Heimlich Maneuver Remains Best Technique for Relieving Choking

The Heimlich maneuver—now more commonly called abdominal thrusts—remains one of the most effective ways to help someone who is choking. Despite years of debate over how the technique should be used, major health organizations still recommend it as part of modern first-aid training.

Today, groups such as the American Heart Association (AHA) continue to teach abdominal thrusts for conscious adults and children older than one year who are choking. However, current guidelines emphasize combining the technique with another step: back blows.

According to the AHA’s latest Guidelines for CPR and Emergency Cardiovascular Care, released in October 2025, rescuers should alternate five back blows with five abdominal thrusts. This cycle should continue until the object causing the blockage is expelled or the person becomes unresponsive.

The updated approach reflects growing evidence that using both techniques can improve the chances of clearing an airway obstruction.

For infants under one year old, the process is different. Because abdominal thrusts can cause injury to an infant’s internal organs, guidelines recommend five back blows followed by five chest thrusts instead.

The abdominal thrust technique was first introduced in the 1970s by Dr. Henry Heimlich, who believed it was the safest and most effective way to remove objects blocking a person’s airway. Heimlich strongly criticized back blows, once referring to them as “death blows,” arguing they could push an obstruction deeper into the throat.

His advocacy influenced medical guidelines for many years. Between 1986 and 2005, organizations such as the American Heart Association and the American Red Cross recommended abdominal thrusts alone for choking emergencies.

However, by 2006, the Red Cross updated its guidance to include both back blows and abdominal thrusts. Research suggested that back blows can be both safe and effective, and experts wanted to avoid relying on a single technique.

Over time, the term “Heimlich maneuver” has largely been replaced in official materials with the more descriptive phrase “abdominal thrusts.”

Some of the controversy surrounding the maneuver relates to Dr. Heimlich himself. In later years, he promoted unproven uses of abdominal thrusts for conditions such as drowning and asthma, which were later discredited. There were also questions raised about how some studies supporting his ideas were conducted.

Still, medical experts emphasize that those controversies do not change the effectiveness of abdominal thrusts for choking emergencies. When used correctly, the technique can quickly create airway pressure and help expel a lodged object.

Modern first-aid guidance now favors the combination approach because both back blows and abdominal thrusts create bursts of pressure that may help clear the airway. Using both methods may also reduce the risk of injury that can sometimes occur when abdominal thrusts are used alone.

Health professionals say the most important step is recognizing choking quickly. A person who cannot speak, cough, or breathe may need immediate help.

With choking incidents possible in homes, restaurants, and schools, experts encourage people to learn basic first aid and CPR. Knowing when and how to use back blows and abdominal thrusts could make the difference in a life-threatening emergency.