For decades, the Heimlich maneuver has been considered the best method for helping someone who is choking. However, experts now suggest that a different technique may be safer and just as effective.
Since its introduction in 1974, the Heimlich maneuver has been the standard response for choking incidents. Typically, a first responder wraps their arms around the choking person from behind and pulls upward and inward on the abdomen. This pressure often expels whatever is blocking the airway.
However, recent studies have linked this method to injuries such as broken ribs, heart valve damage, and tears in the stomach and esophagus. In contrast, delivering back blows between the shoulder blades is a less invasive technique that can also dislodge an obstruction effectively.
In 2005, the American Red Cross updated its guidelines for foreign body airway obstruction (FBAO). They now recommend starting with five back blows before attempting five abdominal thrusts, also known as the Heimlich maneuver.
Grace Lawson, a lead EMT trainer with St John Ambulance, stated, “Starting with back blows is a better option, moving on to abdominal thrusts if necessary.” She emphasized that the abdominal thrusts associated with the Heimlich can cause significant harm.
Before performing any technique, communication is crucial. Lawson advises confirming if the person is choking or if an allergic reaction is causing the throat to swell. If the person cannot cough, she recommends supporting them from the front and administering up to five back blows using the heel of your hand.
If the obstruction remains, then abdominal thrusts can be attempted. Lawson also advises calling an ambulance if these measures do not work.
In 2022, choking accounted for around 5,500 deaths in the U.S., with the elderly and young children being the most vulnerable. Lawson practices caution at home, ensuring her young son does not walk while eating to minimize choking risks.
Following the choking death of five-time Olympic cyclist Daniela Larreal Chirinos last month, Dr. Tonia L. Farmer, an Ohio-based ear, nose, and throat surgeon, shared tips for individuals choking alone. She advises calling 911 and attempting to cough vigorously.
If coughing fails and no air is moving, Dr. Farmer recommends performing the Heimlich maneuver on oneself. One method is to thrust the abdomen against a chair or countertop, ensuring the surface has no sharp edges to avoid injury. If that doesn’t work, she suggests making a fist and thrusting it into the middle of the abdomen, just below the rib cage.
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