Heimlich Maneuver: First Aid Rescue for a Choking Victim

Common choking objects

Common household objects.
Common household objects. | Source

Anyone can be a choking victim

A choking victim is a person whose airway has been obstructed by a foreign object, such as: a button, marble, safety pin, bottle cap, coin, hot dog, banana, chicken, or fish bone, making it impossible to breathe. In a matter of seconds a conscious individual can pass out and, without rescue intervention, could die. I know, because I was a choking victim.

Signs of Choking

1. Cannot speak, cry out or verbally communicate

2. Breathing is difficult, may sound wheezy or whistling sounds, or gasping

3. Possible gurgling or gagging noise

4. Uses the universal choking sign: clutches her own throat

5. Skin begins to turn blue for lack of oxygen-starts at the mouth and facial area

6. Unconsciousness







Famous people who have choked:

1. U.S. President George W. Bush-choked on a pretzel in 2002

2. The Queen Mother-choked on a fish bone in 1993

3. Jimmie Foxx, Major League baseball player-choked on a bone and died in 1967

4. Playwright: Tennessee Williams-choked on a bottle cap in 1983




Henry Heimlich

Henry Heimlich is the person whose name is behind the rescue mechanism of abdominal thrusts. Prior to the Heimlich maneuver people would give the choking victim a hearty blow between the shoulder blades until either the object was expelled or the person became unconscious. In many cases, this would eventually lead to death.

In 1986, both the American Red Cross and the American Heart Association formerly adopted the use of the Heimlich maneuver as the recommended rescue for choking victims over the back blows. However, Australia is one of the countries who have not adopted this based on lack of scientific evidence. There is controversy now about the avoidance of using back blows. In some camps this is the preferred way because it causes less damage to the ribcage. The American Red Cross resumed this part of rescue aid for choking victims in 2006.




Performing the Heimlich Maneuver

Click thumbnail to view full-size
Sometimes a choking victim makes a 'whistling' noise through their obstructed airway.The universal sign for choking: place hands around or at your throat.Encircle the arms around the waist above the navel and below the ribs.Form a fist with one hand pressing the thumb side into the body and use the second hand over the first to add leverage for abdominal thrusts.If alone press the abdomen against a chair, table edge or railing.
Sometimes a choking victim makes a 'whistling' noise through their obstructed airway.
Sometimes a choking victim makes a 'whistling' noise through their obstructed airway. | Source
The universal sign for choking: place hands around or at your throat.
The universal sign for choking: place hands around or at your throat. | Source
Encircle the arms around the waist above the navel and below the ribs.
Encircle the arms around the waist above the navel and below the ribs. | Source
Form a fist with one hand pressing the thumb side into the body and use the second hand over the first to add leverage for abdominal thrusts.
Form a fist with one hand pressing the thumb side into the body and use the second hand over the first to add leverage for abdominal thrusts. | Source
If alone press the abdomen against a chair, table edge or railing.
If alone press the abdomen against a chair, table edge or railing. | Source

How to Perform the Heimlich Maneuver:

A first responder on the scene of an adult choking victim needs to:

1. Assess the situation carefully. If the victim is coughing leave him alone. If the person cannot cough or speak, or if he is only making wheezing gasps, then action is required.

2. Adult victim: wrap your arms around her waist

3. Make a fist and place the thumb side of your fist against her upper abdomen above the navel, but below the ribcage.

4. Grasp your fist with your other hand and press into her upper abdomen with a quick upward thrust. Keep the movement from the hands into the abdomen, NOT squeezing the ribcage.

5. Repeat until the object is expelled.



Performing the Heimlich maneuver

Have you ever had to perform the Heimlich maneuver on a choking victim?

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Choking Infant

To perform the Heimlich maneuver on a choking infant:

1. Place the infant on his back and stand at his feet. Or, hold the baby on your lap facing away from you.

2. Position the middle and index fingers of BOTH hands above the navel and below the ribcage.

3. Pressing in and upward give gentle thrusts taking care not to squeeze the ribcage until the object is expelled.

4. Proceed with CPR if no recovery has occurred.



Unconscious Victim or Obese Person

If the person is unconscious or too large or pregnant to wrap the arms around them move them to the floor on their backs and straddle their hips. Then:

1. Place one hand on top of the other and place the heel of your bottom hand in the position as if they were standing: above the navel and below the ribcage.

2. Using the body for leverage move the hands in a quick upward thrust, as if the victim were standing.

3. Repeat abdominal thrusts until the object is expelled.

4. If the victim remains unconscious or has fallen into unconsciousness proceed with CPR.


Please take the poll

Have you ever experienced choking?

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Heimlich maneuver on your own self

If you are alone:

1. Position the fists under the ribcage and attempt to give yourself abdominal thrusts

2. Or, lean over the back of a chair, railing or table edge and press your upper abdomen against it with a firm thrusting motion.

3. See a doctor following the incident.


My Experience as a Choking Victim:

Eating at new restaurants is something my friend and I enjoy doing ever since our ‘taste test’ experiences in California. In our rural town in North Carolina there are no restaurants to speak of; the ones in town that are not family owned diners are merely fast food joints, certainly nothing to brag about. Whenever possible we seek an opportunity to dine elsewhere. One day, while in Raleigh, it was 'The Cheesecake Factory.'

Seated in a booth near the hallway we discussed how hungry we were and how busy the place was. It didn’t hurt that our booth was also next to the waiter’s coffee nook and we caught young men and women flying by to keep the patron’s mugs filled with hot tea or coffee. I was happy the wait for our food did not take long.

My chicken dish came exactly as I had hoped for-perfect! It looked delicious sitting on a bed of pasta while a lemon and artichokes aroma wafted up to my nostrils. I could hardly wait to try it; however, the wonderful meal was suddenly thwarted with the first bite. Eager to dive into the food, my hunger overrode my common sense and I cut too large of a piece of chicken to swallow.

Initially, I didn’t realize this and it was only until I put the piece into my mouth I became aware of its size. My options at this point were to remove the piece and cut it smaller or attempt to bite into it to make it more manageable. I chose the latter, which was the second mistake I made in that particular dining experience.

Attempting to maneuver the piece to bite it without opening my mouth so large that I imitated a hungry hippo, the chicken began to slide towards the back of my throat. My third mistake: failure to stop and reevaluate the former choice, which was to delicately remove the food from my mouth. Instead, I attempted to swallow the piece of chicken that was obviously too large for my throat. Immediately I knew I was in trouble and looked frantically at my dinner companion who was busily eating his steak.

“What’s wrong?” he asked.

I placed my hands on my throat showing the universal sign for choking and, bug eyed, looked desperately at him.

“Are you choking for real?” he asked.

I nodded anxiously and he quickly jumped out of the booth ordering me to do the same. Just that week I had completed my annual CPR renewal which included how to rescue a choking victim. I was grateful he was also familiar with this practice and had the self-assuredness to spring into action. He calmly put his arms around my midsection and, with his fist, gave a firm upward thrust. This was the beginning of the abdominal thrusts that are recommended by the American Heart Association.

Still being fully conscious I was able to assist the process by attempting to ‘cough’ up the lodged chicken with each thrust. In addition, our position was slightly forward, almost leaning on the table. In the meantime wait staff deftly stepped around this couple in the aisle, seating other customers and standing off to the left of us at the coffee stand chit chatting, oblivious of the emergency crisis occurring only an arm's length away.

In the course of the incident a quiet peace came over me and I was in a state of heightened awareness. I knew this was a life and death situation because I could not breathe at all. I knew it would be only a matter of seconds before I might become unconscious, so time was imperative, and I knew that I was aware that I did not want my life to end from eating food. I would later remember this and think that was an odd thought to have during this event. I also thought of my children and how sad they would be if I didn’t make it.

After the second abdominal thrust I felt a slight shift and by the third attempt I coughed harder and the chicken was expelled from my mouth and flew across the table. We both sat back down and just stared at each other for what seemed like a long time.

Then I quietly said, “You saved my life.”

“Yeah, I know.”

“No, I mean you REALLY saved my life!”

“Yeah…I know.”

More silence followed as we looked at each other absorbing the gravity of the situation. Finally, I said to him, “My throat is sore and I don’t much have an appetite anymore.”

We discussed the aura that had surrounded both of us for he had experienced this same ‘alertness’ that seemed to have encapsulated us.

“I felt like we were in a bubble. I could hear everything that was going on around us, but it was as if time stood still or was in slow motion in this place.”

He concurred with my experience. “Isn’t it amazing that we were not interrupted during that whole time by the wait staff?” he asked.

Giving first aid to a choking victim must be swift, precise and, if you are successful, have a recovery period. We were in the recovery state when our waiter next arrived. I was grateful my friend did not panic or overreact and was successful; the thought of spending a long evening at a local ER was not appealing. I just wanted to get back to my own house and the realization that I had a close encounter with death was still a new and astonishing revelation.

CAUTION: Always follow up a visit to your physician’s office following a choking incident for an examination of any remainder pieces or to assess any damages, including aspirating a piece of the object into the lung, which can result in pneumonia.




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Comments 38 comments

Huntgoddess profile image

Huntgoddess 4 years ago from Midwest U.S.A.

O. M. G. !!! ('G' for "Goodness" of course.)

This made me cry. I did have a similar experience, but not quite as bad as yours --- although I had the same "slow motion" and "life review".

I don't know how many times I've made the same mistakes --- biting off more than I can chew, and then trying to chew it anyway. My dental problems don't help, either. Thanks for the great info.

Thanks be to Providence that we are here alive now. Up, awesome, useful, beautiful.

I don't think it was very nice for the wait staff to just ignore you, though. They should have been calling 911 or something. One time, a lady even interrupted Mass because something happened to her mom. She just shouted out,"Somebody Call 911! Right now!"

I love the photos, also, and they're helpful. I hope more people vote in your poll. So far, I'm the only one.

I didn't know that about Tennessee Williams. Is that how he really died? That's horrible!


Denise Handlon profile image

Denise Handlon 4 years ago from North Carolina Author

Good morning HuntGoddess. I have to say, the wait staff was unaware-seriously unaware. There was another whole paragraph that I originally had in it and deleted it because it was already over 1600 words long. Now I'm wondering if that was such a good idea. The waiter could not believe what we were telling him because he was actually an arms reach away.

But, it just proves how quickly and how efficiently that my friend was and how the process can be. NO ONE KNEW that anything was amiss!!! They seated and served people all around us.

Heck, not sure what they were thinking we were doing with me bent over the table and him behind me squeezing me, haha! The waiter was so apologetic, though, for NOT noticing. That was part of the surrealness of the whole thing.

Glad that you are well also. It is a weird experience for sure, to know you are on the verge of that 'door to the other side'. Thanks for commenting and your vote.


Simone Smith profile image

Simone Smith 4 years ago from San Francisco

Whoah, what an experience! It's so fortunate that you had just gone through CPR training and your friend knew what to do. Great Hub, and I love your demonstrative photos!


Arlene V. Poma 4 years ago

VOTED UP AND EVERYTHING ELSE. Even if you can't wrap your arms around the person who is choking, you can instruct someone to do it. My father was choking on a piece of meat at a picnic, and I had just taken a CPR class. I was lucky to have my brother there to help me. I know this sounds weird, but he was able to save my dad--with coaching from me. This is certainly not the way to learn CPR!


Huntgoddess profile image

Huntgoddess 4 years ago from Midwest U.S.A.

Thanks for your response, Denise. "Door to the other side" --- that's a very accurate way of putting it. Yes, it is weird, very weird, and I hope to not stand at that door again any time soon.

". . . bent over the table and him behind me squeezing me, haha!" ~~ Indeed. That's what I was wondering. LOL!

Oh, so the wait staff just didn't notice. They must have been really busy! I thought you meant they knew and ignored you on purpose. But, yes, it does show how important it is to know the Heimlich.

Thanks again. I've posted and shared this all over. Very important info!


always exploring profile image

always exploring 4 years ago from Southern Illinois

This is a great article. I have had the same experience. I was working in a nursing home when this resident got choked on a peanut butter sandwich, when i performed the Heimlich-Maneuver the food shot across the floor. It is good that you explained it, maybe saving lives..Thank you for sharing


Denise Handlon profile image

Denise Handlon 4 years ago from North Carolina Author

Hi Simone-thanks for your feedback. It was really frightening and for weeks later I would tell Glen, "you're my bodyguard now when I eat" haha. But, it was I who went through the CPR-NOT my friend. He's never taken a first aid or CPR class in his life! That was part of the amazing thing about this very surreal experience.

Arlene, that does not surprise me that your father was saved via your guidance. Think of all of the telemed advise given out long distance. I recall a doctor in the Antarctica, I believe, who had to have emergency surgery and the docs in the country she was from gave instructions to her co-worker who was NOT a doctor! That's some guts.

Glad to know your father was saved that day. Shortly after my incident my daughter Cara reported to me that she had been at a workshop and they stepped outside to eat lunch. A woman a few people away from her began to choke on her food and had to have the H.M. done to her. It is a scary thing, but effective.


Denise Handlon profile image

Denise Handlon 4 years ago from North Carolina Author

Hunt Goddess- you're welcome. Thanks for the shares. Yes, the waiter was sooo apologetic and confused at first as to why I hadn't touched my 'delicious' chicken dinner that I had looked forward to eating. Yet, he was standing so close Glen could have reached his arm out (had he not had it wrapped around me! haha) and touched him.

Hi Ruby-thanks for adding your HM experience. It is an amazingly effective technique! Henry Heimlich did understand about pressure that's for sure. The controversy now is the 'broken ribs' that some victims end up with. Hmmmm, broken ribs vs death-sorry, I'll take the broken ribs! LOL Thanks for reading.


Huntgoddess profile image

Huntgoddess 4 years ago from Midwest U.S.A.

Okay, now I do understand. I thought they were just unfeeling or something.

YVW 4 shares. Everybody should know, and having the pix makes it easier.

Yes, I would also take the broken ribs :-)


Frank Atanacio profile image

Frank Atanacio 4 years ago from Shelton

this was a must read very useful Hub :)


Denise Handlon profile image

Denise Handlon 4 years ago from North Carolina Author

Haha Huntgoddess-glad you finally 'got it', LOL As I stated earlier I had to delte somethings and that was an area that didn't seem as important.

Frank, thank you for reading and commenting. :)


Danette Watt profile image

Danette Watt 4 years ago from Illinois

Very good info here and I hope I never have to go through this experience - on either end! The photos were a big help in showing how to do the maneuver. Voted up, useful and interesting.

I don't know if you remember this story or not but when Marty was a toddler, he began choking on a banana. Mom tried to scoop it out and when he kept choking, she grabbed him and started running next door. In the process, the jiggling and/or her pressure around his gut from carrying him dislodged the banana.

By the way, I knew about Tennessee Williams choking on a bottle cap - it pays to watch Jeopardy!


Denise Handlon profile image

Denise Handlon 4 years ago from North Carolina Author

Danette-LOL 'Jeopardy' hahaha. Thanks for reading and commenting. (and for the votes) I do have to say that I recall that story about Marty, HOWEVER, my version of it was that he choked on a piece of hot dog??? Hmmm I wonder if Marty recalls this, haha I'll have to check out the facts.


Happyboomernurse profile image

Happyboomernurse 4 years ago from South Carolina

Thank goodness your friend knew what to do. Thanks so much for sharing your own experience so that others may benefit from it. This hub can literally be life saving and I think the pictures were very good.

Isn't it strange how we can be in a training situation playing "victim" one week and be the real "victim" of choking the next? Just goes to show that this can happen to any of us at any time.

Thanks so much for sharing this info. Voted up across the board except for funny and I'm sharing this.


Vellur profile image

Vellur 4 years ago from Dubai

Excellent life saving information. Voted up. God blessed you with the breath of life that day. Am so glad you were OK.


Denise Handlon profile image

Denise Handlon 4 years ago from North Carolina Author

Gail-I agree...it is uncanny sometimes. Thanks for sharing.

Hi Vellur-thank you for your comments, that is beautiful.


Derdriu 4 years ago

Denise, What a calm, clear, controlled recounting of what must have been a frightening experience to be on the other side of the EMT interaction! In particular, I appreciate the identification of the somewhat controversial life-saving maneuver as well as its history and possible side-effects. Also, I like how you explain what it feels like to choke and how it looks to acquaintances and onlookers.

It's most user-friendly of you to involve us all in the timeliness of your article by including two pertinent polls, regarding choking and witnessing choking.

Respectfully, and with many thanks for sharing, Derdriu


Denise Handlon profile image

Denise Handlon 4 years ago from North Carolina Author

Derdriu-I appreciate your insightful comments. I especially like how you are so specific in what appeals to you. You are such a positive hubber. Thanks, you really brightened my morning.


Genna East profile image

Genna East 4 years ago from Massachusetts, USA

Oh Denise, what a terrifying event. Thank goodness you had someone there to help you who was calm and knew what to do. And your presence of mind was also quite remarkable; I’m quite sure I would have panicked. Thank you for sharing this story with us, as well as very useful information on this live-saving technique. Excellent write!


Denise Handlon profile image

Denise Handlon 4 years ago from North Carolina Author

Hi Genna, my youngest daughter was so grateful, she wrote my friend a 'thank you' note for saving my life. We were both touched by this sweet gesture. Thanks for your comments.


Pamela99 profile image

Pamela99 4 years ago from United States

This is an especially good topic for your hub, as you shared your personal experience with choking. It sounds very frightening. As a nurse we learned this maneuver in nursing school, but it is so simple everyone should learn how to save a life. This is a very useful hub. Rated up!


Faith Reaper profile image

Faith Reaper 4 years ago from southern USA

Denise, this is really great and useful information for sure. I am sorry you had to experience such. I know it was terrifying. Thank you for sharing this. In His Love, Faith Reaper


Denise Handlon profile image

Denise Handlon 4 years ago from North Carolina Author

Hi Pamela-thanks for reading and Happy Nurses Week to you. I agree-it is a simple and very effective method that can make the difference between life and death.

Hi Faith-Thanks for reading and commenting. Terrifying-yes, and mystifying afterwards. One cannot help but think of God, life and death and the Greater Plan in those moments. God Bless.


kelleyward 4 years ago

Hi Denise, I had to perform the Heimlich on my toddler. He was choking believe it or not on a tiny piece of bread. I called 911 because I couldn't get the bread out. It seemed like FOREVER but I just kept performing the Heimlich and 60 seconds before EMS was there I saw the bread and performed a finger sweep. It was one of the scariest things, even for an RN. Thanks for sharing this important article! Take care, Kelley


Denise Handlon profile image

Denise Handlon 4 years ago from North Carolina Author

Hi Kelley-thanks for sharing. I had to do something similar when my grandson was two. I was staying with my daughter for awhile after my husband's death, and the little one got into my cough drops and popped one in his mouth. He couldn't utter a sound, was turning blue and I instinctively turned him upside down, slapped his back hard once and it popped out. He was too startled at me hitting him to do anything but cry, and my daughter was thankful for the quick action, of course. I never hope to have to do that again!


Huntgoddess profile image

Huntgoddess 4 years ago from Midwest U.S.A.

Hi, Denise. Yes, I can be a little dense --- to say the least. Now I see what you meant.

OMG ~~ poor little grandson! So good you knew what to do, though. Phew !

Sorry about the loss of your husband.


Denise Handlon profile image

Denise Handlon 4 years ago from North Carolina Author

Huntgoddess...thank you for a revisit. :) and thanks for the condolences. Enjoy your approaching weekend.


Huntgoddess profile image

Huntgoddess 4 years ago from Midwest U.S.A.

Thanks, Denise. You, too, dear :-)


alissaroberts profile image

alissaroberts 4 years ago from Normandy, TN

Excellent information on how to give the Heimlich. Your directions with the pictures are so clear and helpful. I hope I never have to be on either end of that situation. And how scary for you to choke - thank goodness your friend stayed calm and knew how to help! Very useful hub - voted up!


Denise Handlon profile image

Denise Handlon 4 years ago from North Carolina Author

Thank you, HG--I will be working this w/e but hopefully, all will go smooth. I do 12 hr midnight shifts from 6:45 pm until 7:15 a.m. so it can be a bit gruelling with multiple days in a row. I've actually written some of my hubs about that subject, LOL.

Hello Alissa-I hope you never have to go through it as well. But, I am SO grateful that Glen was there and in calm control. It is amazing how quickly you will react if one of your children begins to choke. Never fear, it will be instinctual.


Huntgoddess profile image

Huntgoddess 4 years ago from Midwest U.S.A.

I do need to catch up on my Hub reading. So sorry I haven't been able to read Hubs as much as I'd like. Yours are always at the top of my list.

I fervently hope nobody ever needs to use the Heimlich. Keep praying!

Take care, Denise.


Denise Handlon profile image

Denise Handlon 4 years ago from North Carolina Author

Dear HG--I can COMPLETELY relate...I have been so behind in all of my reading it's shameful. I'm hoping my schedule in my personal life lightens up in June and frees me to do more of that. In the end, we can all only do the best we can do. :) No worries or apologies necessary! Thanks for your comment.


Suzie HQ profile image

Suzie HQ 4 years ago from Dublin, Ireland

Hi Denise, What a fantastic hub, everyone should read and know! Your own story was great to include, you were both so lucky you knew CPR and how not to panic. Your photos are excellent to show the steps, a really well written essential first aid procedure for us all. I did the Red Cross training here in Ireland through a job I had and it was so rewarding. Many thanks, voted and will share this on!:)


Denise Handlon profile image

Denise Handlon 4 years ago from North Carolina Author

Hi Suzie HQ Thanks for your feedback on this hub...knowing CPR is a confidence builder for anyone! I'm glad you had a chance to take a class. :)


Denise Handlon profile image

Denise Handlon 4 years ago from North Carolina Author

Hello doctorulna-so nice to see you here and I'm glad that you enjoyed the hub (and found it helpful). Since I last wrote this they actually have updated CPR again. It seems they are constantly critiquing this work, which is beneficial. Still...any knowledge and attempt to help is better than nothing, in my opinion. Thanks for stopping by.


Au fait profile image

Au fait 3 years ago from North Texas

Such important information that I have to share this with my followers. Thankfully I have never been in a situation where I needed this information, but who knows what tomorrow will bring? Everyone needs to know this just in case, and I see from your poll that 40% of those people who responded to the poll have had need of this knowledge. That's quite a few. Always better to be prepared than not. You never know who will need your help and when you will be in circumstances where you can make the difference between life and death for someone, whether it's a loved one or a stranger.

Voted up, useful, pinned to my "Health" board, and shared with my followers.


JayeWisdom profile image

JayeWisdom 3 years ago from Deep South, USA

This is a very important hub, and anyone not famliar with this lifesaving technique should study it carefully. I've not only used the Heimlich Maneuver (successfully) more than once, when my grandson was about seven years old he used it on himself with the back of a dining chair. He'd only recently learned about it in school. Knowing the HM can save someone's life--even your own!

Voted Up+++ and shared

Jaye


Denise Handlon profile image

Denise Handlon 3 years ago from North Carolina Author

Au Fait, thank you for your wonderful comment. I appreciate it. Also, thanks for the shares. :)

Jaye - thank you. How remarkable and quick thinking of your grandson. Thanks for the share and votes. :)

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