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Why YSK:

Despite choking being an emergency, until recently there has been limited high-quality evidence to guide bystanders on the most effective way to help. Techniques like abdominal thrusts (formerly known as the Heimlich maneuver), back blows and chest compressions or thrusts have existed since the mid-1900s but, until recently, recommendations were largely based on case reports rather than rigorous scientific data. This evidence gap is dangerous.

Bystander response is the primary driver of a choking person’s outcome, so ensuring people know the safest and most effective way to care for a choking person can save lives.

Please see the article for the full piece, it's not long.

Article authors:

  • Cody Dunne - Emergency Medicine Physician and PhD Candidate, University of Calgary
  • Andrew McRae - Associate Professor, Departments of Emergency Medicine and Community Health Sciences, University of Calgary
  • Khara Sauro - Associate professor, Cumming School of Medicine, Department of Surgery, University of Calgary

If you need more motivation to open the article, here is an interesting fact:

New research suggests back blows cleared choking obstructions in 72 per cent of cases, superior to both abdominal thrusts (59 per cent) and chest thrusts (27 per cent).

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[-] AFKBRBChocolate@lemmy.ca 28 points 2 weeks ago

I had a surreal experience once. I was at a busy, casual restaurant at a booth, sitting across from my wife. There was a lady eating alone at a booth a little way behind my wife, and I noticed she looked kind of distressed - looking around like she was trying to catch a waiter - but she seemed to be getting more panicked looking and her face didn't look right. I got up and went over and said "Are you chocking?" and she looked at me with big eyes and nodded. I asked if she wanted me to try and help and she said yes and stood up. I never learned how to do the Heimlich except from TV shows, but seemed worth a try, so I did what I remembered, and she coughed up a piece of chicken. She looked really embarrassed and said "Thank you." I said I was glad to help and went back to my seat. No one in the place noticed a thing except for my wife.

[-] fleem@piefed.zeromedia.vip 17 points 2 weeks ago

holy shit! pretty calm, glad it was chill, but you totally saved their life!!

[-] AFKBRBChocolate@lemmy.ca 15 points 2 weeks ago

Funny, when I sat back down, my wife just calmly said, "Did you just save that woman's life?" It was weird, we just went back to eating and never really talked about it again except when someone would mention the Heimlich and my wife would tell the story.

[-] ZiggyTheZygote@lemmy.ca 11 points 2 weeks ago

That was too awkwardly casual of everyone. I would've at least given you a high five!

[-] AFKBRBChocolate@lemmy.ca 13 points 2 weeks ago

We're such weird creatures. That woman was choking to death and she was too shy to ask for help and too embarrassed after to say much of anything.

[-] Marshezezz@lemmy.blahaj.zone 4 points 1 week ago

Might have been shock on her part. I choked in a restaurant before on a peppermint and my mom saved me with abdominal thrusts but I was really shaken up afterwards from how scary it got and couldn’t really react much for a while afterwards

[-] HellieSkellie@lemmy.dbzer0.com 24 points 2 weeks ago

thankfully all i do is blow backs. everytime i see someone i make sure to blow their back. im just back blowing nonstop. i saw your mother at the market last week and blew her back.

[-] BakedCatboy@lemmy.ml 9 points 1 week ago

Thank you for your service

[-] stephen@lemmy.today 3 points 1 week ago

Not all heroes wear capes!

I’m just over here saving my wife’s life on the regular.

[-] TemplaerDude@sh.itjust.works 3 points 1 week ago

Fuck me I was about to question why you see so many choking people 🤣🤣

[-] Imgonnatrythis@sh.itjust.works 9 points 2 weeks ago

Hol up, the maneuver formerly known as Heimlich??

Was Heimlich canceled? First I've seen this.

[-] new_otters_raft@piefed.ca 10 points 2 weeks ago

https://en.wikipedia.org/wiki/Abdominal_thrusts

See the History section here for some controversies. From what I remember, there is disagreement on whether he asked for the name to be changed or if institutions changed it first

[-] ObtuseDoorFrame@lemmy.zip 6 points 1 week ago

Interesting. I was eating at a restaurant with my mom a few years ago and she accidentally inhaled a piece of food which had the same diameter as her esophagus. It was terrifying. She just pointed at her throat and had this look on her face like she knew she was going to die. She stood up, turned around, and I did what I thought was the heimlich maneuver. I must've done it right, or got lucky, but it worked flawlessly. The food came flying out. I guess we're in that 59%.

[-] Slatlun@lemmy.ml 5 points 2 weeks ago

This is interesting because CPR/first aid classes specifically teach (taught) that back blows are harmful and cause obstructions to get lodged lower in the airway except for very young people who you can turn upsidedownish. Time to rethink. Love it!

[-] toofpic@lemmy.world 4 points 2 weeks ago

I was taught the same as a part of nurse training - maybe I was given outdated information, I don't know. Bu t of course I was surprised by the article

[-] NannerBanner@literature.cafe 4 points 1 week ago

My most recent bls cpr recert talked about back blows, and said chest thrusts before abdominal thrusts.

[-] scutiger@lemmy.world 2 points 1 week ago

When giving the back blows, you should have the person bend over first.

[-] SanctimoniousApe@lemmings.world 4 points 1 week ago* (last edited 1 week ago)

Evidence says begin with back blows

I don't think I can push enough air out to make a difference - even from the back.

[-] kboos1@lemmy.world 4 points 2 weeks ago

Interesting because all of my first aid instructions say not to slap people on the back. Why should I believe this over instructors and doctors?

[-] NannerBanner@literature.cafe 5 points 1 week ago

You can read the wikipedia about the abdominal thrusts that another comment linked. There's a line in there about heimlich not being 'scientific' in his pushing of the abdominal thrusts and denigration of back blows.

[-] Catoblepas@piefed.blahaj.zone 2 points 2 weeks ago

The sources for this are also instructors and doctors, OP listed them. It sounds like this is new research and best prescribes may be in the process of changing if further research bears these findings out.

[-] scutiger@lemmy.world 2 points 1 week ago

I recently took a first air course. I was told abdominal thrusts were the first course of action. If the person is obese and you can't get your arms around them, you should try back blows first. You have the person bend over and give them hard palm strikes in the back, not slaps. If you still can't get the obstruction out, the last option is chest compressions, but that's likely to break ribs in the process.

[-] porcoesphino@mander.xyz 3 points 1 week ago* (last edited 1 week ago)

The more eyes the better and this seems to be the recommendation:

If the person goes quiet, cannot speak or cry, or can only weakly cough, you want to start with five strong back blows first. With the person bent forward at their hips, deliver firm glancing blows between their shoulder blades using the heel of your hand up to five times.

If the obstruction does not clear, switch to abdominal thrusts. Continue alternating five back blows and five abdominal thrusts until the obstruction is cleared or the person becomes unconscious.

I'm still looking for what to do if I'm alone and something happens.

The article also uses the text "In the updated guidelines, our Canadian study was cited to inform this critical change, and was the only study directly comparing different choking techniques." to link here:

https://cpr.heart.org/en/resuscitation-science/cpr-and-ecc-guidelines/adult-basic-life-support

But I see no mention of any of these directions there. If someone does, let me know where I'm scanning over.

Edit: Failing at adding an underline to signal the actual link while having the URL readable.

[-] Fondots@lemmy.world 2 points 1 week ago

I'm still looking for what to do if I'm alone and something happens.

You can do abdominal thrusts on yourself, or you can use something like the back of a chair or a railing to rest your fists on and use your body weight to basically perform the same action

[-] Iconoclast@feddit.uk 1 points 1 week ago

I’m still looking for what to do if I’m alone and something happens.

How to unchoke yourself if you're dying alone.

[-] Buddahriffic@lemmy.world 1 points 1 week ago

It's something I've thought about a bunch and the strategy I've come up with is:

If your breath is blocked, hold your breath at first and stay calm. Trying to breathe in could wedge it farther in. And trying to breathe out will likely move it, but gravity might just drop it back where it was only with less air in your lungs, which you need to help dislodge the obstruction. Panicking will make you more likely to waste your chance at getting it without needing to fall on something and potentially break ribs (or fail and die). You'll probably have to suppress your cough reflex. I've never done this before and have no idea how much conscious control one would have in that moment and I'm also someone who trained myself to be able to suppress coughs (to avoid embarrasing bong hits lol).

Lean forward, the farther the better, to the point where loose food in your throat will just fall out your mouth. Then cough, if you make it also a growl, you can add more force, as you don't want to half-ass this. Your air might still be limited.

You should be able to feel if you're making any progress. If you are, keep at it, if not, switch to the "fall on something to knock the wind out of you" strategy, still keeping your mouth angled down and add a cough as it impacts.

If that fails, make a big ruckus. I've told my daughter that if she starts choking and can't speak to get my attention, knock dishes onto the floor to get my attention. If you're completely alone in your home, throw a pot out your window before running out your front door. Try to be efficient with your time and energy. Dial 911 and hope they send someone and don't assume a prank call or a kid when no one responds.

[-] Doom@lemmy.world 0 points 1 week ago

If you're alone. Call 911 (or your regions equivalent) and wait outside for emergency services. Keep trying to cough while you wait. If you see anyone flag them down but don't go searching for people. I know you're looking for a self heimlich but your safest bet is to keep trying to cough and to wait for emergency services or for other help to come along. Getting the thrust you need to clear your airway, especially while starved for oxygen, is not guaranteed. So if you ever find yourself in that situation call for help. If you start choking and you're a healthy adult you'll have 3 to 5 minutes of consciousness. Use it wisely.

[-] porcoesphino@mander.xyz 1 points 1 week ago* (last edited 1 week ago)

The only times I've been a bit worried have been eating chicken that I could get down with water so not really the same thing but sometimes it's gotten difficult enough I've wondered if I'll need a bit of help, but that's not really choking or close to blackout. Unfortunately the times I remember I've been alone, in an apartment building 10+ floors up in a foreign country. Agreed the safest bet is others but based on those situations I think there are times where it's tough to guarantee another person will see you and I was aiming to learn what my last resort should be.

[-] jonesey71@lemmus.org 2 points 1 week ago

Not to be "that guy" but for me it really depends on who is choking. Some people I could see choking and my response would be to calmly finish my meal and in my head hope that they expire before I lose my appetite due to their horrible death rattle.

[-] pineapplelover@lemmy.dbzer0.com 2 points 1 week ago

Well, yeah. Is this just listing the first air procedure for choking? Something we've been doing for fuck long?

this post was submitted on 23 Feb 2026
80 points (97.6% liked)

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