Expired CME Article

The Heimlich Maneuver: Breaking Down the Complications

Authors: Shawn Chillag, MD, Jake Krieg, MD, Ranjana Bhargava, MD

Abstract

The very young and the very old are vulnerable to choking, and there are over 4000 choking-related deaths annually in the United States. Complications from the Heimlich maneuver (HM), as reported in infrequent case reports, predominantly relate to the elderly. It is doubtful that the denominator, numerator, appropriateness, expertise, and problems of maneuvers applied to choking victims will ever be known. This case report and literature review suggests that the treatment for acute elderly choking victims should be applied carefully and that esophageal food impaction, which should be rapidly distinguishable from choking, can have serious complications with application of the HM.


Key Points


* There are over 4000 choking deaths in the United States annually.


* Laceration or rupture of the stomach is the most frequently reported life-threatening complication of the Heimlich maneuver (HM).


* The very young and the very old are the most likely to choke and the most vulnerable to serious complications.


* The collapse of a choking victim after application of the HM should prompt rapid evaluation for gastric, aortic, and cardiac injury.


* A person in distress while eating who can talk and breathe does not have a critically obstructed airway.

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