PERFORMING HEIMLICH MANEUVER

DEFINITION:
HEIMLICH MANEUVER – Is an emergency procedure for dislodging a bolus of food or other obstruction from
trachea to prevent asphyxiation.

ASSESSMENT:
1. Assess air exchange. A foreign body can be complete or partial. Partial airway obstruction will have some air
exchange. If the client can cough, this should be encouraged, and the nurse should not interfere with the
client’s efforts. The cough is usually accompanied by wheezing between coughs. If the client has complete
airway obstruction as indicated by a weak ineffective cough, high pitched inspiratory noises (stridor), and signs
of respiratory distress (cyanosis, loss of consciousness), intervention is necessary.
2. Establish airway obstruction. The universal sign of airway obstruction is clutching the neck with the hands.
In addition, the inability to talk or breathe as well as cyanosis and the progression to an unconscious state are
indicative of airway obstruction.
3. The pediatric client differentiate between infection and airway obstruction. Fevers, gradually increasing
respiratory distress, retractions, stridor. And drooling are all signs of infection. In this situation it is important
to maintain an upright position, keep the child as calm as possible, and seek immediate medical attention. The
Heimlich maneuver is not appropriate in these cases.

SPECIAL CONSIDERATION:
- Only individual with the training to perform this procedure

STEPS RATIONALE EXCELLENT VERY GOO FAIR POOR

FOREIGN BODY AIRWAY
OBSTRUCTION: ALL CLIENTS
1. Assess the airway for complete
or partial blockage
2. activate emergency response
GOOD D
5 4 3 2 1
If there is good air
exchange and the client
is able to cough
forcefully, the nurse
should not intervene
with the client’s
attempts to expel the
foreign body. The nurse
should encourage
attempts to cough and
will provide a more
forceful effort. If
complete airway
obstruction is apparent,
the Heimlich maneuver
or alternative method of
subdiaphragmatic thrust
should be performed
immediately.
Provides follow-up care
assistance if the client is in by professionally trained
respiratory distress or has personnel.
complete blockage; for example,
ask a bystander to call 911.
Conscious Adult Client: Sitting or
Standing (Heimlich Maneuver)
1. Stand behind the client.
2. wrap your arms around the Provides follow-up care
client’s waist. by professionally trained
personnel.
3. Make a fist with one hand and Correct hand placement
grasp the fist with the other is important to prevent
hand, placing the thumb side of internal organ damage.
the fist against the client’s
abdomen. The fist should be
placed midline, below the xiphoid
process and lower margins of the
rib cage and above the navel.
4. Perform a quick upward thrust This subdiaphragmatic
should be separate and distinct. thrust can produce an
artificial cough by forcing
air from the lungs.
5. Repeat this process six to 10 Attempts to dislodge
times until the client either expels food or a foreign body to
the foreign body or loses relieve airway
consciousness. obstruction should be
continued as long as
necessary owing to the
serious consequences of
hypoxia.
Unconscious Adult Client or
Adult Client Who Becomes
Unconscious
1. Repeat skills steps 1 and 2 Determines the need for
intervention and
summons essential help.
2. Position the client supine;
kneel astride the client’s
abdomen
3. Place the heel of the hand Proper positioning is
midline, below the xiphoid necessary to provide an
process and lower margin of the effective
rib cage and above the navel. subdiaphragmatic thrust.
Place the second hand directly on
top of the first hand.
4. Perform a quick upward thrust A client who becomes
into the diaphragm, repeating six unconscious may
to ten times. become more relaxed so

5. Perform a finger sweep
a. Use one hand to grasp the
lower jaw and tongue between
your thumb and fingers and lift.
This will open the mouth and pull
the tongue away from the back of
the throat.
b. using the index finger of the
hand. Insert the finger into the
client’s mouth next to the cheek,
and using a hooking motion,
dislodge any foreign body.
Caution must be used to prevent
pushing the foreign body father
down into the airway.
6. Open the client’s airway and
attempt ventilation.
7. Continue sequence of Heimlich
maneuver, finger sweep, and
rescue breathing as long as
necessary.
STUDENT SCORE
CHOKING MANAGEMENT FOR PEDIATRIC CHILD
STEPS
that the previously
unsuccessful Heimlich
maneuver may be
successful.
Should be used only on
the unconscious client,
who will not fight the
action,
a. Draws the tongue
away from the foreign
body lodged I the back of
the throat.
The brain can suffer
irreversible damage. It is
without oxygen for over
4-6 minutes.
Lifesaving efforts must
continue until they are
successful, or until the
rescuer becomes
exhausted and cannot go
on. Chest thrust should
be used only for the very
obese client or a woman
in the late stages of
pregnancy.
COMMENTS CI SIGNATURE ABOVE PRINTED
NAME/DATE
EXCELLENT VERY GOOD FAIR POOR
 GOOD
5 4 3 2 1
1. Survey the Scene – “The scene is safe. I found a person,
presumed choking”. Can you speak
2. Ask consent to significant other – “I am ______, a trained
First Aider. Can I help?”
3.Assess the client for signs of choking.
4. If with severe obstruction. Activate Medical Assistance and
transport facility.
5. Remove the clothing from infant’s chest (If it is easy to do)
6. Kneel or sit with infant on your lap.
7. Hold the infant facedown with the head slightly lower than
the chest, resting on your forearm.
8. Support the infant’s head and jaw with your hand.
9. Avoid compressing the soft tissues of the infant.
10. Rest forearm on the lap or thigh to support the infant.
11. Deliver up to 5 slaps forcefully between infant’s shoulder
blades, using the heel of your hand.
12. Craddle adequately the infant with two forearms. With
the palm of one hand supporting the face and jaw, while the
palm of the other hand supporting the back of the infant’s
head.
13. Turn the infant as unit while carefully supporting the hand
and neck.
14. Hold the infant’s face up with your forearm resting on
your thigh, keeping infant’s head lower than the trunk.
15. Provide up to 5 quick downward chest thrusts with 2
fingers in the middle of the chest over the lower half of the
breastbone.
16. Deliver chest trust at a rate of 1 per second, each with the
intention of creating enough force to dislodge the foreign
body.
17. Repeat the sequence of up to 5 back slaps and up to 5
chest thrusts until the object is removed or the infant
becomes responsive.
18. Open airway, using head-tilt, chin-lift method; then check
the mouth.
19. If an obstruction is visible, remove with finger sweep with
the use of small finger away from the body.
To relieve choking with in an unresponsive infant; Perform
the following steps:
20. Call for help. If someone responds, send that person to
activate emergency response system.
21. Place the infant on a firm, flat surface.
22. Check breathing and circulation for 10 seconds.
23. No Pulse, No breathing – give CPR
No breathing, has Pulse – Give Rescue Breathing
24. With Pulse, with Breathing – Recovery position
Note: Continue backslaps and chest thrust until obstruction is
expelled, or until emergency response tear or doctors.

STUDENT SCORE COMMENTS CI SIGNATURE ABOVE PRINTED NAME/DATE