How To Perform The Heimlich For Adults Kids Babies?

The Heimlich maneuver is a series of abdominal thrusts used to dislodge an object blocking a person’s airway. For adults and children over one year old, you stand behind them, make a fist, and press inward and upward just above the navel. For babies under one year old, you do not use abdominal thrusts; instead, you alternate five back blows between the shoulder blades with five chest thrusts. The technique differs by age because the anatomy and risk of injury are different.

How Do I Know If Someone Is Actually Choking?

Choking happens when a foreign object blocks the airway. The body’s natural response is to cough. If the person can cough forcefully, speak, or make sounds, the airway is only partially blocked. Encourage them to keep coughing. Do not perform the Heimlich on someone who can still cough or breathe effectively.

You perform the Heimlich only when the airway is completely blocked. The universal sign for this is clutching the throat with one or both hands. Other signs include the inability to speak, weak or no cough, a high-pitched sound when breathing in, blue-tinged lips or skin, and loss of consciousness. If the person cannot breathe, cannot cough, or cannot speak, act immediately.

Time is critical. Brain damage can begin within four to six minutes without oxygen. If you are alone and choking, you can perform the maneuver on yourself using your own hands or by pressing your abdomen against a firm object like the back of a chair or a countertop edge.

How To Perform The Heimlich For Adults Kids Babies: Step By Step

The core technique for adults and children over one year old is the same. For babies under one year old, the approach is completely different. Here is the breakdown by age group.

For Adults and Children Over One Year Old

Stand behind the person and wrap your arms around their waist. Tilt the person slightly forward so the object can exit the mouth rather than go deeper. Make a fist with one hand and place the thumb side of your fist against the person’s abdomen, just above the navel and well below the breastbone.

Grasp your fist with your other hand and press hard into the abdomen with a quick, upward thrust. Think of a J-shaped motion — inward and then upward. Repeat these thrusts until the object is expelled or the person becomes unresponsive. Each thrust should be separate and distinct, not a continuous squeeze.

For a child, you may need to kneel behind them so you are at their level. Use less force than you would for a large adult, but the thrust must still be strong enough to create enough pressure to move the object. The abdominal thrusts rapidly push air out of the lungs, which forces the object out of the airway.

For Babies Under One Year Old

Abdominal thrusts are dangerous for infants because their internal organs are fragile and not fully protected by the rib cage. The liver and spleen are larger relative to body size and sit lower in the abdomen. Using abdominal thrusts on a baby can cause serious internal injury.

Instead, hold the baby face-down along your forearm, with the head lower than the body. Support the head and jaw with your hand. Use the heel of your other hand to give five firm back blows between the baby’s shoulder blades.

If the object is still not out, turn the baby face-up on your forearm with the head lower than the body. Place two fingers in the center of the baby’s chest, just below the nipple line, and give five chest thrusts. These are like chest compressions but sharper and slower. Alternate five back blows and five chest thrusts until the object is expelled or the baby becomes unresponsive.

Do not stick your fingers into a choking baby’s mouth to sweep for the object. You may push it deeper into the airway. Only do a finger sweep if you can actually see the object and can remove it safely.

What Should I Do If The Person Becomes Unresponsive?

If the choking person becomes unresponsive, stop the Heimlich maneuver immediately. Lower them gently to the floor. Call for emergency medical help right away if you have not already done so. Begin CPR starting with chest compressions.

During CPR for an unresponsive choking victim, each time you open the airway to give rescue breaths, look inside the mouth. If you can see the object, remove it with your finger. Do not do blind finger sweeps. After 30 chest compressions, open the airway and check for the object before attempting a breath.

Continue cycles of 30 compressions and two breaths until help arrives or the person starts breathing on their own. Even if the object comes out and the person resumes breathing, they still need medical evaluation. Abdominal thrusts can cause internal injuries, including a torn diaphragm or ruptured internal organs, even when performed correctly.

Can The Heimlich Maneuver Cause Injury?

Yes. The Heimlich maneuver is a life-saving procedure, but it can cause injury. Studies and clinical reports document cases of rib fractures, abdominal organ damage, and internal bleeding after the maneuver. These injuries occur even when the technique is performed correctly by trained professionals.

This is why the maneuver is reserved for complete airway obstruction only. The risk of injury is acceptable because the alternative — no oxygen to the brain — is fatal within minutes. If the person is coughing or breathing, do not perform abdominal thrusts. The natural cough is more effective and safer than any manual technique.

After any choking episode where the Heimlich was performed, the person should see a doctor. This is not optional. Internal injuries may not cause immediate pain or visible symptoms. A medical examination can rule out damage to the abdomen, ribs, or internal organs.

What If The Person Is Pregnant Or Overweight?

Standard abdominal thrusts are not appropriate for a pregnant woman in the later stages of pregnancy or for a person who is significantly overweight. In these cases, the uterus or excess abdominal tissue can block the effectiveness of the thrust and increase the risk of injury.

For a pregnant woman, position your hands higher on the chest. Place your fist at the center of the breastbone, just above the bottom of the sternum, and perform chest thrusts instead of abdominal thrusts. The motion is the same — quick, upward thrusts — but applied to the chest rather than the abdomen.

For a person who is overweight, you may not be able to wrap your arms fully around their abdomen. In this case, chest thrusts are also the appropriate alternative. The technique is the same as for a pregnant woman: fist on the center of the breastbone, quick thrusts inward toward the chest.

If chest thrusts do not work and the person becomes unresponsive, begin CPR. The same protocol applies — compressions, checking the airway for a visible object, and rescue breaths.

Does The Heimlich Maneuver Work Every Time?

No technique works every time. The Heimlich maneuver is highly effective, but it is not a guarantee. Some objects are deeply lodged, some airways are anatomically difficult, and some situations involve other factors like swelling or trauma that the maneuver cannot address.

If the Heimlich does not dislodge the object and the person remains conscious and unable to breathe, continue the thrusts. Emergency medical services should already be on the way. If the person loses consciousness, transition immediately to CPR. The compressions themselves can sometimes dislodge an object because they create pressure in the chest.

In a hospital setting, if physical maneuvers fail, medical professionals have other tools. They may use a laryngoscope to visualize and remove the object directly, or they may perform an emergency cricothyrotomy — a surgical opening in the airway below the blockage. These are not options for a bystander, but they are why calling for emergency help early matters.

Can I Learn The Heimlich Maneuver From Reading About It?

Reading about the maneuver is a good start, but it is not the same as hands-on practice. The force, hand placement, and body positioning are easier to understand when you practice on a mannequin under the guidance of an instructor. Many local fire departments, community centers, and hospitals offer free or low-cost CPR and choking relief classes.

These classes typically take a few hours and cover adult, child, and infant techniques. You also learn how to adapt the maneuver for different body types and situations. The American Heart Association and the American Red Cross both offer certification courses that include hands-on choking relief practice.

If you care for children or older adults, refresher training is particularly valuable. The techniques for infants and for people with mobility limitations have specific considerations that are much easier to grasp with demonstration and practice.