Foreign-Body Airway ObstructionManagementForeign-body airway obstruction should beconsidered in any victim—especially a younger victim–who suddenly stops breathing, becomes cyanotic, orloses consciousness for no apparent reason.The Heimlich maneuver (subdiaphragmaticabdominal thrusts) is recommended for relievingforeign-body airway obstruction. By elevating thediaphragm, the Heimlich maneuver can force air fromthe lungs to create an artificial cough intended to expela foreign body obstructing the airway. Each individualthrust should be administered with the intent ofrelieving the obstruction. It may be necessary to repeatthe thrust several times to clear the airway. Five thrustsper sequence is recommended.When you perform this maneuver, you shouldguard against damage to internal organs, such asrupture or laceration of abdominal or thoracic viscera.To minimize this possibility, your hands should neverbe placed on the xiphoid process of the sternum or onthe lower margins of the rib cage. They should bebelow this area but above the navel and in the midline.Regurgitation may occur as a result of abdominalthrusts. Be prepared to position the patient soaspiration does not occur.HEIMLICH MANEUVER WITH VICTIMSTANDING OR SITTING.—To perform theHeimlich maneuver with victim standing or sitting,stand behind the victim, wrap your arms around thevictim’s waist, and proceed as follows:Step 1—Make a fist with one hand.Step 2—Place the thumb side of the fist against thevictim’s abdomen, in the midline slightly above thenavel and well below the tip of the xiphoid process.Step 3—Grasp the fist with the other hand andpress the fist into the victim’s abdomen with a quickupward thrust. See figure 4-5.Step 4—Repeat the thrusts and continue until theobject is expelled from the airway or the patientbecomes unconscious. Each new thrust should be aseparate and distinct movement.HEIMLICH MANEUVER WITH VICTIMLYING DOWN.—To perform the Heimlichmaneuver with victim lying down, proceed as follows:Step 1—Place the victim in the supine position(face up).Step 2—Kneel astride the victim’s thighs andplace heel of one hand against the victim’s abdomen,in the midline slightly above the navel and well belowthe tip of the xiphoid.Step 3—Place the second hand directly on top ofthe first.Step 4—Press into the abdomen with a quickupward thrust. See figure 4-6.4-14Figure 4-5.—Administering the Heimlich maneuver to aconscious victim who is standing.Figure 4-6.—Administering the Heimlich maneuver to anunconscious victim who is lying down.
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