Why YSK:
Despite choking being an emergency, until recently there has been limited high-quality evidence to guide bystanders on the most effective way to help. Techniques like abdominal thrusts (formerly known as the Heimlich maneuver), back blows and chest compressions or thrusts have existed since the mid-1900s but, until recently, recommendations were largely based on case reports rather than rigorous scientific data. This evidence gap is dangerous.
Bystander response is the primary driver of a choking person’s outcome, so ensuring people know the safest and most effective way to care for a choking person can save lives.
Please see the article for the full piece, it’s not long.
Article authors:
- Cody Dunne - Emergency Medicine Physician and PhD Candidate, University of Calgary
- Andrew McRae - Associate Professor, Departments of Emergency Medicine and Community Health Sciences, University of Calgary
- Khara Sauro - Associate professor, Cumming School of Medicine, Department of Surgery, University of Calgary
If you need more motivation to open the article, here is an interesting fact:
New research suggests back blows cleared choking obstructions in 72 per cent of cases, superior to both abdominal thrusts (59 per cent) and chest thrusts (27 per cent).
The more eyes the better and this seems to be the recommendation:
I’m still looking for what to do if I’m alone and something happens.
The article also uses the text “In the updated guidelines, our Canadian study was cited to inform this critical change, and was the only study directly comparing different choking techniques.” to link here:
https://cpr.heart.org/en/resuscitation-science/cpr-and-ecc-guidelines/adult-basic-life-support
But I see no mention of any of these directions there. If someone does, let me know where I’m scanning over.
Edit: Failing at adding an underline to signal the actual link while having the URL readable.
Edit: Added the preceding “then they are still able to clear the obstruction themselves” paragraph that I’d mostly scanned over when reading the article
It’s something I’ve thought about a bunch and the strategy I’ve come up with is:
If your breath is blocked, hold your breath at first and stay calm. Trying to breathe in could wedge it farther in. And trying to breathe out will likely move it, but gravity might just drop it back where it was only with less air in your lungs, which you need to help dislodge the obstruction. Panicking will make you more likely to waste your chance at getting it without needing to fall on something and potentially break ribs (or fail and die). You’ll probably have to suppress your cough reflex. I’ve never done this before and have no idea how much conscious control one would have in that moment and I’m also someone who trained myself to be able to suppress coughs (to avoid embarrasing bong hits lol).
Lean forward, the farther the better, to the point where loose food in your throat will just fall out your mouth. Then cough, if you make it also a growl, you can add more force, as you don’t want to half-ass this. Your air might still be limited.
You should be able to feel if you’re making any progress. If you are, keep at it, if not, switch to the “fall on something to knock the wind out of you” strategy, still keeping your mouth angled down and add a cough as it impacts.
If that fails, make a big ruckus. I’ve told my daughter that if she starts choking and can’t speak to get my attention, knock dishes onto the floor to get my attention. If you’re completely alone in your home, throw a pot out your window before running out your front door. Try to be efficient with your time and energy. Dial 911 and hope they send someone and don’t assume a prank call or a kid when no one responds.
How to unchoke yourself if you’re dying alone.
This video is surprisingly entertaining and covers:
Back when I was in Boy Scouts, we learned how to do abdominal thrusts, and how to do it to yourself. You make the same hand shape (IIRC, one hand clasped over the other with your thumb knuckles forming a triangle into the abdomin), and place your hand in the back of a chair (assuming you’re near a chair, which is likely). You then press yourself into it.
the extra information is pretty important too… afaik most remediation for choking should be avoided early on because it’s actually fairly likely the person can clear the obstruction themselves, but if you time a thrust with their breath it can be very bad, and actually cause them to suck the object further in when they gasp for air
not a doctor or anyone with medical training, but i heard it at some point and it kinda makes sense
I agree with your callout on specific info. Disagree with the sentiment because the article is long and I missed that info in the first pass because most of the article talks about the research (and doesn’t seem to link accurately). I’ll add the preceding paragraph that you mentioned. Thanks
If you’re alone. Call 911 (or your regions equivalent) and wait outside for emergency services. Keep trying to cough while you wait. If you see anyone flag them down but don’t go searching for people. I know you’re looking for a self heimlich but your safest bet is to keep trying to cough and to wait for emergency services or for other help to come along. Getting the thrust you need to clear your airway, especially while starved for oxygen, is not guaranteed. So if you ever find yourself in that situation call for help. If you start choking and you’re a healthy adult you’ll have 3 to 5 minutes of consciousness. Use it wisely.
I had to wait 45 minutes for an ambulance when I thought I was about to die. You’ll fall unconscious within 5 minutes. Die within the next 5. Even if you manage to make the call, they won’t know what the hell is wrong with you because you can’t talk. Learning to save yourself in that situation is extremely important, because actual first responders won’t make it there on time.
that seems… atypical? in australia at least, the average response time for a code 1 (most critical) emergency is 15-16min depending on the state
which is still super problematic for complete obstruction (your 5+5min might even be too high for a complete obstruction)
but 45min would make the ambulance service as a whole basically a useless concept
Depends on where you are. I’m a stone’s throw from the ambulance. I can quite literally see it out my back window. Most people in the city I live in will see an ambulance within 10 minutes of the call. Contrast that with where I lived a couple of years ago, and 45 minutes might be the earliest, and up to 90 minutes at the most. We had one ambulance for ~20,000 people in a 1,000 square mile area. If ambulance one was called out, a second ambulance was rolled from the next area over to just the edge of ours. I’d say that situation was pretty typical for 5-10% of the people in my greater geographical area, i.e., if you lived outside of a big city.
The only times I’ve been a bit worried have been eating chicken that I could get down with water so not really the same thing but sometimes I’ve it’s gotten difficult enough I’ve wondered if I’ll need a bit of help, but that’s not really choking or close to blackout. Unfortunately the times I remember I’ve been alone, in an apartment building 10+ floors up in a foreign country. Agreed the safest bet is others but based on those situations I think there are times where it’s tough to guarantee another person will see you and I was aiming to learn what my last resort should be.
You can do abdominal thrusts on yourself, or you can use something like the back of a chair or a railing to rest your fists on and use your body weight to basically perform the same action