The Heimlich Maneuver. OR: How to 'de-choke sumboddy'

OK! It's time for The Corporal to spew down bits of 'wisdom' from the top of her soapbox. I was last 'seen' raving about CPR. Now I want to talk about what to do when someone is choking. As usual, I will augment recommended procedure (in bold. This time courtesy of The Heimlich Institute) with my own commentary taken from my 'lectures' back when I was a CPR/1st Aid Instructor. And again, I encourage you all to take a class. Contact your local Fire Department, Community Center or Hospital.

The Heimlich Maneuver for CHOKING

What they tell you, plus my 2 cents worth thrown in!

A choking victim can't speak or breathe (Key words can't speak or breath...if the victim can cough, let them be.) and needs your help immediately. Follow these steps to help a choking victim: From behind, wrap your arms around the victim's waist.

(My 2 cents) OK, wait just a gol'durn minute here. Have we learned nothing from my CPR ranting? Are you really just going to waltz up to someone from behind and wrap your arms around their waist?

If you are smart, the answer is NO! There are steps you must take for your own safety before you do this. (You don't want to become a victim yourself.)

So, FIRST, determine scene safety, and ANNOUNCE your intentions. Something along the lines of "Do you need help? Are you choking? I know the heimlich maneuver! Can I help?" Never say I'm a doctor! Or I'm an EMT ! unless you really are one. (And no, WANTING to be one does not count.) If you have shouted all this, you have covered your arse end in more ways than one. You determine if your 'victim' indeed needs help, and you avoid getting your butt kicked by the 'victim' or other onlookers after you are mistaken for a pervert. You are also getting "permission".

IF you indeed have a victim on your hands (they are unable to respond verbally, they frantically nod 'yes they need your help' etc), AND you have ensured scene safety, you get to wrap your arms around their waist now right? WRONG! Call 911! What happens if you are unable to 'de-choke' the victim and they stop breathing? Get the ambulance rolling. OK, NOW you can wrap your arms around the victims waist.

Don't forget your stance. While you are doing this, you want to put your stronger leg back (acting as your bracing leg) and you other leg "between" your victims legs. This way if they go down, you will be in better position to ease them down to the ground, rather that both of you falling backwards. We don't want you to crack the back of your head open now do we?

Make a fist and place the thumb side of your fist against the victim's upper abdomen, below the ribcage and above the navel.

(My 2 cents)

Do not place it too far up, you don't want to break off the tip of their sternum and cause some nasty internal injury.In case of extreme obesity or late pregnancy, give chest thrusts.

Grasp your fist with your other hand and press into their upper abdomen with a quick upward thrust. Do not squeeze the ribcage; confine the force of the thrust to your hands. Repeat until object is expelled.

(My 2 cents)

Remember, you are trying to expel the offending object from the victim. Keep this in mind: What could not go down, must come up. Think of trying to push the last bits of toothpaste out of the tube.

UNCONSCIOUS VICTIM, OR WHEN RESCUER CAN'T REACH AROUND VICTIM: Place the victim on back. Facing the victim, kneel astride the victim's hips. With one of your hands on top of the other, place the heel of your bottom hand on the upper abdomen below the rib cage and above the navel. Use your body weight to press into the victim's upper abdomen with a quick upward thrust. Repeat until object is expelled. If the Victim has not recovered, proceed with CPR.

(My 2 cents)

Allright, can you see here why my reccomendations from step one above would be to your advantage? For those whose minds are swimming along in the sewer, this could LOOK like a comprimising position. Even thought the victim is unconcious, it never hurts to make your announcements anyway. The victims friends, relatives and any Looky-Lous or gawkers need to know your intentions.(And you never know if the victim might be aware. Unresponsive does not necessarily equal unaware in some cases.)

The Victim should see a physician immediately after rescue.

(My 2 cents)

In other words...get their de-choked selves to the hospital. Even with the best of intentions, you could have done some damage to their innards and/or muscles getting the offending object out of the victim. The object itself could have done some damage. Beside, who knows what triggered the choking bout in the first place. It could have been a straightforward choking (object to large to swallow, went down awkwardly etc.) OR it could have been triggered by a seizure, or any other number of things. Better safe than sorry. Aren't you glad you called that ambulance? Don't slap the victim's back. (This could make matters worse.)

(My 2 cents)

A slap on the back while the victim was eating could have started the whole fiasco in the first place. I know, I know. Your first reaction would be to thump the person on the back. Beat that instinct down and resist!

So there you have it. This concludes my brief overview of The Heimlich Maneuver OR : How to 'de-choke sumboddy'. Please visit The Heimlich Institutes site for what to do when an Infant or Child is choking, or You yourself happen to be the victim. Better yet...GO TAKE A CLASS!

*Jumps down from soapbox for the day.*

See FAQ's" about The Corporal for more EMS shenanigans.