Abdominal Thrusts

Definition: Quick, inward and upward thrusts to the upper abdomen used as part of the choking response in children over 1 year old and adults. Under current AHA 2025 guidelines, abdominal thrusts are now alternated with back blows (5 back blows, then 5 abdominal thrusts) until the object dislodges. Abdominal thrusts are the modern medical term for what is commonly known as the Heimlich maneuver.

Parent Tip: Stand or kneel behind the choking person, slightly lower than or level with them. Lean them forward and start with 5 back blows between the shoulder blades. If the object does not come out, switch to abdominal thrusts: make a fist and place the thumb side just above the belly button and well below the breastbone, about two finger widths above the navel. Wrap your other hand around your fist and pull sharply inward and upward, like you are trying to lift them off the ground. Each thrust should be a distinct, forceful motion, not a squeeze. Continue alternating 5 back blows and 5 abdominal thrusts until the object comes out or the person becomes unresponsive.

Why It Matters: The 2025 AHA guideline change to alternating back blows and abdominal thrusts reflects research showing that combining the two techniques is more effective than either one alone. Abdominal thrusts use the air still trapped in the lungs to forcefully push the object out, the same way a cough would if the airway were not blocked. Never use abdominal thrusts on infants under 1 year old, whose organs are too close to the surface. For pregnant or significantly larger people, use chest thrusts instead of abdominal thrusts.

Related Terms: Back Blows, Chest Thrusts, Choking, Heimlich Maneuver, LifeVac

Written and reviewed by Jeremy Manke, Firefighter / Paramedic (22 years of emergency service)

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