Nursing & Healthcare Programs

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.

Measuring and Recording Output from a Urinary Drainage Bag

Accurate measurement of urination (aka, the output portion of intake and output) allows medical personnel to assess kidney and bladder function. Changes in output quantity or quality can reflect health status changes including new-onset infection or renal injury.

Axillary Temperature with Electronic Thermometer

Compared to other temperature measurement methods, the axillary measurement is considered the least reliable. An axillary temperature measurement typically reads 0.5 to 1 degree Fahrenheit lower than an oral temperature reading [1]. For this reason, it is recommended to use this method only when other methods are contraindicated or when taking an axillary temperature is the safest method for the patient.

Rectal Temperature with Electronic Thermometer

A rectal temperature provides the most accurate core body temperature reading compared to other non-invasive methods. This makes a rectal temperature desirable; however, this procedure comes with more patient discomfort and more safety risks (bowel perforation, mucosal damage, and/or vagus nerve stimulation) than the other temperature measurement methods.

Nail Care (Fingers and Toes) for CNAs

Nail care of both the feet and the hands should be performed as part of the patient’s daily hygiene routine. The status of the patient’s nails can reflect their overall health. Nail issues can also lead to infection that can spread systemically (ex, ingrown nails or fungus). You should never clip a patient’s nails with nail clippers, and always review your institution’s policy about what nail care is allowed.

person wearing orange and white silicone band

Applying Restraints

Restraints have very strict guidelines for use due to the number of complications that can result. Use of restraints is associated with increased physical and psychosocial health issues. Restraints are only considered necessary when restraint-free alternatives have failed and the patient or others are at risk of harm without the restraints. It is illegal to use restraints for the staff’s convenience or to punish the patient.