The Heimlich maneuver is a lifesaving method you can do on someone who is choking, or on yourself if you’re choking and alone. It's also called abdominal thrusts.
Signs of Choking
Choking happens when you get an object lodged in your windpipe and it blocks your flow of air. When someone is choking, you may see one or more of the following signs:
- Their hands may be clutched around their throat.
- They may look panicked or confused.
- They can’t talk.
- Their breathing is strained or louder than usual.
- They may cough weakly or forcefully.
- Their skin, lips, and nails may start to turn blue or gray.
- They may lose consciousness (pass out).
Signs of choking in babies
Because babies can’t signal that they’re choking, some of their symptoms may be different. A baby is likely choking if:
- They can’t cry or make a sound.
- Their skin may be a bluish color.
- They make soft or high-pitched sounds while trying to take a breath in.
- They can’t cough or display other signs of difficulty breathing.
- They lose consciousness.
When to Call 911
If you’re the only person around, help the person choking first and then call 911. If there are others to help, have one person call 911 while the other begins helping. Don’t hesitate to call 911 if you see any of the signs of choking, especially:
- The person’s face is turning red or blue.
- The person can’t talk.
- The person is having trouble breathing or has noisy breathing.
- The person is unconscious.
While you wait for medics to arrive, start the Heimlich maneuver.
What Is the Heimlich Maneuver?
It's a lifesaving method discovered by a doctor named Henry Heimlich in 1974. This technique uses the trapped air in the lungs of someone who's choking to help eject the object blocking their airway.
Before the invention of the Heimlich maneuver, doctors recommended back slaps as a way to help people who were choking.
How to Do the Heimlich Maneuver on Someone Else
You can ask a person who looks like they’re choking, “Are you choking?” They may be able to make a weak cough, but not other sounds, and they may also do the universal sign for choking, which is two hands crossed, clutching the throat.
To do the Heimlich maneuver:
- Stand behind the person and wrap your arms around the waist.
- Place your clenched fist just above the person’s navel. Grab your fist with your other hand.
- Quickly pull inward and upward as if trying to lift the person up. Do this five times. (This is called abdominal thrusts.)
- If the blockage is still not dislodged, continue cycles of five back blows and five abdominal thrusts until the object is coughed up or the person starts to breathe or cough.
- Take the object out of their mouth only if you can see it. Never do a finger sweep unless you can see the object in the person's mouth.
How to do the Heimlich maneuver on bigger bodies
If the person who is choking has a larger body, you may need to alter how you do the Heimlich. The abdominal thrusts should be higher:
- Stand behind the person, wrap your arms around them, and position your hands at the base of the breastbone (sternum).
- Quickly pull inward and upward.
- Repeat until the object is dislodged.
Heimlich maneuver for a pregnant person
You should also position your hands higher for abdominal thrusts on anyone who is pregnant and choking. Like you would for someone with a larger body, put your hands at the base of the breastbone, on the chest, before doing thrusts.
How to Do the Heimlich Maneuver on Yourself
If no one is with you and you start choking, you can do the Heimlich maneuver on yourself. Follow these steps:
- Make a fist with one of your hands and wrap your other hand around it.
- Put the thumb side of your fist just below your ribcage and about 2 inches above your belly button.
- Thrust your hands inward and upward quickly five times.
- Repeat this process until the object comes free.
Another method you can try is to stand facing a railing, chair, or table ledge and then sharply and quickly thrust your upper abdominal area against the edge.
How to Do the Heimlich Maneuver on Pets
The Heimlich maneuver isn’t only for people. If you notice your cat or dog is choking, you may be able to help. Look for signs and then try these methods.
Heimlich maneuver for dogs
A choking dog might make choking sounds or paw at their muzzle and drool. You may notice them rubbing their face on the floor, or they may cough and gag. These can be signs of illness or disease, too, so take a look for other signs, such as blue lips.
To check for an object causing choking:
- Pry open their jaws carefully and look inside with a flashlight.
- Use an index finger to do a mouth sweep.
- If you see an object but can’t reach it, try to break it up or remove it with small tongs.
- If you see a large object, you may be able to pop it out by pressing upwards with your thumbs underneath both sides of the dog’s jaw near the base of the throat.
- If you aren’t able to see the object choking your dog, don’t reach back in the throat. Start the Heimlich maneuver.
To do the Heimlich maneuver on a small dog, you can try two different methods:
- Hold them with their back to your front. Use the thumb side of your fist to gently thrust inwards and upwards on the soft spot of their abdomen, under the ribs.
- Lay the dog on their back. Find the soft spot on the abdomen under the ribs. Using the heel of your hand, gently press inwards and upwards.
For larger dogs:
- Hold your dog up on their hind legs like they’re a person on two legs with their back to your front. Find the soft spot on the abdomen under the ribs. Using your fist, thrust inwards and upwards.
- Lay the dog on their side. Find the soft spot on their abdomen under the ribs. Supporting them from the back, press a fist upwards and inwards towards their spine.
If your dog isn’t breathing, use CPR instead.
Heimlich maneuver for cats
For cats, check if you can see an object in their throat by prying open their mouth and looking inside. If you can’t get it out with your fingers, gently pick them up by their thighs and swing them in the air from side to side. If that doesn’t help to dislodge the object, apply forward pressure to the cat’s abdomen just behind the rib cage.
When to Not Do the Heimlich Maneuver
You should only use the Heimlich method on people who are conscious and can’t breathe or talk. If someone who is choking is unconscious, they need CPR instead.
If you think someone is choking and they can cough normally, they may be able to dislodge the object with more coughing.
The Heimlich maneuver is only for people over 12 months old. (For children under 12 months old, use back slaps.)
Heimlich Maneuver Alternatives
You may need an alternate method to help someone who is choking if you can’t reach far enough around them or they’re in a position (such as in bed or in a wheelchair) that prevents you from doing the method. You may also want to try alternatives if you try the Heimlich maneuver and it doesn’t dislodge the object.
- Back blows. From behind the choking person, put your arm diagonally across their chest and bend them forward so they’re parallel to the ground. Use the heel of your hand to give firm blows on their back between their shoulder blades.
- Chest thrusts. Get in the same position you would for abdominal thrusts, behind the choking person. Place the thumb side of your fist against the center of their chest on the lower half of their breast bone. Cover your fist with your other hand and pull straight back to thrust against them.
Choking Prevention
Protect yourself and those you love from potential choking hazards.
- Don’t attempt large bites. Cut food into small pieces.
- Chew your food slowly and all the way, especially if you wear dentures.
- Focus on chewing and swallowing only when you take a bite. Don’t try to talk or laugh at the same time.
- Don't drink lots of alcohol before and during meals.
To prevent choking in children:
- Keep their living areas free of small objects they could put in their mouth, such as marbles, thumbtacks, coins, and balloons. As a general rule, objects that are less than 1.75 inches in diameter are a choking hazard.
- Teach kids to sit while eating and not walk or run with food in their mouth.
- Give kids under 4 food that won’t get lodged in their throat. Cut foods like grapes, cheese, and meats into very small pieces and avoid nuts or sticky candies that could cause a problem.
- Supervise your young child when they eat.
Takeaways
The Heimlich maneuver is a lifesaving first aid method to treat someone who's choking. It uses quick and hard thrusts with the fists on their abdomen to force stuck objects out of the airway. The Heimlich is only for people over 12 months old and pets who are conscious and choking. You can also perform the Heimlich maneuver on yourself.
Heimlich Maneuver FAQs
What is the Heimlich maneuver used for?
It’s a method used to dislodge objects stuck in someone’s airway. It uses the air in their lungs to push out the object that’s causing choking.
What do you do if someone is choking?
First, ask them if they’re choking. If they can cough, encourage them to do so. Second, have someone call 911. Third, stand behind the choking person, bend them forward, and give them five back blows between their shoulder blades with the heel of your hand. If that doesn’t work, stand behind them and perform the Heimlich maneuver by wrapping your arms around them and using your clasped hands to thrust upward forcefully just underneath their ribcage. Alternate between these steps until the object comes out.
What’s the difference between CPR and the Heimlich maneuver?
The Heimlich maneuver is for people who are choking and conscious (awake). CPR (cardiopulmonary resuscitation) combines chest compressions and rescue breaths to attempt to restart the heart and lungs in someone who's unconscious.
How do I correctly perform the Heimlich maneuver?
Stand behind the choking person and wrap your arms around their waist. Clench your fist and grasp it with the other hand. Place your hands just above their navel and quickly pull inward and upward as if you’re trying to lift the person off the ground. Do five abdominal thrusts.
What’s the BLS Heimlich maneuver?
It stands for “basic life support.” It’s another term for the Heimlich maneuver, or abdominal thrusts, the method that helps dislodge stuck objects in someone’s airway.
Does the Heimlich maneuver work?
Yes, it can save the life of someone who's choking. It’s generally safe to do. However, it’s possible to cause some damage if it isn’t done correctly.
