An interesting complication of the Heimlich manoeuvre

The removal of inhaled foreign bodies using the Heimlich manoeuvre is recom mended as part of the immediate management of the choking child. We report on a case of witnessed laryngeal obstruction by a foreign body in which rep eated Heimlich manoeuvres failed to expel the foreign body, but temporarily relieved the obstruction. The repeated Heimlich manoeuvres dislodged the f oreign body into the trachea and may have contributed to the rapid developm ent of extensive surgical emphysema, pneumomediastinum and pneumopericardiu m. The purpose of this report is to demonstrate that the Heimlich manoeuvre was effective in relieving the airway obstruction, but was associated with potentially severe complications. (C) 1998 Elsevier Science Ireland Ltd. A ll rights reserved.