Abstract
Abdominal thrust, popularized by Henry Heimlich in 1975 is the standard resuscitation method for victims of choking. When properly applied, this procedure can and has saved many lives over the years, but the process itself is somewhat difficult to perform. The main reason for this difficulty is the need to reach around the trunk of the victim and then apply sufficient force to generate enough pressure upwards to the diaphragm, to be able to dislodge the food bolus (or foreign body) out of the larynx. This is compounded by the size of the average American, especially when they are overweight or obese, thus the ability to reach the front of the abdomen and then the prospect of actually trying to lift the victim up through brute force is a challenge for most people. Some difficulties are inherent in the emotionally charged and panicky situations in which such resuscitation measures take place. Some scientists have advocated the use of mechanical devices to apply thrust to the abdomen. However, the lack of availability of such assisting devices at home and even in restaurants is a distinct issue. Damage to the xiphisternum or internal organs by excessive force is also an issue, so much so, most authorities recommend a post-resuscitation check up of all victims at a hospital or clinic. The procedure(s) described in this report is much simpler in execution, while being almost effortless, and applicable to victims of any size. It also exploits the objects that are likely to be present where such choking accidents occur, the restaurants and dining rooms, while also taking advantage of the earth’s gravity to dislodge the offending food bolus. If such objects are not available, an alternate method using the rescuer’s free forearm to support the victim’s weight, while keeping him/her folded over is also described.
Highlights
The method of the abdominal thrusts introduced by Dr Heimlich is for an operator to stand behind the victim, wrap the arms around the waist and place a closed fist in the space between the umbilicus and the sternum, use the other hand to clasp the closed fist and exert abrupt pressure upward and towards the operator, as if attempting to lift the victim up [1]
Any method of resuscitation of choking victims should be simple and easy to administer, effective in dislodging the offending foreign body from the larynx, not require special equipment that would be unavailable at the usual locations where such emergencies arise, and most of the general public should be cognizant of the procedure(s)
The resuscitation method described in this paper fulfills all these goals and we hope, will exceed them
Summary
The method of the abdominal thrusts introduced by Dr Heimlich is for an operator to stand behind the victim, wrap the arms around the waist and place a closed fist in the space between the umbilicus and the sternum, use the other hand to clasp the closed fist and exert abrupt pressure upward and towards the operator, as if attempting to lift the victim up [1]. The American Red Cross [5], Mayo Clinic [6] and The UK National Health Service (NHS) [7] suggest applying 5 slaps on the back of the victim after bending them forward. If these fail to expel the obstructing foreign body, repeat the processes until either is successful or the Emergency Medical Staff arrive. When the choking victim is alone, as back slaps are impossible, “auto abdominal thrusts” have been advocated; these are similar to the usual abdominal thrusts but the victims themselves administer them
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