Heimlich maneuver

Heimlich maneuver

The Heimlich maneuver , also known as the Heimlich handle or upper abdominal compression (after Heimlich) , is an immediate life-saving measure in the event of impending suffocation or impending bolus death due to the obstruction of the airways by a foreign body (bolus aspiration, e.g. through swallowing ). By compressing the abdomen (abdominal cavity), an attempt is made to push the foreign body out of the windpipe or the upper respiratory tract using the excess pressure that this creates. As a preliminary measure, the solution of the foreign body should be attempted by powerful blows between the shoulder blades. There is a risk of rupturing the diaphragm or damaging other organs of the abdominal cavity with the handle and it should not be used on small children if possible.

The maneuver was first described in 1974 by its inventor, the American doctor Henry J. Heimlich (1920–2016).

application

The helper stands behind the patient and holds his upper abdomen with his arms . With one hand he forms a fist and places it in the pit of the stomach below the ribs and breastbone . With the other hand he grabs his fist and then pulls it sharply straight back towards his body. The aim is to push the foreign body out of the windpipe through the sudden increase in pressure in the lungs . If necessary, the maneuver (which can also be carried out from above with the patient lying down) should be carried out up to five times. After each implementation, it should be checked whether the foreign body has already loosened. The chest itself should not be compressed.

When using the Heimlich maneuver, there is a risk of internal injuries in the patient (ruptured spleen, torn liver in children; bursting aneurysms in older patients, rib fractures, stomach injury). The risks, however, due to the acute danger to life from suffocation or reflex cardiac arrest due to a vagus - stimulus accepted. After using the Heimlich Handle, the patient should be taken to a hospital to treat any injuries.

Contraindications

• In a fish bone z. For example, the principle hardly works because it does not completely close the airways and therefore the excess pressure escapes past it without conveying it.
• Drowning : Attempts to remove water from the lungs with the Heimlich maneuver should be avoided.
• The Heimlich maneuver is not carried out if the person is already unconscious . Cardiopulmonary resuscitation begins here immediately .
• The Heimlich maneuver must not be used on infants (age <1 year), as the risk of injury is too high. Instead, as with resuscitation, you compress your chest with two fingers.

Trivia

Although the handle is named after him, Henry Heimlich never used it in an emergency during his work as a medical doctor. It was not until 2000 that he used the maneuver when restaurant guests called the then 80-year-old for help instead of using his handle himself. As a 96-year-old, Henry Heimlich came into the situation again in May 2016 in a retirement home, helping an 87-year-old roommate who had choked on a hamburger and was threatened with suffocation with the Heimlich maneuver.

New York Mayor Ed Koch choked on a restaurant visit in 1981 and was saved by using the Heimlich handle. He then campaigned for a legislative initiative requiring a poster with instructions to be placed in all New York restaurants. Similar regulations exist in other US states.

literature

• Walied Abdulla: Interdisciplinary Intensive Care Medicine. Urban & Fischer, Munich a. a. 1999, ISBN 3-437-41410-0 , p. 5.

Web links

Commons : Abdominal thrusts  - Collection of images, videos, and audio files

• ERC guidelines 2010, Section 2 , p. 12 of the PDF
• ERC guidelines 2005 , Section 2, and on the same page the 2005 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations (CoSTR), Part 2
• Heimlich Institute website

Individual evidence

1. ^ HJ Heimlich, KA Hoffmann, FR Canestri: Food-choking and drowning deaths prevented by external subdiaphragmatic compression. Physiological basis. In: Ann Thorac Surg . Volume 20, No. 2, Aug 1975, pp. 188-195. PMID 1164065
2. ↑ ^{a b} A. J. Handley, R. Koster, K. Monsieurs et al: European Resuscitation Council guidelines for resuscitation 2005. Section 2. Adult basic life support and use of automated external defibrillators. In: Resuscitation. 67 Suppl 1, 2005, pp. S7-S23. PMID 16321717
3. ↑ ERC Guideline 2010, Section 8, doi: 10.1007 / s10049-010-1374-z p. 10 of the PDF
4. ↑ Heimlich: Still saving lives at 83 . In: BBC . March 9, 2003 ( bbc.co.uk [accessed January 1, 2017]).
5. ↑ air! A 96-year-old saves a life - with a world-famous handle that he invented himself. In: Der Spiegel. No. 25, 2016, p. 61.
6. ↑ Joanna Walters: Dr Henry Heimlich uses Heimlich maneuver to save a life at 96 . In: The Guardian. May 27, 2016.
7. ^ Saving Lives in the Workplace . In: GovDocs . November 11, 2013 ( govdocs.com [accessed January 15, 2019]).
8. ↑ Ronald Reagan nearly died before he became president. The Heimlich maneuver saved him. In: Washington Post . December 19, 2016 ( washingtonpost.com [accessed January 15, 2019]).

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