Nursing & Healthcare Programs

Performing the Heimlich Maneuver

Written by Amanda R. McDaniel, MS, BSN, RN
Amanda is a BSN/RN with a MS in Physiology and a BA in English. She worked as a medical writer in the pharmaceutical industry for 11 years before pursuing a career in nursing. She now works as a nurse on a NeuroTelemetry unit and continues to write and edit on a freelance basis. Amanda’s LinkedIn

The Heimlich Maneuver, also known as abdominal thrusts, is used to remove an object that is blocking a resident’s airway and preventing air from reaching the lungs. It only takes four to six minutes for brain damage to occur from lack of oxygen, so prompt action is vital.

How to Perform the Heimlich Maneuver

  1. Ask the resident if he can speak.
    • If he can speak and is coughing, do not proceed. Monitor the resident.
    • If he is unable to speak or becomes unable to speak, go to step two.
  2. If the resident is sitting or standing:
    • Move behind him, kneel if necessary (e.g., to help a child).
    • Wrap your arms around the resident’s waist.
    • Make a fist with your thumb toward the resident and place it just above the resident’s navel.
    • Grasp your fist with your other hand.
    • Make forceful, quick, inward and upward thrusts with your fist until the object dislodges, and the resident can breathe.
  3. If the resident is lying down:
    • Turn him onto his back.
    • Straddle him, facing his head.
    • Make a fist with one hand and place it just above the resident’s navel.
    • Grasp your fist with the other hand.
    • Make forceful, quick, inward and upward (toward head) thrusts until the object dislodges, and the resident can breathe.
  4. Notify the nurse and continue to monitor the resident per institution or unit protocol.

Reference

Heller, J.L. (2015, April). Abdominal thrusts. MedlinePlus. Retrieved from https://medlineplus.gov/ency/article/000047.htm

More Resources

Offering the Bedpan

When a resident is bed-bound, they must use a bedpan to urinate and defecate. This can be embarrassing for the resident, so it should be done with sensitivity to the resident’s privacy and dignity. There are two types of bedpans. A regular bedpan is the deeper and more rounded of the two. A fracture pan has a relatively flat upper end with a trough at the lower end. Fracture pans are used for residents who have difficulty, or restrictions against, moving their hips and/or backs.

Prone Position

Prone position is not used as commonly as other patient positions. This position allows for full extension of the hips and the knees and gives many bony prominences a break from continuous pressure. However, placing patients in prone position does not come without the risks of pressure ulcers.

Transferring the Resident from a Bed with a Mechanical Lift

A mechanical lift is used to transfer residents who cannot support their own weight. When used properly, mechanical lifts prevent injuries for both residents and health care workers. It is important that a nurse’s assistant be trained to use the mechanical lift before attempting to operate it. Most facilities require at least two health care workers to assist when using a mechanical lift.

Using a Gait / Transfer Belt to Assist the Resident to Ambulate

Walking (aka, ambulating) helps residents maintain mobility and independence, and prevents complications. However, ambulation must be done safely so that the resident does not have a fall or injury. A gait or transfer belt, when properly used, can increase resident safety. Gait belts can vary between facilities, so make sure you know how to use the one in your facility.

Supine Position

Supine position is a natural and comfortable position for most people. For this reason, it is a highly utilized position for nursing procedures. Unfortunately, this position puts pressure on many bony prominences that can lead to discomfort and/or pressure ulcers if the pressure is not relieved every so often (typically every two hours or less).

Perineal Care of the Female Resident

Perineal care should be performed during a bath, after using the bedpan, and/or after incontinence. Proper technique is important for maintaining hygiene, preventing infection, and avoiding skin breakdown. Because of the close proximity between a woman’s urethra, vagina, and anus, it is essential to only wipe in a front to back motion. Wiping in the opposite direction is associated with a greater risk for developing a urinary tract infection.