Explained: What Is ‘Heimlich Manoeuvre’? First Aid That Can Save Someone Choking On Food

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US media has been widely reporting how a nine-year-old schoolgirl in Racine, Wisconsin, saved the life of one of her classmates, who was choking on her food. The child, Essie Collier, performed the ‘Heimlich manoeuvre’, which she had learnt about in a YouTube video two years ago.

What is the Heimlich manoeuvre?

The Heimlich manoeuvre is a first-aid technique to save people who are choking on their food. Named after American surgeon Henry J Heimlich, it does not require specialised medical knowledge. It involves a series of simple steps that one needs to learn, so that one can perform it if such an emergency arises.

As described on the website of Harvard Medical School, these steps are:

“Stand behind the person and wrap your arms around his or her waist.

“While making a fist, press your thumb into the person’s abdomen, just above the navel but below the ribcage.

“Wrap your other hand around your fist and then thrust upward quickly into the person’s upper abdomen to expel the object.

”Repeat until the object is expelled.”

The object referred to is the food item on which the victim is choking.

How it began

Dr Henry J Heimlich first described it in the journal Emergency Medicine in 1974. In his article, Dr Heimlich noted that every year in the United States, 3,900 people were strangling on food.

“The incident generally occurs at the dinner table. The victim suddenly chokes, turns blue or black, and is dead in minutes. He can neither speak nor help himself. And chances are no one else will help him either since bystanders frequently confuse the episode with a heart attack,” Dr Heimlich wrote.

Dr Heimlich stressed the need for a first aid procedure that would not require specialised instruments or equipment and could be performed by any person who knew the technique. It could even be considered by a physician, he wrote.

“So, experimentally at least, I have developed such a procedure. It’s been tested only on dogs but I believe the logic of the concept and the favourable findings warrant public dissemination,” he wrote.

The right technique

Dr Heimlich had tested his procedure with beagle dogs and large chunks of meat. He used several physical manoeuvres before arriving at the ideal technique. He was intrigued to find that when he pressed upward on the dog’s diaphragm, the meat shot out, according to an article in PBS in 2006.

“… Heimlich then worked on adapting the manoeuvre for people of all shapes and sizes from small children and women to large men. His prescription was a simple one: ‘Place the thumb side of your fist before the rib cage, just above the belly button, grasp the fist with the other hand and press the fist inward and upward. Perform it firmly and smoothly and repeat until choking object is dislodged’,” the article said.

How it became popular

Arthur Snider, a reporter who wrote a medical column for the Chicago Daily News, which was syndicated in several newspapers, described the Heimlich manoeuvre in his column in June 16, 1974. On June 23, that year, a newspaper in Seattle reported: “News Article Helps Prevent a Choking Death”, according to the PBS article. A retired restaurant owner, named Isaac Piha, who had read Snider’s article, performed the Heimlich manoeuvre to save a woman named Irene Bogachus.

Subsequently, more such cases were reported.

The August 12, 1974 issue of the Journal of the American Medical Association first referred to the procedure as “the Heimlich Manoeuvre”. On October 27, 1975, Dr Heimlich published a peer-reviewed article in the same journal, entitled “A Life Saving Maneuver to Prevent Choking”.

Today, the Heimlich manoeuvre is widely known among medical practitioners, although this is not the only technique they recommend for reviving people who have choked on food.