Heimlich Maneuver (Abdominal Thrusts)

Abdominal Thrusts and Severe Choking

Abdominal thrusts are one part of the current adult choking response. The 2025 AHA adult BLS guideline recommends alternating five back blows with five abdominal thrusts for a responsive adult with severe airway obstruction.

Recognize the Situation

If the person can cough effectively, encourage coughing and monitor closely. Inability to speak, breathe or cough effectively signals severe obstruction. Call for help and activate the emergency response system.

Responsive Adult With Severe Obstruction

1. Give five back blows between the shoulder blades using the technique taught in your current first-aid course.
2. Give five abdominal thrusts: place a fist above the navel and below the breastbone, grasp it with the other hand and thrust inward/upward.
3. Repeat the cycles until the obstruction clears or the person becomes unresponsive.
4. Use chest thrusts instead of abdominal thrusts in late pregnancy or if the abdomen cannot be encircled.

If the person becomes unresponsive, lower them safely, activate emergency response if needed and start CPR beginning with compressions. Look for a visible object when opening the airway for breaths; never perform a blind finger sweep. Use age-specific training for children and infants; abdominal thrusts are not used for infants.

This written explanation does not replace supervised first-aid training.

Use the current care plan and the applicable state rules. Official guidance.