Heimlich maneuver

J

Josiah

Senior Member
Location
50 miles east of Cincinnati, OH
Has anyone ever had to employ the Heimlich maneuver in a real emergency situation?
My wife has been having progressively more trouble getting food to go down the correct tube. I've had to employ HM a couple of times although it wasn't clear whether it was the maneuver that actually fixed the problem? I talked to a nurse about my technique and she warned me that a risk factor was breaking the victim's rib and now I'm worried about the next occurrence because my wife does have osteoporosis.
 

Are there any particular foods that she has trouble with Josiah? Can she just avoid those foods?

On occasion I used to have trouble with rice and I think it was partly my eating too fast and partly a misstep in the 'rings' of the throat that push the food down. It's an awful distressing feeling to be 'choking' so I feel bad for your wife that's for sure. I at least could breathe if I stopped trying to swallow and didn't make the mistake of trying to wash it down with a drink. It seems that those 'rings' must relax and open up at their own pace.
 
I had my throat stretched to help prevent choking. A few years before I retired from the airline, I was flying a non-stop coast to coast flight. I turned the controls over to my First Officer, so I could eat my lunch. I began choking of my food, (can't remember what it was), and luckily, the Purser (head flight attendant) had just asked to come into the cockpit. We sit behind armored doors now, since 911, so we have to buzz them in. Just as she came in, I began choking and she performed it on me. Luckily, the FA's are all trained is this area along with CPR and general first aid.

I went to the doctor's shortly after arriving in San Francisco because my throat was scratchy and sore and I wanted to make sure that nothing else was stuck. He told me that I had an unusually small esophagus and that I should go see an Endoscopic physician when I got home, which I did and he confirmed the diagnosis. He performed an endoscopic exam two days later and said he stretched my throat. It has helped minimally, but I have learned to take smaller bites and chew more before swallowing. I bought the Purser a nice gift card to Red Robin, which is a restaurant, because I wanted to thank her and also I heard her talk about Red Robin quite often. I also had to thank her for introducing me to Red Robin. It's a pretty nice place. Very friendly, even to us seniors.
 

If you know what you are doing Josiah, then you should be ok. Better a broken rib than choking to death anyway.It always looks an impressive manouvre when you see it being done [only seen this on tv though.]Cereal with milk always seems to be hard to eat without a certain amount of coughing and choking for me, so I gave it up, it was the thin liquid combined with a scratchy substance [cornflakes, branflakes] that did it.Try and see what foods affect your wife, are they always the same foods?
 
Thank you all for your helpful comments. In my wife's situation I'm convinced that the dementia which once only affected her cognition is now affecting many autonomically controlled functions such as swallowing. She is on a pureed diet, but I will try to observe which foods she is having trouble with.

I have decided that in accordance with her advanced directive, I will not countenance the use of a feeding tube which may not sit well with some of the nursing home staff.
 
I'm sorry that it's not just a simple fix like 'avoid certain foods'. Have you mentioned that dementia is an issue for your wife? Sorry I just can't remember if I'd read that here before.

That must be so painful for you to bear watching her slip away from you! Truly a sad state of affairs.

I take it from the mention of her 'advance directive' that you both talked about the ramifications of her diagnoses and I suppose that makes it a bit easier to make hard decisions doesn't it?
 
Josiah09 said:
Has anyone ever had to employ the Heimlich maneuver in a real emergency situation?
My wife has been having progressively more trouble getting food to go down the correct tube. I've had to employ HM a couple of times although it wasn't clear whether it was the maneuver that actually fixed the problem? I talked to a nurse about my technique and she warned me that a risk factor was breaking the victim's rib and now I'm worried about the next occurrence because my wife does have osteoporosis.
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Feel for the bottom of the ribcage.. Go beneath it, under the breastbone.. make a fist with one hand and cup it with the other and direct your thrust UPWARD... It may take several thrusts.. IF she loses consciousness, lay her gently down.. Straddle her body.. and again feel the ribs.. go below them and the breastbone and take both hands and push up toward her head.. after every thrust, take a finger and sweep her mouth to clear any food that may have been ejected..

Yes... I have used heimlich several times sucessfully.

About broken ribs... a broken rib is not a huge price to pay for breathing and living. I personally have broken ribs many times during CPR.. The first time it happens it's weird.. to push down on someones chest and to hear that CRACK.... but again, small price to pay for having ones life saved. It happens and is sort of expected especially in an elderly person. However, there is less chance of that with Heimlich (done correctly) than full CPR (done correctly)
 
Josiah: My wife's uncle had Huntington's disease and it ended up taking his life. I also had a very close friend whose Mother had ALS. Both had a very difficult time swallowing. Both wore bibs and had all of their food blended in a blender. (Sorry, can't think of the correct word.) I felt so bad watching my friends try to feed these people. I wished that I could have done something to help, but there really isn't much to do. I bought some special food at a diet store that is powder and then mixed with milk or water and it is supposed to be full of the good stuff, like vitamins and minerals. (I thought that it tasted very good and actually bought some for myself as a snack when flying.) They still had to spoon if for them. That's all that I could do to help.

I also have a friend in Florida that is going through what you are, but he cuts his wife's food in very small, and I mean very small, pieces. He is also in a program, I have no idea exactly what this is, but it is a program that a lady comes in everyday and helps to clean, make beds, etc. and also to feed his wife lunch to give him a break. He is in his low 80's, but he is my friend, so we call each other at least once or twice a month, unless I am in my Florida home. His mind is sharp as a whistle and he has been told that he has a photographic memory, which I thought was just an expression, but is real.

I really appreciate what people do for their loved ones when going through times like these. It isn't just something that we must do, but it is an act of love. Thank you for caring. I know a few people would have shoved their spouse into a nursing home.
 
Pappy said:
QS. I have been told, if you are alone, that a back of a chair can be used in an emergency. I guess it might take a few tries but could save your life. Ever hear of this?
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Yes I have heard that, but have never met anyone who had to use it.. I imagine it would work.
 
QuickSilver said:
Feel for the bottom of the ribcage.. Go beneath it, under the breastbone.. make a fist with one hand and cup it with the other and direct your thrust UPWARD... It may take several thrusts.. IF she loses consciousness, lay her gently down.. Straddle her body.. and again feel the ribs.. go below them and the breastbone and take both hands and push up toward her head.. after every thrust, take a finger and sweep her mouth to clear any food that may have been ejected..

Yes... I have used heimlich several times sucessfully.



About broken ribs... a broken rib is not a huge price to pay for breathing and living. I personally have broken ribs many times during CPR.. The first time it happens it's weird.. to push down on someones chest and to hear that CRACK.... but again, small price to pay for having ones life saved. It happens and is sort of expected especially in an elderly person. However, there is less chance of that with Heimlich (done correctly) than full CPR (done correctly)
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Thank you QS for the very detailed instructions (I was doing it wrong). Debbie with regard to my wife's Advanced Directive, her dementia is so severe that she has been unable to talk seriously about anything for nearly a year. She signed her Advanced Directive long before the onset of her dementia and I'm simply going to have to assume they reflect her current wishes.
 
Josiah09 said:
Thank you QS for the very detailed instructions (I was doing it wrong). Debbie with regard to my wife's Advanced Directive, her dementia is so severe that she has been unable to talk seriously about anything for nearly a year. She signed her Advanced Directive long before the onset of her dementia and I'm simply going to have to assume they reflect her current wishes.
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As her spouse, you automatically take the role of consentor.. as she is unable to make her own decisions... Many people do not have advance directives in place... however, the line of kinship kicks in with regards to healthcare decisions. The first turned to is the Spouse.. If there is no spouse, then the children... after that the parents (if the person is young enough to have living parents).. If there are no parents or children.... then siblings.. If there are no siblings then assorted neices and nephews.. and so on down the line. There is no need to go to court to obtain this authority.

THe reason for advance directives is to let YOU know what HER wishes would have been.. The reason for a healthcare power of attorney is to pick a person to speak for you.. Sometimes people do not want their spouse or kids to have a say. They can change the line of kinship..
 
Josiah09 said:
Thank you QS for the very detailed instructions (I was doing it wrong). Debbie with regard to my wife's Advanced Directive, her dementia is so severe that she has been unable to talk seriously about anything for nearly a year. She signed her Advanced Directive long before the onset of her dementia and I'm simply going to have to assume they reflect her current wishes.
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Well Josiah, our thoughts and prayers are with you and your wife in this dreadful and difficult time. I think what you've shown all of us here is how important it is for each to have these discussions and sign something to indicate our wishes in the event of the unthinkable.

Hey QS! Have you ever seen where a spouse's instructions on behalf of their 'silent' partner was disregarded by the medical establishment? I can't help but remember Terry Schiavo and wonder if we absolutely should have something in writing.
 
Debby said:
Well Josiah, our thoughts and prayers are with you and your wife in this dreadful and difficult time. I think what you've shown all of us here is how important it is for each to have these discussions and sign something to indicate our wishes in the event of the unthinkable.

Hey QS! Have you ever seen where a spouse's instructions on behalf of their 'silent' partner was disregarded by the medical establishment?
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Yes... Because a Living will is not worth the paper it is written on.. A family member can negate a living will and do as they wish and the Hospital will go along. Now... A Healthcare Power of Attorney has teeth... The designated Agent in that is always followed.. It is a legal document.. The family would have to go to court to have it nullified. therefore.. my advise is to always have the Healthcare POA in place... and to have detailed talks with the person you have designated as your Agent so you know that they understand your wishes and are strong enough to stand up to family members who would wish otherwise.
 
Well thanks for that QS. I wonder if it's the same in Canada....probably eh? Well my family knows my wishes, I know theirs and maybe I'll even look into this HPA that you mentioned.
 
My mother developed a crook in her esophagus when she got older, which caused her to choke frequently on foods, even though she was careful and didn't eat large amounts at once. The doctor said it was common in the elderly, and where the crook was also caused a weakening of the area. Supposedly there are various reasons that this may happen to some seniors. They didn't give her anything for it, so she just dealt with it. She let us all know that if she was choking, not to give the HM, because that was not her problem. Once she started choking in a Chinese restaurant, and we left as soon as it was over, she insisted because she was so embarrassed. :(
 
SeaBreeze said:
My mother developed a crook in her esophagus when she got older, which caused her to choke frequently on foods, even though she was careful and didn't eat large amounts at once. The doctor said it was common in the elderly, and where the crook was also caused a weakening of the area. Supposedly there are various reasons that this may happen to some seniors. They didn't give her anything for it, so she just dealt with it. She let us all know that if she was choking, not to give the HM, because that was not her problem. Once she started choking in a Chinese restaurant, and we left as soon as it was over, she insisted because she was so embarrassed. :(
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The choking response is prompted by food entering the trachea and it would seem to me that the HM would always be appropriate as a means of expelling the errant food. Why did your mother feel it wouldn't work, or perhaps I don't understand her situation correctly.
 
I'm not sure Josiah, she just was going by the information she received from the doctor. The coughing always passed and only lasted a minute or so. I didn't question anything at the time, as I was just visiting her and lived out of state. I was out of the loop regarding her health care.
 
It may.... However, choking most commonly is caused by food entering the trachea through the glotis and cutting off the flow of air. The Heimlich works by forcing air out of the lungs at high pressure and expelling the object. Food stuck farther down in the esophagus may not cause the choking response and will just feel very uncomfortable. Rule of thumb... if a person can talk... they are not choking.
 
She did say I'm okay, just a minute while she was choking at the restaurant...so she was able to talk.
 
SeaBreeze said:
She did say I'm okay, just a minute while she was choking at the restaurant...so she was able to talk.
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meaning the food was farther down in her esophagus... because we talk by expelling air from our lungs out our trachea and over our vocal cords.. If that were blocked air cannot escape and we cannot talk. The natural reflex when food goes down the trachea is to cough and choke...This is were the term... "it went down the wrong pipe" comes from... Any hooo...... if someone is coughing and choking you must always ask them if they can talk. If they shake their heads "no"... then do Heimlich.
 
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