Please note that this information does not qualify you as an official first aider, and Virtual College advise calling 999 in the first instance at the scene of an emergency.
This material and any associated assessments do not constitute a qualification or accreditation as an official first aider. All content provided is for general information only.
Virtual College advocate dialling the emergency services before attempting any form of first aid.
The Heimlich Manoeuvre, also known as ‘abdominal thrusts’, is a first aid technique that aims to expel foreign objects in the upper respiratory system that are causing a person to choke. First named in 1974, this straightforward technique is now widely used across the world by professionals and the public alike, along with other methods to resolve airway obstructions. It does this by putting pressure on the diaphragm and compressing the lungs in order to force out obstructions.
In this article, we’re going to explain when to use the Heimlich manoeuvre and a step-by-step guide on how the perform this.
Blockages in the airway will naturally make it difficult for a person to speak, so they are unlikely to be able to tell you that they are experiencing difficulties. First aiders can generally tell that a person is choking if they struggle to speak, are attempting to cough, are turning red, or if they are gesturing towards or are holding their throat. There is also an option to perform a variant of this technique on yourself if you were choking.
The primary survey is a method of assessing a first aid situation such as this, and is one of the courses delivered by Virtual College. Click here to find out more.
Note: This technique can be used on anyone over the age of 1, but it is important to be aware that the nature of the manoeuvre means that the Heimlich for children can cause bruising to the abdomen, and even broken ribs, so should be applied with caution.
Step 1: The first step is encouraging the person to cough, as this will dislodge the blockage in many typical and milder situations. Move immediately onto the next step if the person is unable to do so, or if it proves ineffective.
Step 2: The next step, and before you move onto the Heimlich manoeuvre itself, is to firmly slap the person’s back just between their shoulder blades. It’s recommended this is done at least five times before moving on. It’s also important to note that if possible, you should watch the person’s mouth while doing this, to see if you can see the expelling of the foreign object. Again, many instances of choking will be resolved by this.
Step 3: To begin the Heimlich manoeuvre, stand behind the choking person, and wrap your arms around their waist. If you’re unable to do this, then read through the instructions in the next section.
Step 4: Make a fist with one of your hands, and place the thumb-side of it just underneath their rib cage, above the midriff.
Step 5: Take your other hand, and firmly grasp your fist.
Step 6: Press sharply in- and upwards into the person’s upper abdomen, again just below the rib cage. You should not squeeze the rib cage; your aim is to use your hand and fist to put quick pressure on the bottom of the diaphragm. Many authorities liken this to the action you would take if you were trying to lift the person up.
Step 7: Repeat this process until the obstruction is expelled from the person’s airway. Some medical experts do recommend alternating between the Heimlich manoeuvre and back slaps.
On an unconscious person, or where you cannot reach the full way round the person:
Step 1: Either place the person on their back, or instruct them to lie on their back.
Step 2: Facing the person, straddle their hips.
Step 3: Place the heel of one of your hands just below the person’s rib cage at the top of their abdomen, and place your other hand on top.
Step 4: Press sharply inwards and upwards into the upper abdomen.
Step 5: Repeat this process until the obstruction is expelled from the person’s airway.
Performing the Heimlich Manoeuvre On Yourself:
Step 1: Make a fist with one of your hands, and place the thumb-side of it just underneath your rib cage, above the midriff.
Step 2: Take your other hand, and firmly grasp your fist.
Step 3: Push sharply upwards and inwards towards your upper abdomen
Step 4: Repeat the process until the obstruction is dislodged from your airway.
Note: You do also have the option of using an object to help you. The back of a chair for instance can be used in place of your fist.
If none of your attempts at choking first aid are successful, then you must call 999 immediately (if you haven’t already), and begin giving CPR.
For more information about how Virtual College can help you and your employees deal with first aid situations, such as a choking casualty, then please visit our section on health and safety courses.