Heimlich Maneuver (2024) PDF

2024 Heimlich Maneuver / Aug Dr. Roxana Hessam assistant professor of emergency medicine faculty Introduction and Importance of the Topic Workshop Opening: "Hello everyone, and t...

2024 Heimlich Maneuver / Aug Dr. Roxana Hessam assistant professor of emergency medicine faculty Introduction and Importance of the Topic Workshop Opening: "Hello everyone, and thank you for attending this workshop. Today, we'll be discussing foreign body aspiration and the Heimlich maneuver, which are critical topics in emergency medicine. The ability to quickly and correctly manage these situations can save lives." Definition of Foreign Body Aspiration: "Foreign body aspiration occurs when non-food items, or sometimes food, become lodged in the airway or esophagus. This can rapidly turn into a life-threatening emergency, especially if the foreign body blocks the airway." Consequences of Foreign Body Aspiration: "If the airway becomes blocked, the individual may suffer from an inability to breathe, reduced oxygen supply to the body, and in severe cases, brain damage or death if not treated immediately." Mechanism of Foreign Body Aspiration Description of the Normal Swallowing Process: "Normally, food passes from the mouth into the pharynx, then through the esophagus and into the stomach. However, if a foreign object gets stuck in the pharynx or upper esophagus, it might enter the airway, leading to obstruction." Signs and Symptoms: "Signs of foreign body aspiration include persistent and severe coughing, difficulty breathing, unusual sounds like wheezing or stridor, cyanosis (bluish discoloration of the skin), and in severe cases, loss of consciousness." The universal sign of choking Heimlich Maneuver History and Introduction: "The Heimlich maneuver, named after Dr. Henry Heimlich who introduced it in 1974, is one of the most important life-saving techniques in cases of airway obstruction due to foreign body aspiration." Heimlich Maneuver IMPORTANT POINT: "Before we begin the demonstration, it’s important to remember that the Heimlich maneuver is intended for cases where a person is choking and cannot breathe, speak, or cough effectively. If the person is coughing strongly, you should encourage them to continue coughing as this is the body’s natural way to clear the airway." Steps to Perform the Heimlich Maneuver on an Adult or Older Child 1.Assess the Situation: "First, ensure the person is choking by asking them, 'Are you choking? Can you speak?' If they can only nod or gesture but cannot talk, this indicates a complete airway obstruction and immediate action is needed.“ 2.Position Yourself: "Stand behind the person who is choking. If the person is much shorter than you, you may need to kneel to get into the correct position.“ 3.Prepare Your Hands: "Make a fist with one hand. Place the thumb side of your fist just above the person’s navel, slightly below the ribcage but well above the belly button. This area is called the ‘epigastric region.’" "Your other hand should be placed over the fist to secure it." Steps to Perform the Heimlich Maneuver on an Adult or Older Child 4.Perform the Abdominal Thrusts: "With your hands in position, perform quick and forceful upward thrusts into the abdomen. The motion should be inward and upward, as if trying to lift the person slightly off the ground." "Each thrust should be distinct, forceful, and rapid, aiming to create an upward pressure that forces air out of the lungs and dislodges the object.“ 5.Repeat as Necessary: "Continue performing these thrusts until the object is expelled and the person can breathe, cough, or speak again, or until they lose consciousness. If the person loses consciousness, you will need to move to CPR." Alternative Methods for Infants and Small Children: "For infants, lay the baby face down along your forearm, supporting the head and neck." "Deliver five firm back blows between the infant’s shoulder blades.“ "If the object does not come out, turn the infant face-up, placing two fingers in the middle of the chest just below the nipple line, and perform five quick chest compressions.“ "Continue alternating back blows and chest thrusts until the object is expelled or help arrives." Pregnant or Obese "If the Heimlich maneuver is unsuccessful or if the person is pregnant or obese, chest thrusts or specialized medical devices might be necessary to clear the airway." Demonstrating Chest Thrusts 1.Position Yourself: "Stand directly behind the person. If the person is much taller than you, you may need to stand on a sturdy platform to reach their chest comfortably." "Place your arms under their armpits and position yourself close to their back for stability." 2.Hand Placement: "Make a fist with one hand and place it on the center of the person’s chest, at the lower half of the sternum." "Place your other hand over your fist to reinforce the grip." Demonstrating Chest Thrusts 3.Perform the Chest Thrusts: "With your hands in position, perform quick, backward thrusts. The motion should be directed straight back, towards the spine, rather than upward." "Use a firm and rapid motion.“ 4.Repeat as Necessary: "Continue delivering these thrusts until the obstruction is cleared, the person starts coughing, breathing, or speaking, or until they become unconscious." And what if the patient becomes unconscious ? We start CPR, and after one cycle of chest compressions, before ventilating the patient, we perform a finger sweep if we see a foreign object. Steps to Perform a Finger Sweep 1.Ensure Safety and Positioning: "The person should be lying flat on their back. Kneel beside the person, preferably at their head, to have easy access to their mouth." 2.Open the Airway: "To open the airway, tilt the person’s head back slightly using the head-tilt, chin-lift technique. Place one hand on their forehead and gently tilt the head back, while using the fingers of your other hand to lift their chin." 3.Check for the Object: "Look inside the mouth to see if the foreign object is visible. You should only perform a finger sweep if you can clearly see the object." Steps to Perform a Finger Sweep 4.Perform the Finger Sweep: "Using the index finger of your dominant hand, carefully insert your finger into the person’s mouth along the inside of the cheek.“ "Sweep your finger in a hooking motion, moving from one side of the mouth to the other, to reach the back of the throat. This motion should be gentle but firm enough to grab and remove the object.“ "Be cautious not to push the object further back into the throat.“ 5.Remove the Object: "Once you’ve hooked the object, carefully pull it out of the mouth. Ensure that the airway is clear before proceeding with further care." Steps to Perform a Finger Sweep 6.Reassess the Airway: "After removing the object, reassess the airway by looking, listening, and feeling for normal breathing. If the person is still not breathing, begin CPR immediately." Demonstration Practice for Heimlich Ma. "Now, let’s practice the Heimlich maneuver.I’ll demonstrate the technique first, and then each of you will have the chance to practice." Using a mollage : "When you approach the mollage , remember to position your fist correctly, secure your other hand over it, and perform strong, upward thrusts. It’s important to use enough force to simulate a real-life scenario." NOT Using a mollage : Please ask your colleagues to cooperate and practice the Heimlich maneuver with you. Be careful to perform the maneuver gently to avoid any mistakes or injury to your partner. Observation and Feedback: "As you practice, I’ll be observing and providing feedback to ensure that everyone feels confident in performing the Heimlich maneuver. Don’t hesitate to ask questions or request a demonstration of specific parts if needed." THANKS! DO YOU HAVE ANY QUESTIONS? [email protected] Dr-hessam.ir