SKILLS Heimlich Maneuver PROCEDURE 1. ESTABLISH scene safety. Activate medical assistance. Call for help Conscious Adult and Child 2. Assess client for signs of choking, ask if the patient is choking to confirm or if patient tries to expel obstruction by means of coughing forcefully. *If patient is able to cough forcefully, do not interfere but remain with the patient while continuously observing the patient’s status. 3. Stand behind the patient. Make a fist and place it 1 fingerbreadth above the navel. Give 5 abdominal thrust by supporting the balled fist with the other hand while providing upward inward thrust. 4. Reassess patient’s status. Check if the obstruction was expelled. If still choking, repeat step 3 until patient is relieved from choking. Unconscious Adult and Child 5. Assess client’s consciousness. If unresponsive, open airway by head tilt, chin lift maneuver. 6. Remove obstruction if visible by finger sweeping. If not seen, do not attempt. 7. Assess for pulse and breathing for seven seconds (1, 1002, 1003…1007) *If with pulse but breathless, give 2 rescue breaths by pinching the nose, ensuring adequate chest rise. If air bounces back for the first RB, retilt and reposition the head for the second RB. if still air bounces back proceed with chest compression. 8. Perform 30 chest compressions (1, 2, 3, 4, 5…30) 9. Check for the obstruction. If seen, do finger sweep, otherwise, do not attempt to do so. 1 2 3 4 5 REMARK

provide 2 rescue breaths (mouth to mouth and nose). 17. Conscious and Unconscious Infant Sandwich the infant face down. Draw an imaginary square in between the shoulder blades and use the heel of the hand in giving back blows. . If seen. ensuring adequate chest rise. Gently compress the chest about 1. in the center of the chest. Head should be lower than the body. *If air bounces back for the first RB. 13. the patient exhibits negative pulse and negative breathing. 12. 15. Force of blows depends upon the size and built of the patient. But if the obstruction is not visible. Give 5 back blows to the infant.10. do not attempt to do finger sweep. perform CPR. do finger sweep. retilt and reposition the head. 11. Assess for the brachial pulse and breathing. 14. perform CPR. Assess for the obstruction. Repeat steps 7 to 9 until obstruction is removed.5 inches for 5 times. and give another blow. Sandwich the infant face up or place the infant in firm flat table Give 5 chest thrust using 2-finger technique.repeat steps 11 to 15. If upon assessment. 16. Imagine a horizontal line drawn between the infant’s nipples. If infant became pulseless and breathless. If air bounces back again. Place two fingers of one hand just below this line. If with pulse but negative breathing.