Move over, Heimlich: This chair thrust could save your life

Next time you encounter foreign body obstruction of the airway, look for a chair.

UK researchers have developed a DIY variation of the Heimlich manoeuvre and they’re urging Australians to adopt it.

While the controversial Heimlich manoeuvre has never been recommended for use in Australia, respiratory specialists at the Royal Brompton Hospital are now suggesting our guidelines be changed to include their instructions for self-administered abdominal thrusts using the back of a chair.

In a series of tests involving healthy volunteers they found that self-administered abdominal thrusts could be more effective at generating expulsive intrathoracic pressure than thrusts delivered by first aiders.

How to perform the Heimlich manoevre on yourself

Their auto-administration technique involves the choking person positioning themselves above a high backed chair, with the chair back positioned below the upper half of the abdomen. Using gravity, bodyweight and arm strength, the person allows the back of the chair to thrust up into their abdomen.

In their laboratory tests, they found that chair thrusts created the most thoracic pressure, followed by the circumferential abdominal thrust, where the rescuer stands behind the victim.

Similar thoracic pressure was achieved by the victim placing their own hands in the same position and pulling backwards into their stomach.

“We recommend that the manoeuvre should be performed by inward thrust over the fleshy part of the abdomen, around the level of the navel,” they suggest.

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The case for using the chair thrust is strengthened by its lack of reliance on an external operator, they add.

The researchers note that Australian Resuscitation Council guidelines recommend against the use of abdominal thrusts because life threatening complications have been reported when thrust are directed upwards into the ribcage and organs.

Instead, Australian guidelines recommend up to five sharp back blows, or five chest thrusts by a rescuer.

However the UK researchers say their modified technique, using inward rather than upward thrusts, will minimise these risks and should be adopted by First Aiders globally.

“Concern about possible risk needs to be balanced against the almost certain risk of death if obstruction persists,” they suggest.

“We advise that everyone with complete airway obstruction should, in the first instance, either autoadminister abdominal thrusts or perform a chair thrust.

"The various manoeuvres should be more widely taught in schools, first aid courses, to staff in restaurants and publicised as widely as possible."

More Information:

BMJ Thorax 2017; online.

ANZCOR Guidelines 2016; online.