Can you do the Heimlich maneuver on someone who is unconscious?

ACEP recommends that the Heimlich Maneuver be employed only when a person is choking and his or her life is endangered by a windpipe obstruction. Choking is signaled by an inability to speak, cough or breathe, and may result in a loss of consciousness and death. Avoid using excessive force in employing the Heimlich Maneuver to avoid injury to the ribs or internal organs. Given the potentially life-or-death nature of the situation, use your best judgment.

In the event of choking, the American Heart Association and ACEP offer the following guidelines:

Unconscious Adult

  • Position the person on his or her back, arms by side.
  • Shout for help. Call 911 or the local emergency number.
  • Perform a finger sweep to try to remove any foreign body from the mouth. Only remove an object you can see and easily extricate.
  • Listen for breathing and watch for the chest to rise and fall. If the person is not breathing, perform rescue breathing. If unsuccessful, give six to 10 abdominal thrusts (the Heimlich Maneuver). To perform abdominal thrusts on an unconscious person, kneel over the person and place the heel of one hand on the person’s abdomen, slightly above the navel. Next, place your other hand on top of the first. Press into the abdomen with quick, upward thrusts.
  • Repeat sequence: Perform finger sweep, attempt rescue breathing, perform abdominal thrusts, until successful.
  • Continue uninterrupted until the obstruction is removed or advanced life support is available. When successful, have the person examined by a physician as soon as possible.
  • After the obstruction is removed, begin CPR, if necessary.

Unconscious Infant (Under one year old)

  • Shout for help. Call 911 or the local emergency number.
  • Perform the tongue-jaw lift. (Grip on the jaw by placing your thumb in the infant’s mouth and grasping the lower incisor teeth or gums; the jaw then lifts upward.) If you see the foreign body, remove it.
  • If trained to do so, begin rescue breathing.
  • Perform the sequence of back blows and chest thrusts as described for a conscious infant.
  • After each sequence of back blows and chest thrusts, look for the foreign body and, if visible, remove it.
  • Resume rescue breathing.
  • Continue with the sequence of back blows and chest thrusts, and, after each sequence continue to check for the foreign body, which should be removed.
  • If the foreign body is removed and the infant is not breathing, begin CPR.

Unconscious Child (Over one year old)

  • If the child becomes unconscious, continue as for an adult, except:
  • Do not perform a blind finger sweep in children up to 8 years old. Instead, perform a tongue-jaw lift and remove the foreign body only if you can see it.