Performing the Heimlich Maneuver

Written by Amanda R. McDaniel, MS, BSN, RN
Amanda is a BSN/RN with a MS in Physiology and a BA in English. She worked as a medical writer in the pharmaceutical industry for 11 years before pursuing a career in nursing. She now works as a nurse on a NeuroTelemetry unit and continues to write and edit on a freelance basis. Amanda’s LinkedIn

The Heimlich Maneuver, also known as abdominal thrusts, is used to remove an object that is blocking a resident’s airway and preventing air from reaching the lungs. It only takes four to six minutes for brain damage to occur from lack of oxygen, so prompt action is vital.

How to Perform the Heimlich Maneuver

  1. Ask the resident if he can speak.
    • If he can speak and is coughing, do not proceed. Monitor the resident.
    • If he is unable to speak or becomes unable to speak, go to step two.
  2. If the resident is sitting or standing:
    • Move behind him, kneel if necessary (e.g., to help a child).
    • Wrap your arms around the resident’s waist.
    • Make a fist with your thumb toward the resident and place it just above the resident’s navel.
    • Grasp your fist with your other hand.
    • Make forceful, quick, inward and upward thrusts with your fist until the object dislodges, and the resident can breathe.
  3. If the resident is lying down:
    • Turn him onto his back.
    • Straddle him, facing his head.
    • Make a fist with one hand and place it just above the resident’s navel.
    • Grasp your fist with the other hand.
    • Make forceful, quick, inward and upward (toward head) thrusts until the object dislodges, and the resident can breathe.
  4. Notify the nurse and continue to monitor the resident per institution or unit protocol.

Reference

Heller, J.L. (2015, April). Abdominal thrusts. MedlinePlus. Retrieved from https://medlineplus.gov/ency/article/000047.htm

More Resources

Removing Personal Protective Equipment

It is important to follow the correct procedure while removing personal protective equipment to avoid contaminating your skin or clothing. The most common source of contamination in this process stems from improper removal of gloves. Gloves are often the most soiled piece of equipment. To avoid contaminating your skin or the other equipment worn, gloves should always be removed first. Then remove the goggles, gown, and mask, in that order.

Fowler’s Position

Fowler’s position is used when a patient is eating, is having difficulty breathing, or is ordered by a doctor. This position is easily recognized because the patient will be sitting “straight up.” Semi-Fowler’s is sitting “half-way up,” and is used when patients cannot be laid flat, but wish to be in a more relaxed position than Fowler’s.

Indwelling Catheter Care

Indwelling catheters allow urine to drain from the bladder. They are used when residents are unable to urinate on their own or when the process of cleaning the resident after urination would be difficult for the resident to tolerate (such as during end of life care). Caring for the catheter appropriately is a vital part of preventing infection and skin breakdown.

Supine Position

Supine position is a natural and comfortable position for most people. For this reason, it is a highly utilized position for nursing procedures. Unfortunately, this position puts pressure on many bony prominences that can lead to discomfort and/or pressure ulcers if the pressure is not relieved every so often (typically every two hours or less).

Measuring the Respirations

Respiration is a vital sign that is measured frequently in the healthcare setting. Taking this measurement requires no equipment and relatively little time. However, it is a measurement that must be taken accurately, as a change in respiration may indicate the worsening of a patient’s condition.

Prone Position

Prone position is not used as commonly as other patient positions. This position allows for full extension of the hips and the knees and gives many bony prominences a break from continuous pressure. However, placing patients in prone position does not come without the risks of pressure ulcers.