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The 'five-and-five' approach ------How to perform abdominal thrusts (Heimlich maneuver) on yourself
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A step-by-step guide explaining what to do in a choking emergency.
By Mayo Clinic Staff
The 'five-and-five' approach
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The 'five-and-five' approach
How to perform abdominal thrusts (Heimlich maneuver) on yourself
Open pop-up dialog box
How to perform abdominal thrusts (Heimlich maneuver) on yourself
Choking occurs when a foreign object lodges in the throat or windpipe, blocking the flow of air. In adults, a piece of food often is the culprit. Young children often swallow small objects. Because choking cuts off oxygen to the brain, give first aid as quickly as possible.
The universal sign for choking is hands clutched to the throat. If the person doesn't give the signal, look for these indications:
Inability to talk
Difficulty breathing or noisy breathing
Squeaky sounds when trying to breathe
Cough, which may either be weak or forceful
Skin, lips and nails turning blue or dusky
Skin that is flushed, then turns pale or bluish in color
Loss of consciousness
If the person is able to cough forcefully, the person should keep coughing. If the person is choking and can't talk, cry or laugh forcefully, the American Red Cross recommends a "five-and-five" approach to delivering first aid:
Give 5 back blows. Stand to the side and just behind a choking adult. For a child, kneel down behind. Place one arm across the person's chest for support. Bend the person over at the waist so that the upper body is parallel with the ground. Deliver five separate back blows between the person's shoulder blades with the heel of your hand.
Give 5 abdominal thrusts. Perform five abdominal thrusts (also known as the Heimlich maneuver).
Alternate between 5 blows and 5 thrusts until the blockage is dislodged.
The American Heart Association doesn't teach the back blow technique, only the abdominal thrust procedures. It's OK not to use back blows if you haven't learned the technique. Both approaches are acceptable.
To perform abdominal thrusts (Heimlich maneuver) on someone else:
Stand behind the person. Place one foot slightly in front of the other for balance. Wrap your arms around the waist. Tip the person forward slightly. If a child is choking, kneel down behind the child.
Make a fist with one hand. Position it slightly above the person's navel.
Grasp the fist with the other hand. Press hard into the abdomen with a quick, upward thrust — as if trying to lift the person up.
Perform between six and 10 abdominal thrusts until the blockage is dislodged.
If you're the only rescuer, perform back blows and abdominal thrusts before calling 911 or your local emergency number for help. If another person is available, have that person call for help while you perform first aid.
If the person becomes unconscious, perform standard cardiopulmonary resuscitation (CPR) with chest compressions and rescue breaths.
To perform abdominal thrusts (Heimlich maneuver) on yourself:
First, if you're alone and choking, call 911 or your local emergency number immediately. Then, although you'll be unable to effectively deliver back blows to yourself, you can still perform abdominal thrusts to dislodge the item.
Place a fist slightly above your navel.
Grasp your fist with the other hand and bend over a hard surface — a countertop or chair will do.
Shove your fist inward and upward.
To clear the airway of a pregnant woman or obese person:
Position your hands a little bit higher than with a normal Heimlich maneuver, at the base of the breastbone, just above the joining of the lowest ribs.
Proceed as with the Heimlich maneuver, pressing hard into the chest, with a quick thrust.
Repeat until the food or other blockage is dislodged. If the person becomes unconscious, follow the next steps.
To clear the airway of an unconscious person:
Lower the person on his or her back onto the floor, arms to the side.
Clear the airway. If a blockage is visible at the back of the throat or high in the throat, reach a finger into the mouth and sweep out the cause of the blockage. Don't try a finger sweep if you can't see the object. Be careful not to push the food or object deeper into the airway, which can happen easily in young children.
Begin CPR if the object remains lodged and the person doesn't respond after you take the above measures. The chest compressions used in CPR may dislodge the object. Remember to recheck the mouth periodically.
To clear the airway of a choking infant younger than age 1:
Assume a seated position and hold the infant facedown on your forearm, which is resting on your thigh. Support the infant's head and neck with your hand, and place the head lower than the trunk.
Thump the infant gently but firmly five times on the middle of the back using the heel of your hand. The combination of gravity and the back blows should release the blocking object. Keep your fingers pointed up to avoid hitting the infant in the
back of the head.
Turn the infant faceup on your forearm, resting on your thigh with the head lower than the trunk if the infant still isn't breathing. Using two fingers placed at the center of the infant's breastbone, give five quick chest compressions. Press down about 1 1/2 inches, and let the chest rise again in between each compression.
Repeat the back blows and chest thrusts if breathing doesn't resume. Call for emergency medical help.
Begin infant CPR if one of these techniques opens the airway but the infant doesn't resume breathing.
If the child is older than age 1 and conscious, give abdominal thrusts only. Be careful not to use too much force to avoid damaging ribs or internal organs.
To prepare yourself for these situations, learn the Heimlich maneuver and CPR in a certified first-aid training course.
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Una guía paso a paso que explica qué hacer en una emergencia por atragantamiento.
Por el personal de Mayo Clinic
El enfoque de 'cinco y cinco'
Abrir cuadro de diálogo emergente
El enfoque de 'cinco y cinco'
Cómo realizar compresiones abdominales (maniobra de Heimlich) en uno mismo
Abrir cuadro de diálogo emergente
Cómo realizar compresiones abdominales (maniobra de Heimlich) en uno mismo
La asfixia ocurre cuando un objeto extraño se aloja en la garganta o la tráquea, bloqueando el flujo de aire. En los adultos, un trozo de comida suele ser el culpable. Los niños pequeños a menudo tragan objetos pequeños. Debido a que la asfixia corta el oxígeno al cerebro, brinde primeros auxilios lo más rápido posible.
El signo universal de atragantamiento son las manos agarradas a la garganta. Si la persona no da la señal, busca estas indicaciones:
incapacidad para hablar
Dificultad para respirar o respiración ruidosa
Sonidos chirriantes al intentar respirar
Tos, que puede ser débil o fuerte
La piel, los labios y las uñas se vuelven azules u oscuros
Piel que está enrojecida, luego se vuelve pálida o de color azulado
Pérdida de consciencia
Si la persona puede toser con fuerza, debe seguir tosiendo. Si la persona se está asfixiando y no puede hablar, llorar o reír con fuerza, la Cruz Roja Americana recomienda un enfoque de "cinco y cinco" para brindar primeros auxilios:
Da 5 golpes en la espalda. Párese a un lado y justo detrás de un adulto que se está asfixiando. Para un niño, arrodíllate detrás. Coloque un brazo sobre el pecho de la persona como apoyo. Doble a la persona por la cintura para que la parte superior del cuerpo quede paralela al suelo. Dé cinco golpes separados en la espalda entre los omóplatos de la persona con la palma de su mano.
Dar 5 compresiones abdominales. Realice cinco compresiones abdominales (también conocidas como la maniobra de Heimlich).
Alterne entre 5 golpes y 5 empujes hasta que se desaloje el bloqueo.
La American Heart Association no enseña la técnica del golpe en la espalda, solo los procedimientos de empuje abdominal. Está bien no usar golpes en la espalda si no has aprendido la técnica. Ambos enfoques son aceptables.
Para realizar compresiones abdominales (maniobra de Heimlich) en otra persona:
Párese detrás de la persona. Coloque un pie ligeramente delante del otro para mantener el equilibrio. Envuelve tus brazos alrededor de la cintura. Incline a la persona ligeramente hacia adelante. Si un niño se está ahogando, arrodíllese detrás del niño.
Haz un puño con una mano. Colóquelo ligeramente por encima del ombligo de la persona.
Sujete el puño con la otra mano. Presiona con fuerza el abdomen con un empujón rápido hacia arriba, como si trataras de levantar a la persona.
Realice entre seis y 10 compresiones abdominales hasta que se desaloje la obstrucción.
Si usted es el único rescatista, aplique golpes en la espalda y compresiones abdominales antes de llamar al 911 o al número de emergencia local para pedir ayuda. Si hay otra persona disponible, pídale que pida ayuda mientras usted realiza los primeros auxilios.
Si la persona pierde el conocimiento, realice reanimación cardiopulmonar (RCP) estándar con compresiones torácicas y respiraciones boca a boca.
Para realizar compresiones abdominales (maniobra de Heimlich) en usted mismo:
Primero, si está solo y se está ahogando, llame al 911 o al número local de emergencias de inmediato. Luego, aunque no podrás darte golpes en la espalda de manera efectiva, aún puedes realizar compresiones abdominales para desalojar el objeto.
Coloque un puño ligeramente por encima de su ombligo.
Sujete el puño con la otra mano e inclínese sobre una superficie dura; una encimera o una silla servirán.
Empuje su puño hacia adentro y hacia arriba.
Para despejar las vías respiratorias de una mujer embarazada o una persona obesa:
Coloque las manos un poco más arriba que con una maniobra de Heimlich normal, en la base del esternón, justo encima de la unión de las costillas inferiores.
Proceda como con la maniobra de Heimlich, presionando con fuerza en el pecho, con un movimiento rápido.
Repita hasta que se desprenda la comida u otro bloqueo. Si la persona pierde el conocimiento, siga los siguientes pasos.
Para despejar las vías respiratorias de una persona inconsciente:
Baje a la persona de espaldas al suelo, con los brazos hacia los lados.
Despeje la vía aérea. Si se ve una obstrucción en la parte posterior de la garganta o en la parte superior de la garganta, introduzca un dedo en la boca y elimine la causa de la obstrucción. No intente barrer con el dedo si no puede ver el objeto. Tenga cuidado de no empujar la comida o el objeto más profundamente en las vías respiratorias, lo que puede ocurrir fácilmente en los niños pequeños.
Comience la RCP si el objeto permanece alojado y la persona no responde después de tomar las medidas anteriores. Las compresiones torácicas utilizadas en la RCP pueden desalojar el objeto. Recuerde volver a revisar la boca periódicamente.
Para despejar las vías respiratorias de un bebé menor de 1 año que se está asfixiando:
Asuma una posición sentada y sostenga al bebé boca abajo sobre su antebrazo, que descansa sobre su muslo. Sostenga la cabeza y el cuello del bebé con la mano y coloque la cabeza más abajo que el tronco.
Golpee al bebé suavemente pero con firmeza cinco veces en el medio de la espalda usando la base de su mano. La combinación de la gravedad y los golpes en la espalda deberían liberar el objeto bloqueador. Mantenga sus dedos apuntando hacia arriba para evitar golpear al bebé en la nuca.
Voltee al bebé boca arriba sobre su antebrazo, descanse sobre su muslo con la cabeza más baja que el tronco si el bebé aún no respira. Con dos dedos colocados en el centro del esternón del bebé, dé cinco compresiones torácicas rápidas. Presione hacia abajo aproximadamente 1 1/2 pulgadas y deje que el pecho se eleve nuevamente entre cada compresión.
Repita los golpes en la espalda y las compresiones en el pecho si no se reanuda la respiración. Solicite ayuda médica de emergencia.
Comience la RCP infantil si una de estas técnicas abre las vías respiratorias pero el bebé no reanuda la respiración.
Si el niño es mayor de 1 año y está consciente, déle compresiones abdominales solamente. Tenga cuidado de no usar demasiada fuerza para evitar dañar las costillas o los órganos internos.
Para prepararse para estas situaciones, aprenda la maniobra de Heimlich y la RCP en un curso de capacitación certificado en primeros auxilios.
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A step-by-step guide explaining what to do in a choking emergency.
The 'five-and-five' approach
How to perform abdominal thrusts (Heimlich maneuver) on yourself
Choking occurs when a foreign object lodges in the throat or windpipe, blocking the flow of air. In adults, a piece of food often is the culprit. Young children often swallow small objects. Because choking cuts off oxygen to the brain, give first aid as quickly as possible.
The universal sign for choking is hands clutched to the throat. If the person doesn't give the signal, look for these indications:
- Inability to talk
- Difficulty breathing or noisy breathing
- Squeaky sounds when trying to breathe
- Cough, which may either be weak or forceful
- Skin, lips and nails turning blue or dusky
- Skin that is flushed, then turns pale or bluish in color
- Loss of consciousness
If the person is able to cough forcefully, the person should keep coughing. If the person is choking and can't talk, cry or laugh forcefully, the American Red Cross recommends a "five-and-five" approach to delivering first aid:
- Give 5 back blows. Stand to the side and just behind a choking adult. For a child, kneel down behind. Place one arm across the person's chest for support. Bend the person over at the waist so that the upper body is parallel with the ground. Deliver five separate back blows between the person's shoulder blades with the heel of your hand.
- Give 5 abdominal thrusts. Perform five abdominal thrusts (also known as the Heimlich maneuver).
- Alternate between 5 blows and 5 thrusts until the blockage is dislodged.
The American Heart Association doesn't teach the back blow technique, only the abdominal thrust procedures. It's OK not to use back blows if you haven't learned the technique. Both approaches are acceptable.
To perform abdominal thrusts (Heimlich maneuver) on someone else:
- Stand behind the person. Place one foot slightly in front of the other for balance. Wrap your arms around the waist. Tip the person forward slightly. If a child is choking, kneel down behind the child.
- Make a fist with one hand. Position it slightly above the person's navel.
- Grasp the fist with the other hand. Press hard into the abdomen with a quick, upward thrust — as if trying to lift the person up.
- Perform between six and 10 abdominal thrusts until the blockage is dislodged.
If you're the only rescuer, perform back blows and abdominal thrusts before calling 911 or your local emergency number for help. If another person is available, have that person call for help while you perform first aid.
If the person becomes unconscious, perform standard cardiopulmonary resuscitation (CPR) with chest compressions and rescue breaths.
To perform abdominal thrusts (Heimlich maneuver) on yourself:
First, if you're alone and choking, call 911 or your local emergency number immediately. Then, although you'll be unable to effectively deliver back blows to yourself, you can still perform abdominal thrusts to dislodge the item.
- Place a fist slightly above your navel.
- Grasp your fist with the other hand and bend over a hard surface — a countertop or chair will do.
- Shove your fist inward and upward.
To clear the airway of a pregnant woman or obese person:
- Position your hands a little bit higher than with a normal Heimlich maneuver, at the base of the breastbone, just above the joining of the lowest ribs.
- Proceed as with the Heimlich maneuver, pressing hard into the chest, with a quick thrust.
- Repeat until the food or other blockage is dislodged. If the person becomes unconscious, follow the next steps.
To clear the airway of an unconscious person:
- Lower the person on his or her back onto the floor, arms to the side.
- Clear the airway. If a blockage is visible at the back of the throat or high in the throat, reach a finger into the mouth and sweep out the cause of the blockage. Don't try a finger sweep if you can't see the object. Be careful not to push the food or object deeper into the airway, which can happen easily in young children.
- Begin CPR if the object remains lodged and the person doesn't respond after you take the above measures. The chest compressions used in CPR may dislodge the object. Remember to recheck the mouth periodically.
To clear the airway of a choking infant younger than age 1:
- Assume a seated position and hold the infant facedown on your forearm, which is resting on your thigh. Support the infant's head and neck with your hand, and place the head lower than the trunk.
- Thump the infant gently but firmly five times on the middle of the back using the heel of your hand. The combination of gravity and the back blows should release the blocking object. Keep your fingers pointed up to avoid hitting the infant in the back of the head.
- Turn the infant faceup on your forearm, resting on your thigh with the head lower than the trunk if the infant still isn't breathing. Using two fingers placed at the center of the infant's breastbone, give five quick chest compressions. Press down about 1 1/2 inches, and let the chest rise again in between each compression.
- Repeat the back blows and chest thrusts if breathing doesn't resume. Call for emergency medical help.
- Begin infant CPR if one of these techniques opens the airway but the infant doesn't resume breathing.
If the child is older than age 1 and conscious, give abdominal thrusts only. Be careful not to use too much force to avoid damaging ribs or internal organs.
To prepare yourself for these situations, learn the Heimlich maneuver and CPR in a certified first-aid training course.
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