Abdominal Thrusts

Adult | Child | Infant | Pregnant Woman or Obese Person

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Choking Adult

Conscious Adult

If a person is clutching his or her throat with both hands, he or she is making the universal sign for choking. If the person can cough or talk, encourage him or her to continue coughing. Once the victim can no longer talk or cough, you must clear the obstructed airway. To clear the obstructed airway that causes choking, you must perform the Heimlich maneuver, also known as abdominal thrusts. Stand behind the conscious choking adult, wrapping your arms around his or her waist. With one hand, make a fist. Place the thumb side of the fist against the victim's abdomen just above the bellybutton. Be sure your hand is far below the tip of the breastbone. Put your other hand over the fist and give quick upward thrusts into the victim's abdomen. Continue giving thrusts until the object blocking the airway is dislodged and the victim begins to breathe, or until the victim becomes unconscious.

Unconscious Adult

If, during the primary survey, your breaths will not go in an unconscious adult, and you retilted the head and tried again but the breaths still would not go in, you must assume the victim's airway is obstructed.

If the victim is a conscious choking adult who became unconscious, you must lower him or her to the floor on his or her back. Perform a head tilt and chin lift to try to open the airway, and attempt to remove the obstruction by sweeping it out of the victim's mouth with your finger. This is called a finger sweep. Always use a hooking action, being careful not to lodge the object in further. Perform a head tilt and a chin lift and give 2 slow breaths. If the breaths still do not go in, go to abdominal thrusts.

Straddle one or both of the victim's thighs. Place the heel of one hand on the victim's abdomen, just above the bellybutton yet far below the tip of the breastbone. Place your other hand on top of the first, interlacing your fingers, and give 5 quick upward thrusts. Then do a finger sweep and give 2 slow breaths. If air still will not go in, continue giving 5 abdominal thrusts, a finger sweep and 2 slow breaths. Continue giving thrusts until the object is dislodged, air goes into the victim, or trained medical personnel takes over. If the victim is not breathing but has a pulse, you must perform Rescue Breathing. If the victim is not breathing and does not have a pulse, go to CPR.

 

Choking Child

Conscious Child

If the child can cough or talk, encourage him or her to continue coughing. If the child cannot cough or talk, ask if he or she is choking. Perform abdominal thrusts. Stand behind the victim, wrap your arms around his or her waist, and make a fist with one hand. Place the thumb side of the fist against the child's abdomen, above the bellybutton yet far below the tip of the breastbone. Put your other hand over the fist and give quick upward thrusts into the victim's abdomen. Continue giving thrusts until the airway is cleared and the child begins to breathe, or until the child becomes unconscious.

Unconscious Child

If the child was a conscious choking victim who became unconscious, lower the child down onto his or her back. Or, you may have determined during the primary survey that air would not go in, even after you retilted and tried again. You must give the child 5 abdominal thrusts, do a finger sweep if you see the object, and open the airway with a head tilt and a chin lift and give 2 slow breaths. If the breaths still will not go in, continue giving abdominal thrusts, a finger sweep and 2 slow breaths until the object is expelled, the child starts to breathe or cough, or EMS takes over. If the child is not breathing but has a pulse, you must perform Rescue Breathing. If the child is not breathing and does not have a pulse, go to CPR.

 

Choking Infant

Conscious Infant

During the primary survey, you may determine that the infant is conscious and cannot breathe, cough or cry. You must give 5 back blows and 5 chest thrusts.

Place the infant faceup on your forearm. Put your other arm on top of the infant. Use your thumb and fingers to hold the infant's jaw, sandwiching the infant between your forearms. Turn the infant over, facedown on your forearm. Place your arm down on your thigh, being sure that the infant's head is lower than his or her chest. Using the heel of your hand, give 5 back blows between the infant's shoulder blades. Be sure to hold the infant's jaw with your thumb and fingers to stabilize his or her head.

You must turn the infant back over to give chest thrusts. Place your free hand and forearm across the infant, sandwiching it between your forearms and supporting his or her head . Turn the infant over onto his or her back and place your arm down on your thigh, making sure the infant's head is lower than his or her chest. Imagine a line across the infant's chest between the nipples. Place your ring finger on the infant's breastbone just below the imaginary line. Place the pads of the next two fingers just under the line. Raise your ring finger, and if you can feel the notch at the tip of the infant's breastbone, move your fingers up a little bit. Compress the infant's breastbone 1/2-1 inch with the pads of your fingers and then let the breastbone return to its normal position. Give 5 compressions. Continue giving back blows and chest thrusts until the infant can breathe or cough, or until the infant becomes unconscious.

Unconscious Infant

If the infant was a conscious choking victim who became unconscious, place the infant down on its back. Or, you may have determined during the primary survey, even after retilting the head and trying again, that air would not go in. Perform 5 back blows and then 5 chest thrusts. Do a foreign body check: open the infant's mouth, holding the tongue and lower jaw and lifting them upward, and look for an object; if you do see an object, do a finger sweep to remove it with your little finger. Then give 2 slow breaths. If air still will not go in, continue doing back blows, chest thrusts, foreign body check and 2 slow breaths until the infant starts to breathe or cough or air goes in. If the infant is not breathing but has a pulse, you must perform Rescue Breathing. If the infant is not breathing and does not have a pulse, go to CPR.

 

Choking Pregnant Woman or Obese Person

Conscious Adult

If a choking conscious adult is noticeably pregnant or too obese for you to wrap your arms around in order to perform abdominal thrusts, you must give chest thrusts instead. Stand behind the victim, placing your arms under the victim's armpits and around his or her chest. Make a fist with one hand and put the thumb side of the fist against the center of the victim's breastbone. Make sure your thumb is on the breastbone, not the ribs, and that you are not near the tip of the breastbone. Put your other hand over the fist and give quick inward thrusts. Continue giving thrusts until the object is dislodged, or until the victim becomes unconscious.

Unconscious Adult

If the victim was a conscious choking pregnant woman or obese person who became unconscious, lower the victim gently onto his or her back on the floor. Or, you may have determined during the primary survey, even after retilting the head and trying again, that air woiuld not go into your pregnant or obese victim. You must give chest thrusts. Kneel beside the victim, placing one hand on the center of the victim's breastbone and then placing your other hand on top of it. Give 5 quick thrusts, compressing the chest 1 1/2-2 inches. Do a finger sweep, open the airway with a head tilt and a chin lift, and give 2 slow breaths. If air still will not go in, continue giving chest thrusts, finger sweeps and 2 slow breaths until the object is expelled and air goes in. If the victim is not breathing and has a pulse, go to Rescue Breathing. If the victim is not breathing and does not have a pulse, go to CPR.  

 

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