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For decades, the Heimlich maneuver has been lauded as the best course of action to save someone who is choking, but now experts say there is a better way.
Since it was published in 1974, the Heimlich maneuver has been the de facto emergency strategy for choking.
Typically, a first-aider would approach the choking person from behind, place their arms around them, and pull upwards and inwards on the abdomen; the pressure from this action can usually expel anything lodged in the airway.
However, research has linked the technique to damage to the ribs and heart valves and ruptures in the stomach and food pipe.
Far less invasive than the Heimlich, hitting someone in the back directly between the shoulder blades can be just as effective in dislodging an obstruction.
In 2005, the American Red Cross revised its recommendations for foreign body/airway obstruction (FBAO) to first administer five back blows and, if unsuccessful, then do five abdominal thrusts, AKA the Heimlich maneuver.
Grace Lawson, a lead EMT trainer with St John Ambulance, told The Mirror, “Going for back blows first is always a better option to start with and then moving onto abdominal thrusts.”
She notes that the abdominal thrusts that are the hallmark of the Heimlich “can cause quite a lot of damage to the casualty.”
Before beginning blows or thrusts, Grace says communication with the choking person is paramount, “We start by asking them if they are choking just in case it might be something like a severe allergy which has caused their throat to swell — a different reason for obstruction.”
Grace then asks if the patient can cough to see if the obstruction can be internally dislodged.
“If they can’t or the coughing is quite absent, then we would support them from the front across the shoulders and administer up to five back blows using the heel of your hand in between the shoulder blades,” she continued. “If it still hasn’t come out, then we do up to five of the abdominal thrusts. If that hasn’t worked, call an ambulance and repeat the process, so go back to back blows.”
There were around 5,500 choking deaths in the US in 2022, research shows, with the elderly and young children being most at risk.
Apropos of this, Grace revealed she does not let her young son walk around while he’s eating food to avoid the risk of choking. “I am a little bit more strict with my son now. Like I don’t let him run around with food. He sits in his chair, and if he’s not eating it, we take it away. He doesn’t eat while he’s walking around or anything.”
In the wake of five-time Olympic cyclist Daniela Larreal Chirinos’s death from choking last month, Ohio-based ear, nose, and throat surgeon Dr. Tonia L. Farmer shared exactly what to do if you’re alone and start to choke while eating. Dr. Farmer says to call 911 and try and cough as hard as you can.
“If that doesn’t work, if you can’t cough at all, no air is moving, you’re going to perform the Heimlich maneuver just like you would on somebody else,” Farmer said. “And there’s two ways that you can do that.”
The first is by thrusting your abdomen onto a chair or against a countertop to try to expel the food.
“You want to make sure that the chair that you are using does not have any sharp edges because you don’t want to cut into your abdomen,” Farmer added. “You don’t want to cause any internal injury.”
If that doesn’t work, make a fist and thrust it into the middle of your abdomen, underneath the rib cage, just like you would on someone else, Farmer said.
