Chest thrusts may be used on obese or pregnant casualties
as an alternative to the Heimlich Manoeuvre.
a. Stand behind the casualty.
b. Request casualty to stand with his feet shoulder-width apart.
c. Place one leg in between the casualty’s legs.
d. Slide both arms under the casualty’s armpits to encircle the chest.
e. With one hand, tuck your thumb into your palm and curl your fingers into a fist.
f. Position your fist against the centre of the breastbone.
g. Cover your fist with the other hand.
h. Give 5 thrusts in an inward motion.
i. Look out for any foreign objects that fall out from the casualty’s mouth.
j. If nothing emerges from the casualty’s mouth, continue to give chest
thrusts in sets of 5 (check for foreign objects that fall out from the casualty’s
mouth after each set) until the foreign object is expelled or the casualty falls
unconscious, whichever is earlier.
k. If the casualty falls unconscious, support and lay the casualty down.
l. Proceed to perform chest compressions for unconscious choking
Chest compressions for unconscious choking (casualty falls
unconscious from conscious choking)
a. Support and position the victim on his back on a firm flat surface.
b. Rescuer should shout for help, promptly appoint someone to dial 995 for
an ambulance and another person to get the AED.
c. Start 30 chest compressions (pg 27).
d. Perform head tilt-chin lift manoeuvre to open the airway.
e. Pull down the chin to check for any foreign objects in the mouth.
f. Remove any visible objects with a hooked index finger of your other hand.
g. Check for normal breathing.
h. If breathing is present, monitor his breathing constantly until ambulance
arrives.
i. If breathing is absent, attempt one mouth-to-mouth ventilation (pg 29).
j. If chest does not rise, re-position with the head tilt-chin lift procedure.
k. Attempt second mouth-to-mouth ventilation. If chest still does not rise, the
casualty’s airway is still choked.
l. Repeat from step c onwards until you are able to give 2 successful mouthto-
mouth ventilations with chest rise, ambulance crew arrives or casualty
shows signs of life.
m. Once you can give 2 successful mouth-to-mouth ventilations with chest
rise or casualty shows signs of life, check his breathing. If he is breathing,
monitor his breathing constantly until the ambulance arrives. If casualty is
not breathing, perform CPR and use the AED when it arrives.
• Do not panic