Airway emergency - what would you have done.

[JJS]

While flying between Gallup N.M. and Winslow, A.Z., my passenger
pulled out a peppermint candy, handed it to me and retrieved another
for herself. I popped mine in my mouth, took a gulp from my water
bottle and went back to enjoying the view. Shortly thereafter, my
passenger starts gagging. When she had tossed the lozenge in her
mouth we hit a bit of turbulence and the candy tried to enter her
windpipe whole. A look of distress crossed her face as I quickly
realized what had happened. Her involuntary gag reflex went into
overdrive as she struggled to breathe. A feeling of helplessness
crossed over me as I realized we were 35 miles from the nearest
airport and it would be several minutes at best before we could land.
Even if I set the airplane down on I-40 it would be at least 5-6
minutes. That would lead to me risking the lives of others. With no
autopilot and while flying in rough air, an attempt at the Heimlich
maneuver would undoubtedly lead to an out of control aircraft over
mountainous terrain. What would you have done.
--
Joe Schneider
8437R
(Remove No Spam to Reply)
X-No-archive: yes

[Nathan Young]

I suppose it depends on what type of aircraft, but in my Cherokee, it
is stable enough that you could do the Heimlich and still maintain
control of the plane.


On Sat, 15 May 2004 08:23:36 -0500, "JJS" <jschneider@REMOVE
SOCKSpldi.net> wrote:

>While flying between Gallup N.M. and Winslow, A.Z., my passenger
>pulled out a peppermint candy, handed it to me and retrieved another
>for herself. I popped mine in my mouth, took a gulp from my water
>bottle and went back to enjoying the view. Shortly thereafter, my
>passenger starts gagging. When she had tossed the lozenge in her
>mouth we hit a bit of turbulence and the candy tried to enter her
>windpipe whole. A look of distress crossed her face as I quickly
>realized what had happened. Her involuntary gag reflex went into
>overdrive as she struggled to breathe. A feeling of helplessness
>crossed over me as I realized we were 35 miles from the nearest
>airport and it would be several minutes at best before we could land.
>Even if I set the airplane down on I-40 it would be at least 5-6
>minutes. That would lead to me risking the lives of others. With no
>autopilot and while flying in rough air, an attempt at the Heimlich
>maneuver would undoubtedly lead to an out of control aircraft over
>mountainous terrain. What would you have done.

[Peter R.]

JJS wrote:

> With no
> autopilot and while flying in rough air, an attempt at the Heimlich
> maneuver would undoubtedly lead to an out of control aircraft over
> mountainous terrain. What would you have done.

It is possible for a person to perform the Heimlich maneuver on him or
herself. Assuming the passenger was not panicking, my first thought
would be to talk her through the maneuver.

--
Peter

[Zippo]

Push her out and save yourself !

[Dale]

In article >,
"JJS" <jschneider@REMOVE SOCKSpldi.net> wrote:

> While flying between Gallup N.M. and Winslow, A.Z., my passenger
> pulled out a peppermint candy, handed it to me and retrieved another
> for herself. I popped mine in my mouth, took a gulp from my water
> bottle and went back to enjoying the view. Shortly thereafter, my
> passenger starts gagging. When she had tossed the lozenge in her
> mouth we hit a bit of turbulence and the candy tried to enter her
> windpipe whole. A look of distress crossed her face as I quickly
> realized what had happened. Her involuntary gag reflex went into
> overdrive as she struggled to breathe. A feeling of helplessness
> crossed over me as I realized we were 35 miles from the nearest
> airport and it would be several minutes at best before we could land.
> Even if I set the airplane down on I-40 it would be at least 5-6
> minutes. That would lead to me risking the lives of others. With no
> autopilot and while flying in rough air, an attempt at the Heimlich
> maneuver would undoubtedly lead to an out of control aircraft over
> mountainous terrain. What would you have done.

I would attempt to clear her airway...unless in severe turbulence you
shouldn't go "out of control".

--
Dale L. Falk

There is nothing - absolutely nothing - half so much worth doing
as simply messing around with airplanes.

http://home.gci.net/~sncdfalk/flying.html

[EDR]

In article >, JJS
<jschneider@REMOVE> wrote:

> While flying between Gallup N.M. and Winslow, A.Z., my passenger
> pulled out a peppermint candy, handed it to me and retrieved another
> for herself. I popped mine in my mouth, took a gulp from my water
> bottle and went back to enjoying the view. Shortly thereafter, my
> passenger starts gagging. When she had tossed the lozenge in her
> mouth we hit a bit of turbulence and the candy tried to enter her
> windpipe whole. A look of distress crossed her face as I quickly
> realized what had happened. Her involuntary gag reflex went into
> overdrive as she struggled to breathe. A feeling of helplessness
> crossed over me as I realized we were 35 miles from the nearest
> airport and it would be several minutes at best before we could land.
> Even if I set the airplane down on I-40 it would be at least 5-6
> minutes. That would lead to me risking the lives of others. With no
> autopilot and while flying in rough air, an attempt at the Heimlich
> maneuver would undoubtedly lead to an out of control aircraft over
> mountainous terrain. What would you have done.

You tricycle gear pilots need to learn what your feet are for.
You have rudder peddles, use them!

[Bob Fry]

"JJS" <jschneider@REMOVE SOCKSpldi.net> writes:

> What would you have done.

What did you do?

[Dave S]

I would have asked her 1) are you choking? and if she nodded yes I would
have asked 2) can you talk? and if she nodded no then I would have
intervened. OTherwise as long as shes moving air in SOME form or fashion
I would let HER focus on clearing the obstruction and ME focus on
setting down somewhere if it didnt immediately clear.

If intervention were warranted (assuming a front seat passenger), I
would have attempted one or two modified abdominal thrusts (with similar
direction and force as a heimlich). One or two thrusts will not cause a
total departure from controlled flight in my opinion, and it might
provide enough effect to dislodge the obstruction. Thrust or two..
verify the plane is in control.. thrust again.. etc.. if it doesnt clear
within a few moments of thrusting then its unlikely you will clear the
obstruction in the air with lay skills. At that point, its purely a
personal decision what do do next.

Dave, RN, EMTP, PPSEL

JJS wrote:

> While flying between Gallup N.M. and Winslow, A.Z., my passenger
> pulled out a peppermint candy, handed it to me and retrieved another
> for herself. I popped mine in my mouth, took a gulp from my water
> bottle and went back to enjoying the view. Shortly thereafter, my
> passenger starts gagging. When she had tossed the lozenge in her
> mouth we hit a bit of turbulence and the candy tried to enter her
> windpipe whole. A look of distress crossed her face as I quickly
> realized what had happened. Her involuntary gag reflex went into
> overdrive as she struggled to breathe. A feeling of helplessness
> crossed over me as I realized we were 35 miles from the nearest
> airport and it would be several minutes at best before we could land.
> Even if I set the airplane down on I-40 it would be at least 5-6
> minutes. That would lead to me risking the lives of others. With no
> autopilot and while flying in rough air, an attempt at the Heimlich
> maneuver would undoubtedly lead to an out of control aircraft over
> mountainous terrain. What would you have done.

[G.R. Patterson III]

EDR wrote:
>
> You have rudder peddles, use them!

I don't have any of those, but I *do* have some rudder pedals.

George Patterson
I childproofed my house, but they *still* get in.

[JJS]

A little more background info:

First, without trying to impress anyone, I have been through various
industrial medic, first aid, and emergency first responder training
sessions repeated over and over for the last 25 years. At least one
recurrency training session has been done each year.

The air was very rough with at least moderate turbulence. The yokes
are so low in the Cherokee that it leaves very little room to twist
around in my seat.

EDR: I know the rudders are capable of lifting a wing. I've flown
two axis ultralights as well as tailwheel aircraft. I'd tried doing
this automatically. It wasn't enough to maintain control in the rough
air.

Nathan: I would imagine that my Cherokee is about the same as any
other Hershey bar Cherokee 140 when it comes to handling turbulence.
I have plus or minus 500 hours in this particular airplane. Believe
me when I say that there was no letting go of the yoke for more than a
few seconds before we were in a precarious attitude. I tried it
several times.

Zippo: For heavens sake, that would probably dislodge the candy when
she hit the ground alright, but she's the mother of my two daughters
and as pretty as the day I married her 24 years ago. It ain't
happening dude!

Peter: Excellent suggestion. She tried it. More than once. Didn't
work.

Bob: Here's what I did. I tried to keep her calm. I was very afraid
the candy might be sucked into a position that would totally occlude
her airway. As much as she tried, she could not dislodge the candy.
She could not talk but she was breathing, albeit strenuously. I hit
the nearest key on the GPS, said a prayer and headed directly to the
nearest airport. I monitored her closely and made suggestions, (none
of which worked). I tried hitting her on the back hard enough that I
knew she'd kill me if she lived through the ordeal. She tried sipping
small amounts from the water bottle, hoping that it would help melt
the candy. That didn't work. I intentionally lost altitude in an
attempt to shorten the time to touchdown. Her coughing and gagging
went on for what seemed like at least 10 minutes. I thought she might
vomit and inhale the vomitus. At the first sign of her starting to
have increased difficulty breathing or beginning to loose
consciousness I was going to set the airplane down on the interstate
or frontage road in record time. On loss of consciousness I might
have tried a finger sweep, but it would have been a last resort for
fear of pushing the candy deeper into her windpipe.

Finally, she coughed up the offending confectionary. Even after all
that time it was nearly it's full original size. Her throat was so
raw and sore that she was hoarse for two days. Several trips to the
ice cream store later, all was forgiven... never to be forgotten!

Seriously, this is something that I had never considered happening and
since then I've wondered about other airborne medical emergencies more
than ever. One thing is for sure. We will put some thought into any
snacks we eat in-flight from now on. If you fly with children, it
might be an even more important consideration.

"Bob Fry" > wrote in message
...
> "JJS" <jschneider@REMOVE SOCKSpldi.net> writes:
>
> > What would you have done.
>
> What did you do?

[Teacherjh]

Could SHE have held the yoke while you climbed in back and gave her the
heimlich? I suppose if not the problem would be exacerbated, but it's another
reason to consider something along the pinch-hitters thing - enough traning for
your wife and kids to land the plane safely if something happend to you.

Or in this case, even to her.

I'm glad it turned out all right. I can't even imagine how I'd feel if it were
me, and it didn't.

Jose

--
(for Email, make the obvious changes in my address)

[EDR]

In article >, G.R. Patterson III
> wrote:

> EDR wrote:
> >
> > You have rudder peddles, use them!
>
> I don't have any of those, but I *do* have some rudder pedals.

Thanks, at least I didn't spell it "petals".

[JJS]

Jose,

Thanks for the suggestion. This might have worked! I doubt I
could have climbed into the back seat. But, I may have found a
workable position if I hadn't had to keep one hand on the yoke. In
her physical state I believe she may have been able to control the
airplane for a very short time. I was hoping for some "out of the
box" input like this. I was also hoping to get others thinking about
situations they may face that they hadn't previously considered.
She has been through ground school, and I was hoping to get her
through a pinch hitters course but she unfortunately isn't interested.
She still likes to fly and we've been through other trips since this
long cross country.

Every flight an adventure!
Tag, you're it!

"Teacherjh" > wrote in message
...
> Could SHE have held the yoke while you climbed in back and gave her
the
> heimlich? I suppose if not the problem would be exacerbated, but
it's another
> reason to consider something along the pinch-hitters thing - enough
traning for
> your wife and kids to land the plane safely if something happend to
you.
>
> Or in this case, even to her.
>
> I'm glad it turned out all right. I can't even imagine how I'd feel
if it were
> me, and it didn't.
>
> Jose
>
> --
> (for Email, make the obvious changes in my address)

[JJS]

Dave,

Obviously, you've provided some expert feedback. Thanks for the
reply. Your first paragraph is pretty much how I handled it, and
thank God I never had to progress too much further. I did try back
blows, which may or may not have been wise. I felt pretty helpless
even with the training I've had. In this case the back blows made no
difference. Every time I attempted to move myself into a position to
help if needed, I had problems controlling the airplane in the rough
air. I might have been able to keep my left hand on the right side of
the yoke and wrap my right arm around her waist, slide my fist up and
provide some modified thrusts. Don't know if I'd have moved much air
with that one armed procedure. It was if that candy was cemented in
place!

Every flight an adventure!

"Dave S" > wrote in message
ink.net...
> I would have asked her 1) are you choking? and if she nodded yes I
would
> have asked 2) can you talk? and if she nodded no then I would have
> intervened. OTherwise as long as shes moving air in SOME form or
fashion
> I would let HER focus on clearing the obstruction and ME focus on
> setting down somewhere if it didnt immediately clear.
>
> If intervention were warranted (assuming a front seat passenger), I
> would have attempted one or two modified abdominal thrusts (with
similar
> direction and force as a heimlich). One or two thrusts will not
cause a
> total departure from controlled flight in my opinion, and it might
> provide enough effect to dislodge the obstruction. Thrust or two..
> verify the plane is in control.. thrust again.. etc.. if it doesnt
clear
> within a few moments of thrusting then its unlikely you will clear
the
> obstruction in the air with lay skills. At that point, its purely a
> personal decision what do do next.
>
> Dave, RN, EMTP, PPSEL
>

[David Dyer-Bennet]

"JJS" <jschneider@REMOVE SOCKSpldi.net> writes:

> While flying between Gallup N.M. and Winslow, A.Z., my passenger
> pulled out a peppermint candy, handed it to me and retrieved another
> for herself. I popped mine in my mouth, took a gulp from my water
> bottle and went back to enjoying the view. Shortly thereafter, my
> passenger starts gagging. When she had tossed the lozenge in her
> mouth we hit a bit of turbulence and the candy tried to enter her
> windpipe whole. A look of distress crossed her face as I quickly
> realized what had happened. Her involuntary gag reflex went into
> overdrive as she struggled to breathe. A feeling of helplessness
> crossed over me as I realized we were 35 miles from the nearest
> airport and it would be several minutes at best before we could land.
> Even if I set the airplane down on I-40 it would be at least 5-6
> minutes. That would lead to me risking the lives of others. With no
> autopilot and while flying in rough air, an attempt at the Heimlich
> maneuver would undoubtedly lead to an out of control aircraft over
> mountainous terrain. What would you have done.

I haven't yet seen any suggestion of finding smoother air; might that
have been possible more quickly than landing somewhere? Seems like
that would let you put more attention on the medical emergency
(especially if the smoother air happened to be *higher*).
--
David Dyer-Bennet, >, <http://www.dd-b.net/dd-b/>
RKBA: <http://noguns-nomoney.com/> <http://www.dd-b.net/carry/>
Pics: <http://dd-b.lighthunters.net/>,<http://www.dd-b.net/dd-b/SnapshotAlbum/>
Dragaera/Steven Brust: <http://dragaera.info/>

[JJS]

David,
I think this is another excellent suggestion worthy of
consideration. Climbing would possibly have worked, especially in a
higher powered airplane. IIRC, we were westbound at 10,500 when this
took place over fairly high terrain. My little Cherokee 140 doesn't
climb very well at that altitude. My thought was to get lower to get
it on the ground quickly if needed. If I was flying something like a
182 then perhaps I'd have had more options. Your suggestion was one
that never entered my mind, but should have at least been considered.
Thanks.

What did I do wrong? Well for one thing, no one mentioned calling for
help. How about this... I never called FSS and let them know of our
predicament. I didn't think the situation progressed far enough. On
reflection, that may not have been very smart. FSS could have had an
ambulance enroute to or waiting at the nearest airport or in the
vicinity of the area I decided to land at on the interstate. As I
was losing altitude over high terrain the possibility of losing radio
contact with help was increasing. Why do we as pilots sometime wait
until the situation is nearly unsalvageable before we take action? Is
it embarrassment? The fear of having to pay for services whether we
use them or not?

Joe Schneider
8437R

"David Dyer-Bennet" > wrote in message
...

> I haven't yet seen any suggestion of finding smoother air; might
that
> have been possible more quickly than landing somewhere? Seems like
> that would let you put more attention on the medical emergency
> (especially if the smoother air happened to be *higher*).

[Dave S]

The modified maneuver I was thinking of was flying with your feet (I
routinely use the rudders to maintain heading and bank on long XC's),
twisting towards the passenger seat and reaching across with the left
hand (as if to punch.) and thrust in/up between the navel and the
bottome of the sternum with the left hand/fist.

As with any kind of abdominal thrusts, you run the risk of laceration or
perforation of abdominal organs. However, these risks rarely (in my
mind) outweigh the immediate risk of death from a completely obstructed
airway.

Back blows really dont do a lot to increase intrathoracic pressure (and
blow out the obstruction) but may help shake loose the obstruction. They
are not recommended in the management of adult or child airway
obstructions by any credentialling organization that I'm aware of, but
the American Heart Association still teaches their use in the treatment
of infant obstructed airways.

If an ADULT has completely passed out and is unconscious from a total
airway obstruction (which is a truly grave situation) then blind finger
sweeps of the mouth and throat are part of the treatment regimen (Take a
CPR course sometime). In my experience with the average adult, you can
reach far enough back to feel the opening of the windpipe (* DO NOT DO
THIS ON SOMEONE WHO IS RESPONSIVE.. they will bite your fingers off!)

Again, I am limiting my interventions to what they lay person could be
expected to provied, and I must ask that this not be considered "medical
advice" but rather an opinion, and an encouragement to get proper lay
training in dealing with possible emergencies. American Heart and
American Red Cross are both excellent resources; for an introduction to
the more professional aspects of emergency health care you can check
with a local junior college or state board of health regarding First
Responder or EMT training in your area.

Dave

JJS wrote:

> Dave,
>
> Obviously, you've provided some expert feedback. Thanks for the
> reply. Your first paragraph is pretty much how I handled it, and
> thank God I never had to progress too much further. I did try back
> blows, which may or may not have been wise. I felt pretty helpless
> even with the training I've had. In this case the back blows made no
> difference. Every time I attempted to move myself into a position to
> help if needed, I had problems controlling the airplane in the rough
> air. I might have been able to keep my left hand on the right side of
> the yoke and wrap my right arm around her waist, slide my fist up and
> provide some modified thrusts. Don't know if I'd have moved much air
> with that one armed procedure. It was if that candy was cemented in
> place!
>
> Every flight an adventure!
>
> "Dave S" > wrote in message
> ink.net...
>
>>I would have asked her 1) are you choking? and if she nodded yes I
>
> would
>
>>have asked 2) can you talk? and if she nodded no then I would have
>>intervened. OTherwise as long as shes moving air in SOME form or
>
> fashion
>
>>I would let HER focus on clearing the obstruction and ME focus on
>>setting down somewhere if it didnt immediately clear.
>>
>>If intervention were warranted (assuming a front seat passenger), I
>>would have attempted one or two modified abdominal thrusts (with
>
> similar
>
>>direction and force as a heimlich). One or two thrusts will not
>
> cause a
>
>>total departure from controlled flight in my opinion, and it might
>>provide enough effect to dislodge the obstruction. Thrust or two..
>>verify the plane is in control.. thrust again.. etc.. if it doesnt
>
> clear
>
>>within a few moments of thrusting then its unlikely you will clear
>
> the
>
>>obstruction in the air with lay skills. At that point, its purely a
>>personal decision what do do next.
>>
>>Dave, RN, EMTP, PPSEL
>>
>
>
>

[Elwood Dowd]

I think this story points out the need for pilots to have some
rudimentary first aid training. It has been 20 years since I took a
class, and I feel somewhat less than prepared. Heimlich is one thing,
but there are other scenarios that could pose a much greater problem.

I'm in the middle of creating a good long-distance first aid and
survival kit right now, and in doing research it surprises me the things
I never thought about. (http://www.aeromedix.com has some great
articles and products---no affiliation, just a happy customer!) One of
the things I really hadn't thought about was my first-aid skill set,
which can not be purchased.

And I'm surprised no one has asked---what happened on the airway!? I'm
assuming the passenger dislodged the candy from her windpipe.

[Peter Duniho]

"JJS" <jschneider@REMOVE SOCKSpldi.net> wrote in message
...
> [...] I tried hitting her on the back hard enough that I
> knew she'd kill me if she lived through the ordeal.

Ack. Thank goodness you didn't wind up lodging the obstruction in even
further. Remember: gravity is at work, even inside your body. Knock
something loose that's inside your airway, and the most likely place for it
to go is down.

The last thing a person having trouble breathing needs is a whack on the
back. At least, not until you turn them upside down. I'm surprised with
all your emergency medical training, no one's mentioned this.

The traditional Heimlich is done from behind, of course, but it seems to me
that with a strong enough arm, especially with a partial obstruction, you
might have had some luck from the side. Just get your fist in good under
her diaphragm (not, not THAT diaphragm...this is serious you guys :) ), and
push hard and quick, in the same motion you'd use from behind.

It would at least be worth a try.

Barring success getting the thing out quickly, I can't imagine flying all
the way to an airport, even one nearby. You should have appropriate landing
sites below you nearly all the time. A passenger choking seems to me to be
just as serious as an airplane on fire, and would warrant an emergency
descent to an off-airport landing so that proper first-aid (e.g. a real
from-behind Heimlich) can be given.

Pete

[[email protected]]

On Sat, 15 May 2004 19:51:00 GMT, EDR > wrote:

>You tricycle gear pilots need to learn what your feet are for.
>You have rudder peddles, use them!

You're saying that once in the air, there is some kind of perceptable
difference between a taildragger and a trigeared airplane? My
experience has been that once in the air, tri geared or not, the
required rudder use is no different one from the other.

Corky Scott

[JJS]

You missed one of my posts or at least part of it. She coughed it up
after an eternity went by.

Joe Schneider
8437R


> And I'm surprised no one has asked---what happened on the airway!?
I'm
> assuming the passenger dislodged the candy from her windpipe.
>

[JJS]

> Ack. Thank goodness you didn't wind up lodging the obstruction in
even
> further. Remember: gravity is at work, even inside your body.
Knock
> something loose that's inside your airway, and the most likely place
for it
> to go is down.

That was my concern too, Pete. She wasn't exactly sitting upright,
though. She was doubled over, gagging more than coughing.

> The last thing a person having trouble breathing needs is a whack on
the
> back. At least, not until you turn them upside down. I'm surprised
with
> all your emergency medical training, no one's mentioned this.

I'd do it again... you probably had to be there to understand. It is
hard to describe her condition and varying positions with words.
Sometimes she was bent over like she was about to vomit into a toilet
positioned between the yokes. She would have gladly done so if
possible. Rember this took place over several minutes.

> The traditional Heimlich is done from behind, of course, but it
seems to me
> that with a strong enough arm, especially with a partial
obstruction, you
> might have had some luck from the side. Just get your fist in good
under
> her diaphragm (not, not THAT diaphragm...this is serious you guys
:) ), and
> push hard and quick, in the same motion you'd use from behind.
>
> It would at least be worth a try.

Thank goodness it never came to the point that I needed to try it.
Your suggested method was on my list. I'd probably have kept trying
various things until successful or we were on the ground.

> Barring success getting the thing out quickly, I can't imagine
flying all
> the way to an airport, even one nearby. You should have appropriate
landing
> sites below you nearly all the time.

Landing sites are few and far between in that neck of the woods. If
you have a chart of the area and are unfamiliar, take a look. I think
Aeroplanner might show the sectional if you want to try that.

A passenger choking seems to me to be
> just as serious as an airplane on fire, and would warrant an
emergency
> descent to an off-airport landing so that proper first-aid (e.g. a
real
> from-behind Heimlich) can be given.

I agree and that was my plan if things progressively got worse. The
situation wasn't static. A million things ran through my mind. You
are correct about the traditional Hiemlich being done from behind but
there is also a modified version for a person who is passed out and
lying on the floor. You roll them on their back, straddle them while
kneeling and force air out of their lungs from the front side of the
victim.

>
> Pete
>
>

[TThierry]

Peter R. > wrote:

> the Heimlich maneuver

May I ask what it is?
--
TThierry __|__
http://flyinfrance.free.fr \___(x)___/
! ! !

[TThierry]

"JJS" <jschneider@REMOVE SOCKSpldi.net> wrote:

> Why do we as pilots sometime wait
> until the situation is nearly unsalvageable before we take action?

Thanks for this very valuable thread. Worth spending a bit of time
thinking about it.
--
TThierry __|__
http://flyinfrance.free.fr \___(x)___/
! ! !

[JJS]

You are welcome. There have been some good suggestions made such as
climbing to smoother air and letting her hold the yoke. I learned
from it too, so thanks to all who provided input.

Joe Schneider
8437R

"TThierry" > wrote in message
...
> "JJS" <jschneider@REMOVE SOCKSpldi.net> wrote:
>
> > Why do we as pilots sometime wait
> > until the situation is nearly unsalvageable before we take action?
>
> Thanks for this very valuable thread. Worth spending a bit of time
> thinking about it.
> --
> TThierry __|__
> http://flyinfrance.free.fr \___(x)___/
> ! ! !

[Peter R.]

TThierry ) wrote:

> Peter R. > wrote:
>
> > the Heimlich maneuver
>
> May I ask what it is?

Here is one of many websites that explains what it is and how to perform
it:

http://www.heimlichinstitute.org/howtodo.html

--
Peter