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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

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.

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.

Assisting the Resident to Sit on the Side of the Bed

Having the resident sit on the side of the bed is otherwise referred to as dangling. When a resident quickly changes position, especially from lying to sitting or standing, there can be a rapid drop in the resident’s blood pressure. This drop in blood pressure may cause dizziness or lightheadedness.

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.

Tympanic Membrane Temperature with Electronic Thermometer

A tympanic membrane thermometer uses an infrared sensor to measure the temperature of the tympanic membrane (ear drum). This type of thermometer is considered an accurate and reliable predictor of a patient’s core temperature because the tympanic membrane’s blood supply is sourced from the carotid artery, which is the same artery that carries blood to the hypothalamus in the brain.

Putting on Personal Protective Equipment

Personal protective equipment is worn to protect the mouth, nose, eyes, clothing, and skin from unwanted pathogens. In the health care setting, a patient’s condition often prompts the use of personal protective equipment; however, a health care worker is able to wear personal protective equipment whenever he or she deems it is necessary (e.g., during procedures with the potential for excessive contact with bodily fluids).

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