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June 29, 2008

BehindTheMedspeak: The Heimlich Maneuver — Revisited

The other day I read the following in the autobiography of the late British businessman Charles Forte: "I had been invited to lunch there, and found myself sitting next to Lord Mountbatten. We got involved in a vigorous argument about the merits of a certain politician, whom I was denouncing loudly and he was defending. I got so carried away that I began to choke on a piece of meat. I rushed from the room, but my wife saw what had happened, followed me, and banged my back hard. The meat was fortunately dislodged. When I returned, I found that Mountbatten had taken the whole event extremely seriously. He had had a friend in India in the army who had died in such a way and he advised me always to keep a large glass of water by my plate to avoid any recurrences. When I next went to Broadlands, his home, the vital glass of water was by my plate."


In no particular order, some comments on the passage above.

1) More often than not, when an adult chokes on food in the manner described above, they've been drinking. This results in the ingestion of a piece of meat too large to be conveniently masticated which, along with the loss of coordination of upper airway and pharyngeal musculature due to alcohol's effect on the brain, can end in a potentially catastrophic anatomical obstruction as the meat comes to rest on the opening of the trachea behind the epiglottis.

2) If you suspect such a thing has happened to someone in the vicinity, DO NOT offer them a glass of water or bang on their back or ask "Are you OK?" Rather, the one question to ask (assuming they are still conscious, which will be the case if nothing is done for up to a minute) is, "Can you talk?" If the person shakes their head "No," immediately perform the Heimlich manuever (top).

3) In the event you are alone and find yourself with an obstructed airway, do not panic: you can perform the Heimlich manuever on yourself. Stand up in front of a table or chairback, then ram your upper abdomen as hard as you can against the edge. I mean really hard, so that it hurts. If it doesn't work the first time, do it over and over until the chunk of food pops out. You'll thank me for this. Trust me....

June 29, 2008 at 02:01 PM | Permalink


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The article reminded me of a time that we were eating dinner at a wedding reception. One of our friends was choking and got up and left the room, rather than choke in front of us. Luckily, my brother-in-law saw what was happening and followed him out. He had to perform the Heimlich maneuver on our friend. Please let people know, if they are choking, do not leave the room!!!

Posted by: ageekymom | Jul 1, 2008 6:43:19 PM

The Heimlich is not just for people; I onced saved a Weimaraner choking on a stick.

Posted by: Nick | Jun 30, 2008 12:03:14 PM

I had an obstructed airway once, and thankfully only once. As a young "I know it all" man, I was using vitamin C in an attempt to ward off colds from my class of 4th grader's (I only taught two years). I had chewable C that was more "natural" but each tablet was about 3/4 of an inch in diameter. I tried swallowing it whole. Instant obstruction. I can vividly (at least in my thinking) recall the look on my face in the mirror. No one around, I'm going to die type of look. I started looking around for a chair to fall on. I tried using the air left in my lungs and used my diaphragm to push out the air with all my might. It worked. The tablet pinged off the bathroom mirror, and I was mightily relieved. I hope I never have it happen again, but thank you for the reminder on the methods.

Posted by: Matt Penning | Jun 29, 2008 8:35:06 PM

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