Boating and the Heimlich Maneuver

When people envision the Heimlich maneuver, they typically imagine it being performed at the dinner table or in a crowded restaurant. Rarely do they envision it being performed on a boat or on the shore. This technique, however, is an essential part of the first aid repertoire for any serious boater.

The Heimlich maneuver is essential to boaters because the physical characteristics of drowning are so similar to those of choking. Indeed, a drowning person is just a person choking on water! Like choking victims, drowning victims will turn blue, struggle to breathe, and experience excruciating pressure in the lungs. In both cases, the individual will probably lose consciousness before dying.

Since the characteristics of choking and drowning are so similar, it stands to reason that the treatment protocol for the two conditions will be similar as well. In the past, rescuers have been advised to administer cardiopulmonary resuscitation to drowning victims. Now, however, it is recommended that CPR only be performed after the execution of the Heimlich maneuver.

The effective performance of the Heimlich maneuver will be easier in certain circumstances than in others. For instance, it can be very difficult to deliver the necessary force when both parties are suspended in deep water. Therefore, if at all possible, the victim should be moved either to shallow water or to dry land before rescue attempts are made. Of course, if this cannot be done quickly than the Heimlich maneuver should be executed as effectively as possible given the circumstances.

The basic performance of the Heimlich maneuver is the same regardless of where it is performed. The rescuer will stand behind the victim, and position his or her arms under the arms of the victim. The rescuer should make his or her right hand into a fist and place it on the victim’s upper abdomen, just below the rib cage. His or her left hand is then placed on top of the right hand, and a series of rhythmic, forceful motions are made toward the victim’s solar plexus. If done correctly, this motion should force out whatever is blocking the victim’s breathing passage. It may take four or five thrusts to entirely clear the breathing passages of water.

In order to get the leverage required to generate the appropriate force, the rescuer should be standing or sitting on the ground. If this is impossible, and both rescuer and victim are in deep water, a life jacket should be placed between the chest of the rescuer and the back of the victim. This will enable the rescuer to generate a bit more force. As much as possible, the victim’s head should be tilted back so that the breathing passages are open. It is imperative that the victim’s face be kept above water at all times during the Heimlich maneuver. Also, it is typical for the victim to lurch backward as the water is expelled from his or her lungs, so the rescuer should be wary of being struck by the victim’s head.

If the Heimlich maneuver is being performed on dry land, the rescuer can lie on the ground with the victim on top of him or her. The rescuer can then wrap his or her leg around the victim, in effect holding the victim in place while the Heimlich maneuver is performed.

Research suggests that the Heimlich maneuver is especially effective in cases where the drowning has occurred in a swimming pool. In part, this is because it is usually quite easy to move a victim from the pool onto solid ground. The Heimlich maneuver is also especially beneficial in pool drowning because it rapidly removes the chemicals in pool water from the body. It seems that in many pool drowning episodes, the victim experiences long-term health problems because of the prolonged internal exposure to the harsh chemicals that are used to clean the water.

In any case, the Heimlich maneuver is a quick and effective way to clear the breathing passages in cases of drowning. When it is performed, the rescuer should check to make sure that water is being expelled from the victim’s mouth. In most cases, the expulsion of water will be accompanied by a physical response from the victim, typically coughing or wheezing. If, however, the maneuver does not immediately provoke response or restore consciousness, the rescuer should begin cardiopulmonary resuscitation.


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