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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[–] 127 points 7 months ago (20 children)

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.

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  • [–] 61 points 7 months ago (1 child)

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

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  • [–] 58 points 7 months 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.

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  • [–] 39 points 7 months ago (5 children)

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

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  • [–] 50 points 7 months ago (4 children)

    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.

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  • [+] 24 points 7 months ago* (last edited 2 months ago) (3 children)
  • [–] 12 points 7 months ago (2 children)

    Same for the person I performed the heimlich on, I found it odd at the time and her daughter thanked me profusely, it was surreal. I also remember being terrified on hurting her as well as potentially being sued if I had, she was a bigger lady and really short so I had her like fully off the ground squeezing the absolute fuck out of her

    What a world where I have to have that thought while trying to help

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  • [–] 15 points 7 months ago (8 children)

    I have the exact opposite experience. I was waiting tables at place with a stage and 500 seats, lights are out, I notice a woman is choking and I went for the heimlich, successfully dislodged something as the house lights were brought on and 500 people are staring at us.

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    [–] 59 points 7 months ago (4 children)

    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.

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  • [–] 55 points 7 months ago* (last edited 7 months ago) (12 children)

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

    If an adult or child can still cough, cry or speak clearly, then they are still able to clear the obstruction themselves. Get them to lean forward while encouraging them to cough forcefully.

    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.

    Edit: Added the preceding "then they are still able to clear the obstruction themselves" paragraph that I'd mostly scanned over when reading the article

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  • [–] 29 points 7 months ago (1 child)

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

    How to unchoke yourself if you're dying alone.

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  • [–] 12 points 7 months ago*

    This video is surprisingly entertaining and covers:

    • You can't talk to 911 (or equivalent) if you're chocking
    • Ideally go where people might see you
    • How to try to dislodge what you're chocking on if no-one helps
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  • [–] 12 points 7 months ago

    Back when I was in Boy Scouts, we learned how to do abdominal thrusts, and how to do it to yourself. You make the same hand shape (IIRC, one hand clasped over the other with your thumb knuckles forming a triangle into the abdomin), and place your hand in the back of a chair (assuming you're near a chair, which is likely). You then press yourself into it.

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  • [–] 9 points 7 months 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

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  • [–] 8 points 7 months ago (4 children)

    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.

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  • [–] 16 points 7 months ago (2 children)

    I had to wait 45 minutes for an ambulance when I thought I was about to die. You'll fall unconscious within 5 minutes. Die within the next 5. Even if you manage to make the call, they won't know what the hell is wrong with you because you can't talk. Learning to save yourself in that situation is extremely important, because actual first responders won't make it there on time.

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  • [–] 7 points 7 months ago (1 child)

    the extra information is pretty important too… afaik most remediation for choking should be avoided early on because it’s actually fairly likely the person can clear the obstruction themselves, but if you time a thrust with their breath it can be very bad, and actually cause them to suck the object further in when they gasp for air

    not a doctor or anyone with medical training, but i heard it at some point and it kinda makes sense

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    [–] 21 points 7 months ago (1 child)

    Hol up, the maneuver formerly known as Heimlich??

    Was Heimlich canceled? First I've seen this.

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  • [–] 20 points 7 months ago (9 children)

    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!

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  • [–] 10 points 7 months ago (4 children)

    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

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  • [–] 6 points 7 months ago

    Specifically.... Right up until they changed it just last year.

    Things like this and CPR get changed more often than a lot of people would expect (which is also to say most people never know it changes) but it all gets changed based on what seems like it has the best outcome based on the information\data at hand. Usually there's one or two adjustments every decade. Make some changes and then see if odds improve over the course of years.

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    [+] 18 points 7 months ago (10 children)
  • [–] 15 points 7 months ago (8 children)

    Learn to be ok with taking the L and spit food that is too hot back out of your mouth instead of swallowing. Also, test the temperature with smaller bits that will cool inside your mouth easier before going for a big bite.

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    [–] 17 points 7 months ago (1 child)

    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%.

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  • [–] 8 points 7 months ago

    The same thing happened to my son. Luckily I had first aid training and actually knew how to do the Heimlich. I didn't know that you were supposed to do back blows first though. When I learned, they just told me to go straight for the Heimlich.

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  • [–] 13 points 7 months ago (2 children)

    Great, now I can't wait to E.Honda the shit out of someone's back.

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    [–] 12 points 7 months ago* (3 children)

    We're god's perfect creations, except accidentally running the very simple commands "swallow" and "breath" at the same time can result in a fatal error.

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    [–] 11 points 7 months ago

    Finally, a YSK post that actually is a YSK.

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  • [–] 8 points 7 months ago (6 children)

    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?

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    [–] 5 points 7 months 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.

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