The Heimlich maneuver is often used on a choking victim who is conscious but can’t speak or breathe due to a blocked airway. It can also be used on asthmatics during an attack and a drowning victim as well as victims who are too large to wrap your arms around.

For Choking

The most common use for the Heimlich maneuver is to help a victim who is choking. Whether you’re in a restaurant or your own home, choking can happen at a moment’s notice. Just be sure the person is actually choking before you begin.

• Ask the victim, "Are you choking?" just to be sure you do not attempt the Heimlich maneuver on someone who is not breathing for a reason other than a blocked airway.
• Wrap your arms around the victim’s waist from behind.
• Make a fist and push the thumb side of your fist against the victim’s upper abdomen, which is below the ribcage and above the navel.
• Grab hold of your fist with your other hand and press into the upper abdomen with a fast, upward thrust. Make sure to maintain the force of the movement in your hands alone. Do not squeeze the ribcage or squeeze with your arms.
• Repeat until the object blocking the airway is expelled.

For Victim Too Large To Reach Around and Unconscious Victims

Some people pass out when the object blocking their airway cuts off their breathing for too long. You won’t be able to support the dead weight of a faint victim. If this is the case, you must clear the airway before delivering CPR. Use the same approach when your arms are too short to wrap around a victim’s waist.

• Lay the victim on his back.
• Straddle the victim’s hips, facing him.
• With one hand on top of the other, push the heel of your bottom hand on the upper abdomen (below the ribcage and above the navel).
• Using your body weight, push into the victim’s upper abdomen with a fast, upward thrust.
• Repeat until the object blocking the airway is expelled.
• If the victim is still not breathing when the airway is clear, begin CPR.

For Infants

Over 70% of the time, babies choke on pen caps. It’s the small things that you don’t notice that catch a baby’s eye and end up in its mouth. Prevention is the best medicine if possible, but if the little one moves a little faster than you, at least you’ll be prepared.

• A baby will not be able to tell you if he or she is choking. You will have to ascertain if there are breathing or guttural sounds coming from the infant. If not, proceed with the Heimlich maneuver.
• Place the baby on its back on a firm surface and kneel or stand at its feet.
• The other option is to hold the baby on your lap facing away from you.
• Either way, place the middle and index fingers of both of your hands on its upper abdomen (below the ribcage and above the navel).
• Push in with fast, upward thrusts gently.
• Repeat until the object blocking the baby’s airway is expelled.

For Yourself

If you’re alone and you start to choke or no one else around you is acting quickly enough, take care of things yourself.

• If you can’t speak or breathe and you have something stuck in your throat, you need to give yourself the Heimlich maneuver if no one else around is qualified.
• Make a fist and push the thumb side of your fist into your upper abdomen (below the ribcage and above the navel).
• Take hold of your fist with your other hand and push into your upper abdomen with a fast, upward thrust.
• Repeat until the object blocking your airway is expelled.

Alternative Heimlich for Yourself

You may not feel like you have the energy to give yourself powerful thrusts, in which case the assistance of a piece of furniture or railing will come in handy.

• Bend over an immovable, hard, horizontal object (chair, railing, table edge) and press your upper abdomen against the edge to create the fast, upward thrust.
• Repeat until the object blocking your airway is expelled.

For Drowning Victims (Out of the Water)

A drowning victim will not be conscious or breathing, but before you can offer breath through CPR, you must first expel the water from their lungs. If the victim is light enough or if you have help, then pull him or her out of the water. It will be easier to deliver the Heimlich maneuver successfully before CPR (if CPR is still necessary).

• Lay the victim on their back. Turn head to one side to allow the water to drain from the victim’s mouth.
• Straddle the victim’s hips, facing him.
• Place one hand on top of the other and push the heel of your bottom hand into the upper abdomen (below the ribcage and above the navel).
• Push into the victim’s upper abdomen with a fast, upward thrust using your body weight.
• Repeat until water no longer drains from the victim’s mouth.

For Drowning Victims (In the Water)

The water will help support the weight of the victim as you perform the Heimlich maneuver. However, you will have a better chance of success if the water is shallow enough for you to stand.

• Wrap your arms around the victim’s waist from behind.
• Make a fist and push the thumb side of the fist into the victim’s upper abdomen (below their ribcage, and above their navel).
• Take hold of your fist with your other hand and push into the victim’s upper abdomen with a fast, upward thrust.
• Do not squeeze with your arms. Do not squeeze their ribcage. Keep the force in your hands alone.
• Repeat until water no longer drains from the victim’s mouth.

For Asthmatics Suffering From an Attack

Asthmatics suffering from an asthma attack will not be able to breathe. Only perform the Heimlich maneuver on a sufferer of acute asthma who has not responded to the medication or is unable to take the medication. The Heimlich maneuver will relieve an asthma attack. Perform as if the victim has an object blocking their airway.

• Wrap your arms around the victim’s waist from behind.
• Make a fist and push the thumb side of the fist into the victim’s upper abdomen (below their ribcage, and above their navel).
• Take hold of your fist with your other hand and push into the victim’s upper abdomen with a fast, upward thrust.
• Do not squeeze with your arms. Do not squeeze their ribcage. Keep the force in your hands alone.
• Repeat until no longer necessary.

If you are suffering from an asthma attack, perform the Heimlich maneuver upon yourself as per usual.

• If you can’t speak or breathe and you have something stuck in your throat, you need to give yourself the Heimlich maneuver if no one else around is qualified.
• Make a fist and push the thumb side of your fist into your upper abdomen (below the ribcage and above the navel).
• Take hold of your fist with your other hand and push into your upper abdomen with a fast, upward thrust.
• Repeat until no longer necessary.

OR

• Bend over an immovable, hard, horizontal object (chair, railing, table edge) and press your upper abdomen against the edge to create the fast, upward thrust.
• Repeat until the object blocking your airway is expelled.

Tips

• Never slap the victim’s back as that can make the situation worse by forcing the object further into the throat.
• Victims should go to emergency room or see the doctor immediately after Heimlich maneuver has been successfully performed.

History of the Heimlich Maneuver – A Timeline

15th Century - Common practice was to lay a drowning victim face down across a barrel and roll the barrel back and forth. This movement pushed the diaphragm up and into the lungs which pushed the water out.

1903 - The Schafer prone-pressure method was first used to expel water from the lungs of a drowning victim. The victim was placed face down and the rescuer pressed on the lower back. This forced exhalation and water from the lungs.

1961 – Mouth to mouth or ‘artificial respiration’ is adopted during a medical conference in Stavenger, Norway because it delivers more air to the lungs than the Schafer method. They replace the Schafer method with mouth to mouth for drowning victims without consideration for how first to remove the water from the lungs.

1973-1983 – Studies are done that prove that 57% of drowning victims die when CPR alone is used and that 86% vomit, further blocking the airway and complicating the rescue.

1974-1975 – The Heimlich maneuver is introduced and The American Red Cross adopts it as standard protocol for rescuing choking victims.

1982 – Studies show that four Heimlich maneuvers administered in under 10 seconds will successfully clear water from the lungs of a drowning victim.

1986 – The American Heart Association endorses the Heimlich maneuver to save drowning victims, including it in their manual, American Heart Association Standards and Guidelines, which is followed by the American Red Cross and other medical organizations.