If you are in the correct position, you will have anatural midabdominal position and are unlikely todirect the thrust to the right or left. A rescuer too shortto reach around the waist of an unconscious victim canuse this technique. The rescuer can use their bodyweight to perform the maneuver.C H E S T T H R U S T S W I T H V I C T I MSTANDING OR SITTING.—This technique is usedonly in the late stages of pregnancy or in the markedlyobese victim. To perform chest thrusts with victimstanding or sitting, proceed as follows:Step 1—Stand behind the victim, with your armsdirectly under the victim’s armpits, and encircle thevictim’s chest.Step 2—Place the thumb side of your fist on themiddle of the victim’s sternum (breastbone), takingcare to avoid the xiphoid process and the margins of therib cage.Step 3—Grab your fist with the other hand andperform backward thrust until the foreign body isexpelled or the victim becomes unconscious. Seefigure 4-7.CHEST THRUSTS WITH VICTIM LYINGDOWN.—Chest thrusts should be used only for victimsin the late stages of pregnancy and when the Heimlichmaneuver cannot be applied effectively to theunconscious, markedly obese victim. To perform chestthrusts with victim lying down, proceed as follows:Step 1¾Place the victim on his back and kneelclose to the victim’s side.Step 2––Place the heel of your hand on the lowerportion of the sternum (in the same manner as youwould when performing chest compressions).Step 3––Deliver each thrust firmly and distinctly,with the intent of relieving the obstruction.M A N U A L R E M O VA L O F F O R E I G NBODY.—A foreign body can be removed byperforming a “finger sweep.” This procedure,however, must be performed on unconsciousvictims only (though not on seizure victims). Toperform a finger sweep, proceed as follows:Step 1––With the victim’s face up, open thevictim’s mouth by grasping both the tongue and lowerjaw between the thumb and fingers and lifting the jaw.This action draws the tongue away from the back of thethroat and away from a foreign body that may belodged there. This step alone may partially relieve theobstruction.Step 2––Insert the index finger of the other handdown along the inside of the cheek and deeply into thethroat to the base of the tongue.Step 3––Use a hooking action to dislodge theforeign body and maneuver it into the mouth so that itcan be removed. See figure 4-8.4-15Figure 4-7.—Administering the chest thrust to a consciousvictim who is standing.Figure 4-8.—Finger sweep.
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