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How to Perform the Heimlich Maneuver

The Heimlich maneuver (abdominal thrusts) is a three-step emergency response technique that can save a life in seconds. It is a simple action that will often dislodge food or another object from a person's airway when they are choking, as it provides an increase in pressure in the abdomen and chest, enabling the object to be expelled. The onset of choking will often be sudden, and knowing how to do it properly and being willing to use that knowledge can save someone's life. Learn the method for performing the Heimlich maneuver by following these simple steps.


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    Determine if the person truly choking. A choking victim will often have their hands around their throat and a desperate or panicked look on their face. They will not be able to breathe or speak, as they are suffering from complete airway obstruction (no air reaching their lungs). This means that they won't be able to respond to you when you ask if they're okay, or if they need help, other than nodding their head. Causes include food, trauma from injury or internal swelling from a severe allergic reaction. Look for the common symptoms of complete or total airway destruction:[1][2]
    • Cannot breathe, or is making obvious efforts to take in breaths with great difficulty (observe for any in-drawing of spaces between the ribs and above the collarbones)
    • Cannot speak effectively or at all
    • Noisy breathing
    • Inability to cough effectively
    • Blue or gray color to lips and fingernail beds, face is grayish, due to lack of oxygen
    • Clutching at throat with both hands (the universal sign for choking)
    • Loss of consciousness.
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    Reassure the victim immediately that you are going to help him or her. Realize that you call for emergency help after you've tried to save the victim as every second counts.[3] Have someone else call while you're attending the victim, if others are around.
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    Get the victim in a standing position. It can also be performed in a sitting position if the victim is too heavy for you or you're in a confined space such as a plane; just be sure to have plenty of room to perform the moves.
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    Do not perform back blows to a choking victim before proceeding to use the Heimlich maneuver. Although recommended by some first aid classes, they often only cause the object to be forced further down the trachea.[4]
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    Stand behind the victim. Stand with your legs separated, to form a "tripod" shape if the victim faints or becomes unconscious (this will help you to catch them and stabilize their fall quickly).
    • Reach around the victim from behind. Circle your hands around the victim's abdomen (stomach).
    • Make a fist with your dominant hand. The thumb of this fist should point into the stomach. Place this fist just above the victim's navel (belly button) and under the breastbone.
    • Wrap your other hand firmly around this fist. Be sure to keep your thumb away from the victim's body, to prevent injury to the victim.
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    Perform the Heimlich maneuver, also known as abdominal thrusts:
    • Pull inward and upward, pressing into the victim's abdomen with quick upward thrusts, using good force. Make the motion similar to the letter "J" – in, then up.
    • Make the thrusts quick and forceful, as if you are trying to lift the victim off his or her feet from this position.
    • Perform abdominal thrusts in quick succession. Repeat the series of thrusts until the object is dislodged and expelled. The victim will cough out the obstacle obstructing their airway if this maneuver is successful.
    • Use less force if the victim is a child.
    • If the victim falls unconscious, stop the thrusts immediately. Be aware that this can happen if the object is not removed.
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    Check to see if normal breathing has returned. Once the object is gone, most people will return to breathing normally. If normal breathing has not returned, continue the thrusts.
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    Call for help immediately if you fail to dislodge the obstruction. If the victim is unconscious, stop abdominal thrusts:
    • Call emergency services. Ask for immediate assistance. Have someone else do this where possible, to save time.
    • Seek to clear the victim's airway (check the mouth and see if you can dislodge anything obvious) and provide artificial respiration (CPR).
    • Remain with the victim constantly. This is life threatening and he or she could die any moment; continue to administer artificial respiration to try to prolong their chances.


  • If you ever have an opportunity through your school, college, employer, or other group, take a Red Cross or similar organization's first aid course. You will get hands-on experience with dummies and learn about other aspects such as legal issues, etc.
  • Also learn how to perform the Heimlich maneuver on yourself. It could save your own life.
  • If the victim can cough, encourage him or her to do that before attempting the Heimlich maneuver. If the victim can cough, do not use this technique as they are suffering from partial blockage and should be encouraged to cough the object out on their own. A strong cough will often dislodge an obstruction.
  • Watch out for falling victims; if they are indeed choking, at some point they will become unconscious, and fall. If this happens, help them to the ground and then begin abdominal thrusts on the patient.
  • If treating a pregnant woman or an obese person, modify your Heimlich maneuver technique as follows:[1]: 1)Place your hands higher than described above. The correct position is with the hands on the breast bone just above where the lowest ribs join. 2) Press hard into the chest with quick thrusts as described above. However, you will not be able to make the same upward thrusts.


  • If you do not know what to do, call your local emergency number. They can help to talk you through treating the victim (put them on loudspeaker).
  • Choking is life-threatening. Be prepared to act immediately if someone is experiencing this.
  • Do not attempt to slap a choking victim on the back if he or she is coughing! A coughing victim indicates only a partial blockage, and slapping one on the back can induce a full air blockage by lodging the object farther down. Allow him or her to cough up the blockage or show signs of choking before you intervene.

Sources and Citations

  • The Merck Manual of Medical Information, Choking, p. 1690, (2003), ISBN 978-0-7434-7733-8 – research source
  1., Choking:First Aid,
  2. St John, The New Zealand First Aid Handbook, Choking, p. 35, (2009), ISBN 978-014-301187-3
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