When and How to Perform the Heimlich Maneuver

Parents of young children know all too well that small objects and pieces of food can easily get lodged in the throat. This can cause choking, which closes off the airway. Big kids and adults are also at risk of choking. The Heimlich maneuver is a tool used to help someone who is choking.

This article explains how to tell if someone is choking and how to help them based on their age.

Verywell / Laura Porter

History of the Heimlich Maneuver

In the early 1970s, Henry J. Heimlich, MD, developed a first aid technique for choking, known as the Heimlich maneuver. Dr. Heimlich developed this tool, also called abdominal thrusts, after reading an article about accidental deaths. He was shocked to learn that choking was a leading cause of death, especially in children under 3 years of age.

He even used his maneuver himself. At age 96, Dr. Heimlich used this technique on a fellow diner at his home, saving the life of an 87-year-old woman who was choking.

How to Tell If Someone Is Choking

According to the American Red Cross, if a person is unable to breathe, cough, speak, or cry, they are likely choking. They may wave their arms above their head or point to their throat to indicate they are choking. They even may start to turn blue from lack of oxygen.

In these instances, timing is everything. Brain damage starts after approximately four minutes without oxygen.

How to Perform the Heimlich Maneuver

If a person is choking, there a few ways to help them. These techniques depend on the person's age, pregnancy status, and weight.

Performing the Heimlich maneuver has its risks. The performer may accidentally break a rib(s) of the person who is choking.

Adults and Children Over the Age of 1

The National Safety Council provides the following steps to help a person who is choking, if they are still conscious:

1. Stand behind the person with one leg forward between the person's legs.
2. For a child, move down to their level and keep your head to one side.
3. Put your arms around the person and locate their belly button.
4. Place the thumb side of one fist against the stomach just above their belly button.
5. Grasp your fist with your other hand and thrust inward and upward into the person's stomach. Use quick, thrusting movements five times or until they expel the item.
6. Continue thrusts until the person expels the object or becomes unresponsive.
7. If the person becomes unresponsive, begin CPR.
8. Seek medical attention as soon as possible.

Infants (Under 1 Year Old)

This technique is not safe for infants under 1 year old. Instead, place the infant on your forearm or thigh, make sure their head is supported, and hit their back with the palm of your hand until the item is expelled. Seek medical care immediately.

Pregnant Person or Person With Obesity

For a responsive pregnant person or person with obesity, give chest thrusts from behind. Avoid squeezing the ribs with your arms. Seek medical attention as soon as possible.

Yourself

If you are alone and choking, you can thrust yourself against the back of a chair to expel the object. This works better than trying to perform the thrusting motion on yourself.

When to Use the Heimlich Maneuver

If a person appears unable to speak or starts motioning toward their throat, they are likely choking. In these cases, it's crucial to help immediately.

Prevention

Ways to prevent choking include:

• Keep small and dangerous objects, like marbles and balloons, out of reach of children.
• Avoid giving small kids hard candy, ice cubes, and popcorn.
• Cut foods that kids can easily choke on into tiny pieces. This can include grapes and other fruit, raw carrots, hot dogs, and chunks of cheese.
• Supervise kids when they are eating.
• Avoid laughing or talking while chewing and swallowing.
• Take your time when eating, take small bites, and chew carefully.

Summary

The Heimlich maneuver is a technique used for people who are choking. There are different techniques to use based on age, pregnancy status, and weight. If a person becomes unconscious, perform CPR and have someone call 911 to get immediate medical care.

A Word From Verywell

Choking is an incredibly scary experience, because it happens so suddenly and immediate help is needed. Learning how to perform the Heimlich maneuver correctly can help save a life. After the choking event resolves, be sure to seek medical attention for yourself or the person who was choking.

Frequently Asked Questions

If the person is unconscious. In this scenario, start CPR immediately and have someone call 911 to get immediate medical attention.

Yes. This technique can save lives, but it has its risks. If a person performs this technique incorrectly, they might break a rib(s) of the person choking. However, this might be a small price to pay for saving a life.

Perform CPR and have someone call 911 at the same time. Timing is everything. A person starts developing brain damage after approximately four minutes without oxygen.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

1. Heimlich H, American Broncho-Esophogeological Association. Historical essay: the Heimlich maneuver.
2. GraCincinnati Inquirer. At 96, Heimlich performs his own maneuver.
3. American Red Cross. Conscious choking.
4. Johns Hopkins Medicine. Choking and the heimlich maneuver.
5. National Safety Council. Choking prevention and rescue tips.
6. Cleveland Clinic. Heimlich maneuver.
7. Pavitt MJ, Swanton LL, Hind M, et al. Choking on a foreign body: a physiological study of the effectiveness of abdominal thrust manoeuvres to increase thoracic pressure. Thorax. 2017;72(6): 576–578. doi:10.1136/thoraxjnl-2016-209540

By Lauren Evoy Davis
Evoy Davis is a health journalist based in Chesapeake Bay, Maryland. She is a member of the American Society of Healthcare Journalists.

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