ABSTRACT
The Heimlich maneuver (HM) is lifesaving in a patient choked by a foreign body. It is safe and effective and does not require specific instruments. Nevertheless, rare severe complications have been reported, such as traumatic injury of the gastrointestinal tract, pneumomediastinum, rib fracture, diaphragm rupture, acute thrombosis of abdominal aortic aneurysm and mesenteric laceration. Abdominal injuries are the most common complications, especially esophageal and gastric wall rupture. This anatomic site is the most common location of organ injuries, in consequence of the main target of the force generated by the HM. Furthermore, the execution of HM by an untrained person may increase the risk for possible serious complications. Usually, HM complications are treated surgically, but based on clinical conditions, a conservative approach is possible. In our report, we described a case of esophageal rupture after a forceful HM, and we made a brief revision of literature concerning HM complications. We have also assessed the correlation between HM complications, abuse of non-steroidal anti-inflammatory drugs and the execution of the abdominal thrusts by untrained rescuers.
Subject(s)
Airway Obstruction , Aortic Aneurysm, Abdominal , Esophageal Diseases , Heimlich Maneuver , Stomach Rupture , Thoracic Injuries , Humans , Heimlich Maneuver/adverse effects , Aortic Aneurysm, Abdominal/complications , Airway Obstruction/complications , Airway Obstruction/therapy , Thoracic Injuries/etiology , Stomach Rupture/complications , Esophageal Diseases/complicationsABSTRACT
The Heimlich maneuver is a lifesaving bystander intervention to assist an individual with airway obstruction however, cholesterol embolization syndrome is a rare, but serious potential complication of the Heimlich maneuver. We present the case of the 56-year-old female presenting to the emergency department with acute right foot pain following performance of the Heimlich maneuver who was found to have distal arterial occlusion resulting from cholesterol embolization syndrome. The patient underwent right popliteal artery exploration, right popliteal and tibial thrombectomy, and popliteal patch angioplasty resulting in restoration of blood flow to her right foot.
Subject(s)
Airway Obstruction/therapy , Arterial Occlusive Diseases/etiology , Embolism, Cholesterol/etiology , Heimlich Maneuver/adverse effects , Aorta, Abdominal/injuries , Female , Humans , Lower Extremity , Middle AgedABSTRACT
BACKGROUND: The Heimlich maneuver is a simple and universal resuscitative procedure that is performed to relieve foreign-body airway obstruction. We present a case of silent Stanford type A aortic dissection, a rarely reported complication of the Heimlich maneuver. CASE REPORT: A 67-year-old male presented to the emergency department with left-sided hemiplegia shortly after receiving a Heimlich maneuver. Acute ischemic stroke was suspected, and the thrombolytic protocol was initiated. Fortunately, Stanford type A aortic dissection was diagnosed before the thrombolytic therapy was initiated. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Aortic dissection can develop after the Heimlich maneuver. For patients who develop a neurologic deficit after the Heimlich maneuver, vascular dissection should be considered as a possible cause.
Subject(s)
Aortic Dissection/etiology , Heimlich Maneuver/adverse effects , Aged , Airway Obstruction/therapy , Aortic Dissection/diagnosis , Aortic Dissection/diagnostic imaging , Computed Tomography Angiography/methods , Humans , Male , Resuscitation/methods , Resuscitation/standardsABSTRACT
We report a case of cervical esophageal perforation caused by the Heimlich maneuver in a healthy 16-year-old boy. The patient reported a short coughing episode while eating rice, and his mother performed the Heimlich maneuver on him. Five days later, he presented to the emergency department with throat pain, odynophagia, secretion intolerance, muffled voice, and neck stiffness. He was admitted to the pediatric intensive care unit for conservative management. The next day he underwent transcervical incision and drainage of purulence, but the esophageal perforation could not be visualized at that time. The perforation was identified several days later and successfully repaired surgically. Esophageal perforation as a complication of the Heimlich maneuver is exceedingly rare, but the clinician should be aware of this entity in the differential diagnosis, as it is associated with a high mortality rate and warrants multidisciplinary care, including timely surgical intervention.
Subject(s)
Esophageal Perforation/etiology , Heimlich Maneuver/adverse effects , Adolescent , Humans , MaleSubject(s)
Airway Obstruction/therapy , Heimlich Maneuver/adverse effects , Hernia, Diaphragmatic, Traumatic/etiology , Hernia, Hiatal/etiology , Aged, 80 and over , Female , Hernia, Diaphragmatic, Traumatic/diagnostic imaging , Hernia, Diaphragmatic, Traumatic/surgery , Hernia, Hiatal/diagnostic imaging , Hernia, Hiatal/surgery , Humans , Tomography, X-Ray Computed , Treatment OutcomeSubject(s)
Barotrauma/complications , Esophageal Diseases/etiology , Heimlich Maneuver/adverse effects , Hemorrhage/etiology , Vomiting/complications , 2-Pyridinylmethylsulfinylbenzimidazoles/therapeutic use , Aged , Aged, 80 and over , Barotrauma/etiology , Conservative Treatment , Contrast Media , Endoscopy, Digestive System , Female , Gastrostomy , Humans , Pantoprazole , Parenteral Nutrition , Proton Pump Inhibitors/therapeutic use , Tomography, X-Ray ComputedABSTRACT
The Heimlich manoeuvre is well recognised worldwide as an emergency technique to clear an obstructed airway. The potential for serious injury to the choking victim is also well reported. We report the first case of significant musculoskeletal injury suffered by a rescuer performing the Heimlich manoeuvre. He eventually made a full recovery from his injury. However, we need to be aware of the possibility of injury in the rescuer as well as the rescued.
