Heimlich grip

Carola Felchner is a freelance writer in the medical department and a certified training and nutrition advisor. She worked for various specialist magazines and online portals before becoming a freelance journalist in 2015. Before starting her internship, she studied translation and interpreting in Kempten and Munich.

More about the experts All content is checked by medical journalists.

You should use the Heimlich grip if someone threatens to choke on a foreign body in the windpipe. To do this, grasp the person affected by the chest from behind and perform a jerky push that is intended to drive the foreign body out of the airways. Here you can find out exactly how this works and what risks the Heimlich grip entails!

Brief overview

What is the Heimlich handle? A life-saving remedy when a person's airway is obstructed / blocked by a foreign object.
Procedure: Grasp the patient's chest from behind with both arms and push them abruptly towards the diaphragm.
In what cases? If the airways are blocked by a foreign body (e.g. grape, candy, etc.) so that the person can no longer breathe.
Risks: Damage to organs (such as the spleen, stomach), injury to the diaphragm, broken ribs.

Caution!

The Heimlich grip must not be used on children under one year of age as the risk of injury is too high.
In older people, the Heimlich handle can burst an existing aneurysm (balloon-like protrusion of the wall of blood vessels). That is life-threatening!

How does the Heimlich grip work?

The Heimlich handle (Heimlich maneuver, Heimlich handle) is a life-saving first aid measure when a foreign body blocks the airways. It is used to prevent suffocation.

To do this, the first aider grabs the person's chest and jerks them backwards and upwards. The resulting overpressure is supposed to push the foreign body (e.g. leftover food) up out of the windpipe.

The Heimlich handle is named after its inventor, the American doctor Henry Heimlich (1920-2016). With his invention he indirectly saved the lives of thousands of people. Indirectly insofar as the handle has been used by numerous other people for first aid when there is a risk of suffocation. Heimlich himself is said to have only actively used the handle for the first time in 2016.

When do I use the Heimlich grip?

The Heimlich grip is used when a foreign object such as a piece of candy or a marble accidentally gets into the windpipe and blocks it, making it difficult or impossible for the person to breathe (medical aspiration). Often this happens to (young) children. Your swallowing mechanism is not yet fully developed. In addition, their airways are narrower than in adults. Elderly people are also prone to aspiration if they choke while eating. It is typical for aspiration that the person affected is - initially - conscious, but can neither speak nor breathe.

First cough and tap!

Since the Heimlich maneuver involves a number of risks (see below), first aiders should encourage the person affected to cough first. This is often enough to get the foreign body out of the airways.

If the affected person can no longer cough, bend them forward (children can lie down on their lap with their stomach down) and tap them vigorously with the flat of the hand, usually from bottom to top, between the shoulder blades. If this measure is also unsuccessful after five strokes, use the Heimlich grip.

Heimlich-Griff: That's how it works

Stand or kneel behind the suffocating person.
If you bend it forward, the foreign body can fall out more easily.
Grasp the victim from behind: To do this, make a fist with one hand and place it between the lower edge of the sternum and the belly button. Put the other hand around your fist.
Then pull jerkily backwards and upwards.
Repeat this movement five times.
If the foreign body does not come off, you should alternately perform back blows and Heimlich hand movements.

If the victim loses consciousness and is not breathing, start the resuscitation immediately. You can read more about this in the text Resuscitation in Adults and Resuscitation in Children. Ask someone else to call an ambulance or do it yourself if no one else is around.

Even if the foreign body comes off, you should take the affected person to the doctor.He can ensure that everything is in order and that you have not inadvertently injured the person concerned with the Heimlich grip.

Perform Heimlich grip on yourself

If you yourself have got a foreign body in the airways and are alone, you can also perform the Heimlich maneuver on yourself: The procedure is basically the same as described above - with the difference that it is your own hands that are used in the Quickly press the area between the costal arch and the navel several times inwards and upwards. Use as much force as you can bear.

When is the Heimlich grip not indicated?

The Heimlich handle should or must not be used in the following cases:

in children under one year of age (high risk of injury!)
if there is water in the lungs, e.g. B. if the victim nearly drowned
if the affected person is already unconscious (then he must be resuscitated!)

The Heimlich maneuver usually does not help with swallowed fishbones, as they are too filigree to completely close the trachea. The generated overpressure passes them by.

Alternatives to the Heimlich grip

There are various alternatives to the classic Heimlich handle that can also remove a foreign body from the airways:

Chair maneuvers

The person concerned can carry out this first aid measure himself:

He stands behind a chair, bends his upper body over the backrest, supports himself with his hands on the seat and hits himself in the stomach with the backrest - as hard as he can bear.

"Circumferential" abdominal pressure

The "circumferential" abdominal pressure (cirumferential "horizontal" abdominal thrust) is carried out by a first aider. Initially, this proceeds as with the classic Heimlich handle:

He grasps the victim from behind and places a fist below the costal arch and above the belly button on the victim's stomach. The thumb of the fist should rest on the soft abdominal wall (not accidentally on a rib).
The first responder then wraps his fist with his second hand.
Now he presses his hands towards himself (i.e. inside the patient's stomach). He starts with medium strength and then pushes harder and harder - ultimately as hard as the patient finds it bearable.

The risk of injury should be lower here than with the classic Heimlich maneuver. In addition, this first aid variant can also be carried out by first aiders who are smaller than the person concerned, as there is no need to push upwards from below.

According to British researchers, the chair maneuver is said to be the most effective of all variants (Heimlich grip performed by a first aider or on yourself, "circumferential" abdominal pressure). In your opinion, in an emergency, those affected should first try to help themselves - by means of chair maneuvers or a Heimlich grip performed on themselves.

Risks of the Heimlich grip

As a first aid worker, you can cause internal injuries to the person concerned due to the strong jolt when the Heimlich grip is applied. This can lead to a rupture of the liver, especially in children, and a rupture of the spleen or stomach injuries in adults. Broken ribs are also possible.

Particularly in older patients, the jerky bumping can also cause any bulges on the blood vessel walls (aneurysms) to burst.

In general, however, the following applies: In an emergency, do not shy away from the Heimlich grip! It is better to risk an unintentional injury than to suffocate the person affected by failing to take the necessary measures.

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