How to perform the Heimlich Maneuver: A guide for security professionals

Continuous readiness is a fundamental pillar in the work of State security forces. In situations where a citizen’s life hangs by a thread, the ability to respond immediately and correctly is what makes the difference. Few emergencies are as sudden and critical as choking. Knowing how to act quickly and effectively in these situations can be the key to saving a life.

Recognizing choking: warning signs

To act, you must first identify whether a person is choking. Rapid recognition is important. According to guidelines from the American Heart Association (AHA) and the Spanish Red Cross, some key signs include:

• Partial or complete airway obstruction: the person may cough weakly, make high-pitched sounds, or be unable to speak at all. In severe cases, they will not be able to breathe.
• Universal choking gestures: the person often clutches their throat with their hands.
• Change in coloration: the skin, especially around the lips, may start to turn bluish (cyanosis) due to lack of oxygen.

The Heimlich Maneuver: steps to follow

Once choking is confirmed, act without delay. The Heimlich maneuver differs depending on whether the person is an adult/child over one year, an infant, pregnant, or obese.

For adults and children over one year:

If an adult is choking, it is crucial to call emergency services (112) immediately. In a choking incident, a foreign object blocks air from reaching the lungs, and your intervention can save the victim’s life.

To perform the maneuver on adults and children over one year, follow these steps based on standardized first aid protocols from the Spanish Red Cross:

1. Encourage the person to cough.
2. If they cannot cough and are conscious, give 5 firm back blows between the shoulder blades.
3. If the foreign object does not dislodge, stand behind the person and wrap your arms around their waist. Make a fist with one hand and place it just above the person’s navel, grasping your fist with the other hand.
4. Give 5 sharp abdominal thrusts inward and upward.
5. Repeat the sequence (5 back blows and 5 abdominal thrusts) as necessary until the object is expelled or the person loses consciousness.

If the person loses consciousness:

The Red Cross also outlines steps if the person becomes unconscious. Gently lower them to the ground and, if you are trained, begin chest compressions (CPR) while seeking immediate help. This involves performing 30 chest compressions (similar to cardiac massage) followed by 2 rescue breaths. Each time you attempt a rescue breath, look into the mouth to see whether the object is visible and can be removed.

For pregnant women or obese persons:

In these cases, abdominal thrusts may be ineffective or unsafe. Instead, perform chest compressions, following guidance from the Spanish Red Cross and medical sources:

1. Place your arms under the person’s armpits and wrap them around the chest.
2. Place your hands on the center of the sternum, just above the lower part of the breastbone.
3. Perform firm, quick compressions straight down.

For infants (under one year):

The technique for infants is different and requires great delicacy. As stated in guidance from the Spanish Association of Primary Care Pediatrics, follow these steps:

1. If the infant is coughing, allow them to cough and encourage continued coughing; they will often recover without intervention. Do not slap the back or attempt blind finger sweeps of the mouth.
2. If the infant’s cough is weak, they have severe difficulty breathing, cannot cry, or turns blue, act immediately. First call emergency services (112).
3. If a foreign object is visible and accessible in the mouth, you may attempt to sweep it out gently with a finger along the inside of the cheek, taking care not to push it further in.
4. If the object is not visible or cannot be removed, give 5 firm back blows with the heel of your hand between the shoulder blades. Position the infant face-down across your forearm or lap with the head lower than the body, supporting the head with one hand.
5. If the infant still does not expel the object, turn them face-up and deliver 5 chest compressions in the center of the chest, just below the line between the nipples. Position the infant on your forearm with the head lower, and use two fingers to perform quick compressions directed forward and downward.
6. Repeat this cycle (check the mouth – back blows – chest compressions) as many times as necessary until the infant expels the object, breathes better, or loses consciousness.

Additional advice for security professionals

• Stay calm: your composure is important for the victim and for performing the maneuver correctly.
• Call emergency services: whenever possible, request medical emergency assistance (112 or local number) simultaneously with your actions.
• Ongoing training: regular practice and first aid and basic life support (BLS) training are important to keep skills up to date.

The ability to act decisively and knowledgeably in a choking emergency distinguishes a prepared professional. Mastering the Heimlich maneuver is a basic skill that can turn a potential tragedy into a scare. We hope this guide serves as a valuable resource in your daily duty and prepares you for any eventuality.