The Heimlich Maneuver is the best known method of removing an object from the airway of a person who is choking. If the airway is almost completely blocked, there may be high-pitched noises when the person inhales, great difficulty breathing, and a very weak, ineffective cough. If the person cannot speak, cough, or breath, then the person may have a completely blocked airway. Position your fist slightly above your navel and give yourself quick, inward and upward thrusts, or lean forward and press your abdomen quickly over any firm object, such as the back of a chair or a porch railing. If you think another person is choking because of an almost or completely blocked airway, CALL FOR HELP, and immediately prepare to do abdominal thrusts (the Heimlich Maneuver). Then pull your fist firmly and abruptly into the top of the stomach in order to force the object up the windpipe. Following the expulsion of the object that caused the choking, keep the victim still and get medical help. DO NOT begin the chest compressions of CPR (if heartbeat has stopped) until the airway is cleared. If you are not alone, have one person call the local emergency number while another person begins CPR.
Maintain the head position, close the victim's nostrils by pinching them with your thumb and index finger, and cover the victim's mouth tightly with your mouth. Kneel at the victim's feet or astride the thighs (or to the side if the victim is obese or pregnant). Place the heel of your hand in the middle of the abdomen just above the navel, well below the tip of their breastbone. Do not place your hand on the ribs or on the tip of the breastbone.) Place your other hand on top of the first hand.
Each thrust is a separate attempt to clear the victim's airway by forcing air out through the windpipe. DO NOT give chest compressions if there is a heartbeat; doing so may cause the heart to stop beating. DO NOT move the victim's head or neck to check for breathing if a spinal injury is suspected. When rolling the victim over, take care that broken bones are not further complicated by improper handling. The rescuer's hand closest to the victim's head should be placed on the victim's head and neck to prevent them from twisting.
The rescuer should use the other hand to grasp under the victim's arm furthest from rescuer. Pull carefully under the arm, and the hips and torso will follow the shoulders with minimal twisting.

Press gently to check the victim's carotid artery pulse for at least five seconds but no more than ten seconds.
If a pulse is present, continue administering artificial ventilation once every 5 seconds or 12 times a minute. Never interrupt CPR for more than five seconds, except to check the carotid pulse or to move the victim. Place the hand used to locate the notch at the rib cage on top and parallel to the hand which is on the sternum.
Each compression should squeeze the heart between the sternum and spine to pump blood through the body. CPR is performed for times when the breathing or the heartbeat has stopped, such as for electric shock and drowning. This page is a very fast, very general look at what to do in the event of an emergency.There's no substitute for a formal CPR or First Aid course. Pinch victim's nose closed, take a normal breath, cover victim's mouth with yours and blow out your breath until you see victim's chest rise. Signal people that are nearby that you are choking: do this right away, before you pass out.
Emergency care for a person with a completely blocked airway, or a person with an airway almost completely blocked is the same. Place your fist, thumb side in, just below the victim's breast bone and above the belly button, and with the other hand placed firmly over the fist. Each thrust should be distinct and delivered as if it will be the only thrust needed to free the obstruction.
All choking victims should have a medical examination, since complications can arise not only from the incident but also from the first aid measures that were taken. Roll the victim onto his back on a hard surface, keeping his back in a straight line, firmly supporting his head and neck.
Open the victim's mouth with your thumb and index finger, placing your thumb over his tongue and your index finger under his chin. Lift the victim's chin while tilting the head back to move the tongue away from the windpipe.
If the victim's chest still doesn't rise, and it appears there is still a breathing obstruction, begin abdominal thrusts, as follows. Give 6 to 10 quick thrusts compressing the victim's chest about 2 inches, pressing your hands inward and upward. Slide your fingers into the groove between the Adam's apple and the muscle on the side of their neck to feel for a pulse for 5 to 10 seconds. Roll the victim as a unit so that the head, shoulders, and torso move simultaneously with no twisting.

Maintain the head position and place the heel of your hand 2 finger-widths above the lowest notch of the victim's breastbone (where the lower edge of the ribcage meets in the middle). After the fourth cycle, recheck the carotid pulse in the neck for a heartbeat (5 to 10 seconds). Permanent damage to the brain can occur if oxygen flow is not restored within about 4 minutes. Roll the child onto their back on a hard surface, keeping the back in a straight line, firmly supporting the head and neck.
Tilt the baby's head back and give one firm but gentle puff of breath through the mouth and nose.
Call your local hospital or fire department and ask where the next CPR course is going to be given in your neighborhood. Repeat the thrusts as described above until the obstructions comes free or the victim becomes unconscious. Therefore, it is critical that blood flow and breathing be continued until trained medical help arrives. Lift the child's chin while tilting the head back to move the tongue away from the windpipe. Maintain the head position, close the child's nostrils by pinching them with your thumb and index finger, and cover the child's mouth tightly with your mouth.
Maintain the head position and place the heel of your hand 2 finger-widths above the lowest notch of the child's breastbone. IF NOT, DIAL 911 say INFANT NOT BREATHING, give them the address and GET BACK TO THE CHILD. While the victim may appear to improve and breathe normally, in a few days signs and symptoms of a foreign body in the lung will appear such as, wheezing, persistent cough, and pneumonia. Lean your shoulder over your hand, and quickly press about 1 inch into the child's chest 5 times. Give the compressions in a smooth, rhythmic manner, keeping your hand on the child's chest. Lean your shoulders over your hands, and firmly press down about 2 inches into the victim's chest. Give the compressions in a smooth, rhythmic manner, keeping your hands on the victim's chest.

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