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Heimlich maneuver The Heimlich maneuver is a series of abdominal thrusts designed to create an artificial cough, which forces a foreign object out of the airway. More than 2,600 children die from accidental choking each year in this country, according to the American College of Emergency Physicians (ACEP).

These accidents are usually attributed to food, liquid, balloons, marbles, or other foreign objects that lodge in the airway and result in suffocation. Children are more susceptible to choking because their airways are narrower than adults' airways. Foods commonly implicated in choking incidents include nuts, grapes, hot dogs, popcorn, chunks of meat, hard candy, and peanut butter.

The Heimlich maneuver can be performed on an older child or adolescent using this method:

1. The helper stands behind the child and locates the bottom rib with the hand.

2. The helper moves the hand across the abdomen to the area above the navel, and makes a fist. The thumb side of the fist is kept on the child's abdomen.

3. The helper places the other hand over the fist, pressing into the child' s stomach with a quick upward thrust until the foreign object is dislodged. The force of the thrust should be adjusted according to the child's physique. A

heavy 15-year-old girl needs a firmer thrust than would a six-year-old child.

4. The helper should have someone else call 911 after the Heimlich maneuver begins, or if the child has lost consciousness. The Heimlich maneuver should be continued until the object is dislodged.

5. If the child stops breathing, loses a heartbeat, and becomes unresponsive, cardiopulmonary resuscitation (CPR) should be started immediately until help arrives.

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