Heimlich Maneuver- An Overview.

Introduction

Choking can occur when food or small objects become lodged in the throat, obstructing the airway. This keeps oxygen from reaching the lungs and the brain. Young children are at high risk of choking. When someone is choking, quick action taken can be life-saving. The Heimlich maneuver is immediately performed to relieve the serious effects of choking.

How to Administer First Aid for Choking?

Choking occurs when the object gets stuck in the throat or windpipe. If a person needs help look for the following signs

• The internationally recognized indication of choking involves hands gripping the throat.

• Inability to talk.

• Squeaky sounds during breathing.

• Cough (weak or forceful)

• Due to lack of oxygen, bluish discoloration of the skin, lips, and nails may occur.

• Loss of consciousness.

• Difficulty breathing.

How to Perform a Five and Five Approach?

In case the person is able to cough forcefully, the person should continue coughing. When an individual is choking and unable to communicate through speech, crying, or laughter, it is advisable to employ the "five and five" technique.

Give Five Back Blows:

• The procedure to carry out back blows is as follows-

• Stand to the side and just behind the choking adult.

• For a child, kneel down behind. To gain support, place one arm across the patient's chest.

• Position the individual at the waist level, ensuring that their upper body is parallel to the ground.

• Give five distinct back blows using the heel of the hand between the patient's shoulder blades.

Give Five Abdominal Thrusts: The procedure is to carry out five abdominal thrusts, also known as the Heimlich maneuver.

What Is the Heimlich Maneuver or Abdominal Thrust Maneuver?

The Heimlich maneuver refers to the first aid procedure performed in the case of choking conditions. When there is an obstruction of the throat or windpipe due to food, toys, or any foreign bodies, it may result in choking. The Heimlich maneuver or abdominal thrusts are performed in different ways in adults and children.

Dr. Henry Heilminch invented the Heimlich maneuver in 1974. Dr. Heimlich discovered that the air in the lungs could be used to free a foreign object from the esophagus using quick, upward thrusts under the ribcage. Earlier, the backslap method was the most popular first aid for choking treatment. Later, Dr. Henry Heimlich introduced conscious adults. Back slaps (back blow) are still recommended for infants, whereas cardiopulmonary resuscitation (CPR) is recommended for unconscious adults, infants, and children.

What are the Indications to Perform Heimlich Maneuver?

• It is indicated in conscious patients with choking.

• The universal choking symbol refers to holding the throat with both hands and clutching the throat.

• This method is not indicated if a person is able to speak, cough, or talk.

• Ask the person to continue coughing, as the coughing activity can sometimes help in clearing the objects from the throat.

• The Heimlich maneuver is indicated if the person's life is in danger.

How to Perform a Heimlich Maneuver?

To execute the Heimlich maneuver effectively, follow these steps:

• Position Behind the Person: Stand behind the individual and encircle the arms around their abdomen.

• Create a Fist: Form a fist with one hand, clasping the other hand tightly around it.

• Proper Hand Placement: Ensure the thumb side of the fist is positioned below the ribcage and approximately two inches above the belly button.

• Administer Sharp and Quick Thrusts: Deliver sharp and rapid thrusts into the abdomen, repeating the motion five times consecutively.

• Repeat Until Object is Freed: Continue this process until the obstructing object is dislodged. If the person loses consciousness, initiate cardiopulmonary resuscitation (CPR).

Heimlich Maneuver on Children: The Heimlich maneuver can also be performed on children. If the child is younger than five years or weighs less than 45 pounds, a slight variation in the method is followed. The rescuer should kneel behind the child to get down to their level. In this method, less forceful thrusts should be given than the typical maneuver technique.

Heimlich Maneuver on Pregnant Women: A slight variation from the regular procedure is followed for pregnant women. The thrusts given on the abdomen are altered and should be placed on the breastbone (sternum).

Heimlich Maneuver on Self: If a person is alone and choking, he or she can try to free the object by practicing the Heimlich maneuver. Certain steps are followed to perform on self, and these include:

• Form a fist with one hand and clasp the other hand tightly around.

• Place the thumb side fist just below the ribcage and about two inches just above the navel (belly button).

• Sharp and quick thrusts are given with hands inward and upwards five times.

• Repeat these steps until the object is freed or dislodged.

• In addition, try leaning over a chair, railing, or table edge. Then sharply and quickly thrust the upper abdominal area against the edge.

Heimlich Maneuver on Babies: This Heimlich maneuver is not exactly performed on infants 12 months or younger. Instead, babies should receive back slaps.

To perform this method, follow these steps:

• Turn the infant face down with the chest resting on the forearm. Make sure the baby’s head is lower than its body.

• Using the heel of the hand, strike the infant between the shoulder blades five times. The force applied should be firm but should not cause injury.

• Remove the objects if visible in the infant’s mouth.

• If their airway is still blocked, keep the infant face up with their head down. Using the second and third fingers, give five inward and upward thrusts about half to one and a half inches into the infant’s breastbone (sternum).

• Again check the infant’s mouth for visible objects.

• Repeat the process until the object is freed or dislodged. If the infant becomes unconscious, start with cardiopulmonary resuscitation (CPR).

How to Prevent Choking in Babies?

Young children aged from one to three years are especially at high risk for choking. To prevent the child from choking:

• Supervision of the child is mandatory while eating and playing.

• Cut the baby’s food into small pieces.

• Small objects and other hazardous things should be kept away from children.

• Be cautious with round-shaped foods such as grapes and nuts.

• Hard candy should be avoided.

What Are the Risks of the Heimlich Maneuver?

• If the procedure is not performed properly, it may result in severe abdominal injury.

• If the foreign object is not removed, it may result in further complications.

• Complications such as broken ribs and perforations in the gastrointestinal tract may arise during the execution of the procedure.

Conclusion:

The Heimlich maneuver is a life-saving rescue technique but should be performed if the patient is conscious and cannot breathe on their own. Some rare abdominal complications may occur due to the force applied, but in a life-or-death situation, performing this maneuver is always recommended.