Abstract
AimTo study the most effective body position for Heimlich maneuver.MethodsA choking simulation manikin was connected to a laryngeal model of a child or an adult, and a differential pressure transducer recorded the airway pressure and waveform during the maneuver. A konjac jelly was placed on the larynx to mimic complete supralaryngeal obstruction. The maneuver (five successive compressions) was carried out six times each in standing, prone, and supine positions. For cases of children, we added a supine position with a pillow under the back.ResultsIn the adult model, airway obstruction was more frequently relieved in the supine and prone positions than in the standing position (P < 0.001). In the child model, airway obstruction was more frequently relieved in the supine position, with a pillow, and in the prone position, than in the standing position (P < 0.001). Without relief, successive Heimlich maneuvers made the airway pressure increasingly negative (adult, from −21.9 ± 6.5 cmH2O to −31.5 ± 9.1 cmH2O in the standing position [P < 0.001]; child, from −15.0 ± 9.5 cmH2O to −30.0 ± 9.2 cmH2O in the standing position [P < 0.001] and from −35.0 ± 17.4 cmH2O to −47.3 ± 25.1 cmH2O in the supine position without a pillow [P = 0.002]).ConclusionsThe Heimlich maneuver was more effective in the supine and prone positions. In children, the prone position may be most effective. Successive Heimlich maneuvers may be harmful when the airway is not relieved after the first compression.
Highlights
C HOKING ON FOOD is one of the most frequent causes of accidental death in children and aged people.[1,2] The Heimlich maneuver was first reported as a first aid measure to prevent choking in 1974, and in 1975, 162 patients were saved by this maneuver.[3]
Expiratory volume produced by the Heimlich maneuver in the absence of a foreign body
T HE EXPIRATORY VOLUME produced from the manikin by the Heimlich maneuver in the absence of a foreign body was significantly greatest in the supine position, Fig. 3
Summary
C HOKING ON FOOD is one of the most frequent causes of accidental death in children and aged people.[1,2] The Heimlich maneuver was first reported as a first aid measure to prevent choking in 1974, and in 1975, 162 patients were saved by this maneuver.[3]. Because it is difficult to know the level of obstruction, except when it occurs in the mouth and nose, the effectiveness of the Heimlich maneuver in complete supralaryngeal obstruction and at body positions other than standing remains largely unknown. We studied the effect of the Heimlich maneuver on the supralaryngeal obstruction in the standing position, compared to other positions (supine and prone position), using a manikin as a choking model. This is the first study to investigate the success rate of the Heimlich maneuver in three positions by recording airway pressure during the maneuver
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