top of page
  • Writer's pictureDr. Steven Horwitz

Choking and the LifeVac

How to effectively respond to a choking victim must be part of every CPR and BLS course. We teach the following methods for responding to a choking victim: Back blows, Abdominal thrusts (Heimlich Maneuver), Back blows/chest thrust for the infant.

These are great for most people. BUT ....

  • What if the person is so large that you cannot get your arms around them?

  • What if she is pregnant?

  • What if the person is wheelchair bound?

For a pregnant woman, a typical class will teach the Heimlich Maneuver with one change. Place your fist on the sternum (breastbone), not just above the belly-button. The problem here is that you are pushing into a hard bone as opposed to the soft tissue of the abdomen to engage the diaphragm. Thus, the maneuver is not as effective.

For a very large person or wheelchair bound person, getting your arms around them is not possible, so what is the best option?

We suggest the LIFEVAC (we have no financial interest in LIFEVAC). This device is perfect for a very large person, pregnant woman, or wheelchair bound victim. It is even effective for infants.



  1. Stand behind the choking victim.

  2. Wrap your arms around the victim's waist.

  3. Place the fist of one hand in the middle of the victim's abdomen just above the belly-button.

  4. Wrap your other hand around your fist and pull up and in HARD!

  5. Continue until the object is dislodged or the victim collapses.

  6. If the victim collapses and is unresponsive, do your best to get them on their back and start CPR!


  1. Grasp the infant in your arms and support their head. You can stand or sit (use your thigh to support your forearm). Keep the head a bit lower than their buttocks (angled head down).

  2. Perform 5 back blows using the palm of one hand and hit between the infant's shoulder blades.

  3. If that does not dislodge the item, turn the infant over, always supporting the head, and perform 5 chest thrusts using 2-3 fingers on the chest just like performing CPR compressions.

  4. Repeat 5 back blows, then 5 chest compressions until the object is dislodged or the infant collapses.

  5. If the infant collapses and is unresponsive, do your best to get him/her on his/her back and start CPR!

See the response algorithms below.




Rated 0 out of 5 stars.
No ratings yet

Add a rating
bottom of page