Foreign-Body Airway Obstruction
Management
Foreign-body airway obstruction should be
considered in any victim—especially a younger victim
–who suddenly stops breathing, becomes cyanotic, or
loses consciousness for no apparent reason.
The Heimlich maneuver (subdiaphragmatic
abdominal thrusts) is recommended for relieving
foreign-body airway obstruction. By elevating the
diaphragm, the Heimlich maneuver can force air from
the lungs to create an artificial cough intended to expel
a foreign body obstructing the airway. Each individual
thrust should be administered with the intent of
relieving the obstruction. It may be necessary to repeat
the thrust several times to clear the airway. Five thrusts
per sequence is recommended.
When you perform this maneuver, you should
guard against damage to internal organs, such as
rupture or laceration of abdominal or thoracic viscera.
To minimize this possibility, your hands should never
be placed on the xiphoid process of the sternum or on
the lower margins of the rib cage. They should be
below this area but above the navel and in the midline.
Regurgitation may occur as a result of abdominal
thrusts.
Be prepared to position the patient so
aspiration does not occur.
HEIMLICH MANEUVER WITH VICTIM
STANDING OR SITTING.—To perform the
Heimlich maneuver with victim standing or sitting,
stand behind the victim, wrap your arms around the
victim’s waist, and proceed as follows:
Step 1—Make a fist with one hand.
Step 2—Place the thumb side of the fist against the
victim’s abdomen, in the midline slightly above the
navel and well below the tip of the xiphoid process.
Step 3—Grasp the fist with the other hand and
press the fist into the victim’s abdomen with a quick
upward thrust. See figure 4-5.
Step 4—Repeat the thrusts and continue until the
object is expelled from the airway or the patient
becomes unconscious. Each new thrust should be a
separate and distinct movement.
HEIMLICH MANEUVER WITH VICTIM
LYING DOWN.—To perform the Heimlich
maneuver 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 and
place heel of one hand against the victim’s abdomen,
in the midline slightly above the navel and well below
the tip of the xiphoid.
Step 3—Place the second hand directly on top of
the first.
Step 4—Press into the abdomen with a quick
upward thrust. See figure 4-6.
4-14
Figure 4-5.—Administering the Heimlich maneuver to a
conscious victim who is standing.
Figure 4-6.—Administering the Heimlich maneuver to an
unconscious victim who is lying down.
