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

Sim’s Position

The position a patient is placed in is often ordered by the physician, or recommended by a speech, occupational, or physical therapist. The position dictates whether a patient is sitting, lying, standing; or if they are on their side, back, or prone (face-down). Positioning is also determined by the patient’s current needs, such as: Are they eating? Sleeping? Having surgery on their back? Are they receiving nutrition through a nasogastric tube?

Perineal Care of the Female Resident

Perineal care should be performed during a bath, after using the bedpan, and/or after incontinence. Proper technique is important for maintaining hygiene, preventing infection, and avoiding skin breakdown. Because of the close proximity between a woman’s urethra, vagina, and anus, it is essential to only wipe in a front to back motion. Wiping in the opposite direction is associated with a greater risk for developing a urinary tract infection.

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.

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.

Applying Elastic Support Hose

Elastic stockings are worn to prevent deep vein thrombosis (DVT) and reduce the pooling of blood in vessels. Many hospitals and care facilities use elastic stockings in patients with reduced mobility, such as surgical patients and/or the elderly. There are a few risks in wearing elastic stockings; however, these risks can be prevented with proper application and care.

Measuring the Apical Pulse

The apical pulse rate is the most accurate non-invasive measurement of heart rate because it is measured directly over the apex of the heart. Apical pulse is preferred in cases when the radial pulse is difficult to palpate, when the pulse is irregular, greater than 100 beats per minute, or less than 60 beats per minute when measured by other means (electronic, radial, etc.).