Heimlich Maneuver (Abdominal Thrusts)
The Heimlich maneuver (now officially called abdominal thrusts) is an emergency first-aid technique used to dislodge a foreign object blocking the airway of a choking person. It involves standing behind the victim and delivering upward abdominal thrusts below the diaphragm to force air from the lungs and expel the obstruction.
Exam Tip
Conscious adult choking: abdominal thrusts (Heimlich). Pregnant/obese: CHEST thrusts. Infants: back blows + chest thrusts (never abdominal). If person becomes unconscious: start CPR. Universal choking sign = hands at throat. Always ask for consent and call for help.
What Is the Heimlich Maneuver?
The Heimlich maneuver, developed by Dr. Henry Heimlich in 1974, is the standard emergency response for conscious choking victims. The American Red Cross and American Heart Association now refer to it as "abdominal thrusts." CNAs must know how to recognize choking and perform abdominal thrusts, as this is a critical safety skill.
Recognizing Choking
| Sign | Partial Obstruction | Complete Obstruction |
|---|---|---|
| Coughing | Can cough forcefully | Cannot cough |
| Speaking | Can speak or make sounds | Cannot speak or make sounds |
| Breathing | Can breathe, may wheeze | Cannot breathe |
| Universal sign | May clutch throat | Clutches throat (universal choking sign) |
| Skin color | May be normal | Turns blue/cyanotic |
| Action | Encourage coughing | Perform abdominal thrusts immediately |
Steps for Conscious Adult/Child (Standing)
- Ask: "Are you choking? Can I help you?" (get consent)
- Call for help: Have someone call 911/code team
- Stand behind the person with one foot slightly in front of the other for stability
- Wrap your arms around the waist
- Make a fist with one hand, place the thumb side against the abdomen, above the navel and below the breastbone (xiphoid process)
- Grasp the fist with your other hand
- Deliver quick upward thrusts (inward and upward) until the object is expelled or the person becomes unconscious
- Each thrust should be a separate, distinct movement
Special Populations
| Population | Modification |
|---|---|
| Pregnant women | Chest thrusts (hands on center of breastbone, not abdomen) |
| Obese individuals | Chest thrusts if you cannot reach around the abdomen |
| Infants (under 1 year) | 5 back blows alternating with 5 chest thrusts (NOT abdominal thrusts) |
| Unconscious person | Begin CPR; look in mouth before rescue breaths; do NOT do blind finger sweeps |
| Yourself (alone) | Lean over a chair back or counter edge and thrust abdomen against it |
If the Person Becomes Unconscious
- Lower them gently to the floor
- Call 911 if not already done
- Begin CPR (30 compressions, 2 breaths)
- Each time you open the airway to give breaths, look for the object
- If visible, remove it; if not visible, do NOT do a blind finger sweep
Exam Alert
Choking response is a critical CNA safety skill. For conscious adults: abdominal thrusts (Heimlich). For pregnant or obese: chest thrusts. For infants: back blows and chest thrusts (never abdominal thrusts). If the person becomes unconscious: begin CPR. Always call for help. Know the universal choking sign (hands clutching throat).
Study This Term In
Related Terms
Aspiration
Aspiration is the entry of food, liquid, saliva, or other foreign material into the airway and lungs instead of the esophagus. Aspiration can cause choking, aspiration pneumonia, and in severe cases, death, making prevention a critical nursing assistant responsibility.
Dysphagia
Dysphagia is difficulty swallowing food, liquids, or saliva, which increases the risk of aspiration (food or liquid entering the airway), choking, malnutrition, and dehydration. Dysphagia is common in elderly patients and those with stroke, dementia, or neurological conditions.
Vital Signs
Vital signs are the fundamental measurements of basic body functions: temperature, pulse (heart rate), respirations (breathing rate), blood pressure, and pain (often called the "5th vital sign"). They provide critical data about a patient's physiological status and are assessed by all levels of nursing staff.
10 free AI interactions per day
Stay Updated
Get free exam tips and study guides delivered to your inbox.