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The abdominal thrust maneuver, also known as the Heimlich maneuver, is used to treat upper airway obstructions caused by foreign bodies. This maneuver is commonly taught during basic life support and advanced cardiac life support classes but is not given as much attention as chest compressions. Although this maneuver can save lives and is generally safe to perform, serious intra-abdominal harm can ensue if this maneuver is not performed correctly. To prevent intra-abdominal damage, practitioners at all levels should be familiar with how to perform this technique safely. This activity reviews the indications and contraindications of this procedure and describes how to perform it safely. This activity highlights the role of interprofessional teamwork in improving patient outcomes. Objectives: Identify the indications and contraindications for the abdominal thrust maneuver. Describe how to perform the abdominal thrust maneuver. Identify potential complications associated with the abdominal thrust maneuver. Explain the role of interprofessional teamwork in improving outcomes for patients with upper airway obstruction due to foreign bodies. Access free multiple choice questions on this topic.

Abdominal thrusts or the Heimlich maneuver is a first-aid procedure used to treat upper airway obstruction caused by a foreign body. This skill is commonly taught during basic life support (BLS) and advanced cardiac life support (ACLS) classes, but it never receives as much attention as chest compressions and rescue breaths do. The abdominal thrust maneuver can be performed in both children and adults via different techniques.[1] In the 1960s, choking on food, toys, and other objects was the sixth leading cause of accidental death in the United States. Slapping individuals on the back was the main response and was frequently found to be ineffective, at times even lodging the object further down.[2] The Heimlich maneuver was initially introduced in 1974 by Dr. Henry Heimlich after proving his theory that the reserve of air in the lung could serve to dislodge objects from the esophagus by quick upwards thrust under the ribcage.[3][4] The medical community of the time did not embrace the maneuver right away. The American Red Cross (ARC) and the American Heart Association (AHA) continued to promoted backslaps for ten years after the introduction of the Heimlich maneuver.[5][6] Today, the Heimlich maneuver is accepted and taught during BLS and ACLS for conscious adults, but backslaps are still a recommendation for infants, and chest compressions are recommended for unconscious patients. Furthermore, different techniques of the maneuver have been developed with conflicting effectiveness results.[7]

Ever since the introduction of the Heimlich maneuver, cases of harm inflicted by the forceful displacement of the diaphragm and sudden increase in intrathoracic pressure have driven numerous studies and reviews. Although this maneuver is considered life-saving and generally safe to perform, serious intra-abdominal harm can ensue from incorrect technique and unusually vigorous application.[20] One manikin study mentioned above also concluded that the risk of serious harm ensues if the foreign body is not relieved after the first set of thrusts.[18] The most commonly reported complications are rib fractures and gastric or esophageal perforations. Although other rare traumatic injuries such as splenic rupture, pneumomediastinum, aortic valve cusp rupture, aortic dissection, diaphragmatic herniation, esophageal and jejunal perforation, hepatic rupture, cholesterol embolization leading to arterial occlusion, and mesenteric laceration have been described.[21][22][23][24][25][26][27][28]

The Heimlich maneuver exemplifies what is achievable by involving the general population in community healthcare. BLS training is progressively a requirement for an increasing part of the community, even including high-school students.[31] [Level 3] Ultimately, the overall improvement in patient outcomes has relied heavily on bystander cardiopulmonary resuscitation and basic life support.[32] [Level 1]