the fist with your other hand.
4. Quickly and forcefully thrust your hands inward and upward five times.
5. Repeat the process until the object is expelled or you can breathe or cough on your own.

Alternatively, you can also try leaning against a sturdy object like a railing, chair, or the edge of a table. Press your upper abdomen forcefully and sharply against the edge until the object is expelled.

Importance of First Aid Knowledge:
It is very important to have first aid knowledge when performing the Heimlich maneuver. If you would like more information or wish to assess any potential damage to your airway after a choking incident, consider seeking medical evaluation at the nearest healthcare facility.

What Should Be Considered While Performing the Heimlich Maneuver?

Deciding who the Heimlich maneuver will be applied to is very important. If the choking person is conscious, able to speak, or can cough, the Heimlich maneuver is not recommended. The maneuver should only be applied if the person is conscious. In cases where the person is unconscious, CPR should be started instead.

First aid is a delicate topic. Therefore, performing it without knowledge, even with good intentions, can cause more harm than good. In case of an emergency, consider calling 112 (emergency services).

How to Perform the Heimlich Maneuver on Infants?

The Heimlich maneuver may not be suitable for infants. It is generally not recommended to perform the Heimlich maneuver on babies under 12 months old. Instead, back blows are used to try to clear the airway. If the choking person is under 1 year old, the steps to perform the life-saving method are as follows:

1. Turn the baby face down, ensuring their chest is resting on your forearm.
2. Make sure the baby’s head is lower than their body.
3. Using the palm of your hand, deliver five firm back blows between the shoulder blades. The blows should be firm but not strong enough to cause injury.
4. Check the baby’s mouth and carefully remove any visible objects.
5. If the airway is still blocked, turn the baby onto their back, with the head lower than the body, and use your second and third fingers to perform five chest compressions on the sternum, pressing inward and upward.
6. Check the baby’s mouth again for visible objects.
7. Repeat the process until the object is expelled from the airway or the baby becomes unconscious.
8. If the baby becomes unconscious, begin CPR.

Emergency help is more likely to be effective when performed by trained individuals. If you encounter an emergency, consider calling 112 (emergency services) and heading to the nearest healthcare facility.