page_title: Choking
section_title: Abdominal Thrusts (Heimlich Maneuver)
hierarchical_section_title: Choking / Treatment / Basic treatment (First-Aid) / Abdominal Thrusts (Heimlich Maneuver)
caption_attribution_description: English: The chest thrusts anti-choking maneuver. It shows the point of applying on sternum (breastbone). Español: La maniobra anti-atragantamiento de compresión torácica. Muestra la zona de aplicación en el esternón.
context_page_description: Choking occurs when breathing is impeded by a constricted or obstructed throat or windpipe.
  In some cases the air flow is completely blocked, in other cases some amount of air can pass to the lungs. Insufficient oxygen being delivered to the body will result in oxygen deprivation. Although oxygen stored in the blood and lungs can keep a person alive for several minutes after breathing stops, this sequence of events can lead to death. Choking was the fourth most common cause of unintentional injury-related death in the US in 2011.
  Deaths from choking most often occur in the very young and in the elderly. Obstruction of the airway can occur at the level of the pharynx or the trachea. Foods that can adapt their shape to that of the pharynx can be a danger not just for children but for persons of any age.
  Choking is one type of airway obstruction, which includes any blockage of the air-conducting passages, including blockage due to tumors, swelling of the airway tissues, and compression of the laryngopharynx, larynx or vertebrate trachea in strangulation.
context_section_description: Abdominal thrusts are performed with the rescuer standing behind the choking victim. The rescuer closes his skillful hand, grasps it with the other hand, and presses forcefully inwards and upwards with both of them on the area located between the chest and the belly button of the victim. The pressure is not focused directly against the ribs, to avoid breaking any of them. If the first thrust doesn't solve the choking, it can be repeated several times. Usage of abdominal thrusts is not recommended in infants under 1 year of age due to risk of causing injury; there exist adapted techniques for them (see more further below). Abdominal thrusts should not be used, either, when the patient's abdomen presents problems to receive them, like pregnancy or excessive size; then chest thrusts are advised (see further below).
  The purpose of abdominal thrusts is to create a pressure capable to expel the object lodged upwards in the airway, relieving the obstruction. This method was discovered by Dr. Henry Heimlich in 1974, so it is referred to as "The Heimlich Maneuver." Dr. Henry Heimlich claimed that his maneuver was better than the back blows, arguing that back blows could cause the obstruction to become more deeply lodged in the victim's airway. That claim started a debate into the medical community, that ended up with the recommendation of alternating both techniques, but making the patient to bend the back before receiving the slaps. So the Heimlich Maneuver itself uses only abdominal thrusts, but is also part of anti-choking protocols that include the back blows (back slaps) technique.
caption: Chest thrusts anti-choking technique: if the victim can not receive thrusts on the abdomen, use chest thrusts; apply them on the lower half of the chest bone, but not in the very endpoint.
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