Ever wonder what to do if an infant began choking next to you? Ever wonder if one procedure was more effective than another? Well, one of our students did and emailed me a question about his topic. In this video blog entry I open up the discussion about back slaps and chest thrusts, what they do, and how they work to help a choking victim. Then at the end, I give you the secret about which one is more effective. Enjoy!
The Choking Child—A Life-Threatening Emergency
Evaluation of Current Recommendations
Susan B. Torrey, MD
Airway pressure with chest compressions versus Heimlich
manoeuvre in recently dead adults with complete airway
Accepted 22 November 1999. published online 17 August 2004.
In a previous case report a standard chest compression successfully removed a foreign body from the airway after the Heimlich manoeuvre had failed. Based on this case, standard chest compressions and Heimlich manoeuvres were performed by emergency physicians on 12 unselected cadavers with a simulated complete airway obstruction in a randomised crossover design. The mean peak airway pressure was significantly lower with abdominal thrusts compared to chest compressions, 26.4±19.8 cmH2O versus 40.8±16.4 cmH2O, respectively (P=0.005, 95% confidence interval for the mean difference 5.3–23.4 cmH2O). Standard chest compressions therefore have the potential of being more effective than the Heimlich manoeuvre for the management of complete airway obstruction by a foreign body in an unconscious patient. Removal of the Heimlich manoeuvre from the resuscitation algorithm for unconscious patients with suspected airway obstruction will also simplify training.
Heimlich vs Back Blows/Chest Thrusts
Consensus Guidelines Not Followed in 1985 Release Encouraging Heimlich Maneuver