You are at the mall or in the park and you see someone choking. What you do can mean the difference between life and death. On two occasions I have had the opportunity to use the Heimlich maneuver. I once saw someone choking at a picnic in the park and on another occasion I used the maneuver on a friend at a restaurant who was short of breadth after eating a piece of steak and was able to save both of their lives. In this article I will discuss how to do the Heimlich maneuver and perhaps one day you find it necessary to use and it just may save a life.
The Heimlich maneuver is an emergency procedure that is used to dislodge foreign bodies from the throats of choking victims. In the early 1970s, the American surgeon Henry J. Heimlich observed that food and other objects causing choking were not freed by the recommended technique of delivering sharp blows to the back. As an alternative, he devised a method of using air expelled from the victim’s lungs to propel the object up and out of the throat. The Heimlich maneuver is used only when the victim’s airway is totally obstructed and he is rendered unable to speak, breathe, or to cough the object out; with only partial blockage of the throat, the victim can generally work the object free by his own efforts.
Three thousand people a year died from choking in this country alone. What was most striking was how choking usually occurred in the most ordinary circumstances. The object on which most people choked was usually on a piece of food or, with children, a toy, a coin, or any small object that they happened to put in their mouths. It is of interest that you will rarely hear of these deaths by choking. Only when a prominent person died – such as Ethel Kennedy’s sister-in-law, Joan Skakel, who choked to death on a chunk of meat, did you read about it in the newspaper. Two music stars, bandleader Tommy Dorsey and pop singer Mama Cass Elliot, lost their lives to choking. Even Claudius I, Emperor of Rome, had also choked to death accidentally – not strangled by a rival, as is commonly believed. One of my urologic colleagues, Dr. Mims Ochsner, was at a restaurant in Atlanta and was coughing and excused himself to go to the restroom and died in the restroom with at least ten doctors within twenty feet of the toilet. His death didn’t have to happen.
Who may need the Heimlich maneuver?
The universal sign for choking is hands clutched to the throat. If the person doesn’t give the signal, look for these indications:
Inability to talk
Difficulty breathing or noisy breathing
Inability to cough forcefully
Skin, lips and nails turning blue or dusky
Loss of consciousness
The Heimlich maneuver is not designed as a procedure performed by a doctor a healthcare professional. The procedure can be performed by anyone.
How is it done?
For a conscious person who is sitting or standing, position yourself behind the person and reach your arms around the person’s waist.
Place your fist, thumb side in, just above the person’s navel and grab the fist tightly with your other hand.
Pull your fist abruptly upward and inward to increase airway pressure behind the obstructing object and force it from the windpipe.
If the person is conscious and lying on his or her back, straddle the person facing the head. Push your grasped fist upward and inward in a maneuver similar to the one above.
You may need to repeat the procedure several times before the object is dislodged. If repeated attempts do not free the airway, an emergency cut in the windpipe may be necessary.
Choking occurs when a foreign object becomes lodged in the throat or windpipe, blocking the flow of air. In adults, a piece of food often is the culprit. Because choking cuts off oxygen to the brain, administer first aid as quickly as possible.