Choking Safety and the Heimlich Maneuver

What is Choking Safety and the Heimlich Maneuver?

During a company lunch event at a manufacturing plant in Dayton, Ohio, maintenance technician Luis Herrera began choking on a piece of steak. He stood up, grabbed his throat, and tried to cough but could not make a sound. Three coworkers watched in confusion for nearly 40 seconds before a supervisor ran over and performed abdominal thrusts, dislodging the food on the fourth attempt. Luis was fortunate -- an unconscious choking victim can suffer brain damage in as little as four minutes without oxygen, and the delay nearly cost him his life.

Choking safety is the awareness and skill set needed to recognize airway obstructions and respond immediately using the Heimlich maneuver or other clearing techniques. It covers prevention strategies for eating and working environments, the universal choking sign, and the correct physical technique for conscious and unconscious victims.

Key Components

1. Recognizing a Choking Emergency

• A person with a complete airway obstruction cannot cough, speak, or breathe and may clutch their throat with both hands -- this is the universal choking sign
• Skin may turn blue or gray, especially around the lips and fingertips, and the person may make high-pitched wheezing sounds or no sound at all
• Distinguish between mild and severe choking: if the person can cough forcefully and speak, encourage them to keep coughing and do not intervene with thrusts
• Children and elderly individuals are at higher risk, but choking can happen to anyone eating too quickly, laughing while eating, or working with small objects near the mouth

2. Performing the Heimlich Maneuver Correctly

• Stand behind the conscious choking victim, wrap your arms around their waist, and place the thumb side of your fist just above the navel and well below the breastbone
• Grasp your fist with your other hand and deliver quick, forceful upward thrusts that compress the diaphragm and force air up through the windpipe
• Continue delivering thrusts until the object is expelled, the person can breathe and cough on their own, or they become unconscious
• For a pregnant person or someone too large to reach around, perform chest thrusts by placing your fist on the center of the breastbone and pulling straight back

3. Handling Unconscious Choking Victims and Special Situations

• If a choking victim becomes unconscious, lower them carefully to the ground, call 911 immediately, and begin CPR starting with chest compressions
• Before each set of rescue breaths during CPR, look into the mouth for the obstructing object and remove it with a finger sweep only if you can see it clearly
• For infants under one year, use a combination of 5 back blows between the shoulder blades and 5 chest thrusts with two fingers on the breastbone -- never use abdominal thrusts on infants
• After any choking event that required the Heimlich maneuver, the person should be evaluated by medical personnel because abdominal thrusts can cause internal bruising or organ injury

Building Your Safety Mindset

1. Prevent Choking Before It Happens

   • Cut food into small pieces, chew thoroughly, and avoid talking or laughing with food in your mouth during work meals and break room dining
   • Keep small hardware items like screws, bolts, and caps out of your mouth -- a habit many workers develop without thinking about the aspiration risk
   • Ensure break rooms and eating areas are supervised or have at least two people present so someone is always available to help during a choking emergency

2. Build the Confidence to Act Immediately

   • Practice the hand positioning for the Heimlich maneuver on a training mannequin so the fist placement and thrust motion become second nature
   • Remember that a choking person has minutes, not hours -- hesitation is the biggest threat, and performing imperfect thrusts is far better than standing by while someone suffocates
   • Mentally rehearse the scenario: someone stands up, grabs their throat, cannot speak -- you move behind them, position your fist, and deliver thrusts without waiting for permission

3. Create a Team-Ready Response Culture

   • Discuss choking response during your next team safety meeting and ask everyone to demonstrate the correct fist placement on their own abdomen
   • Post a simple choking response poster in every break room and eating area showing the universal choking sign and the Heimlich maneuver steps
   • After any choking incident, debrief as a team to review what happened, how quickly the response occurred, and what could be improved

Discussion Points

1. If someone at the next table in the break room suddenly stood up and could not speak or breathe, how many seconds would pass before you physically intervened -- and what is causing that delay?
2. What are the most common choking hazards in your specific work environment beyond food, and how should the response differ for an object like a small bolt versus a piece of food?
3. How would you modify your response if the choking victim were significantly larger than you, pregnant, or in a wheelchair and you could not get behind them easily?

Action Steps

• Practice the correct hand position for the Heimlich maneuver right now by placing your fist above your own navel and visualizing the upward thrust motion
• Verify that a choking response poster is visible in your break room or eating area, and request one from your safety coordinator if it is missing
• Identify at least two coworkers in your immediate work area who have current first aid training that includes choking response
• Review the differences between responding to a conscious choking adult, an unconscious victim, and an infant so you are prepared for any scenario