If a choking person is very large or has lost consciousness use this version of hte Heimlich maneuver:

1. Lay him on the floor and sit straddling his thighs.

2. Place the heel of one hand on the victims's upper abdomen, slightly abov his namvel but below the rib cage.

3 Place your other hand on top of quick thrusts.

4. With your index finger, probe the mouth of an unconscious victim to remove any obstructions. Be ready to start rescue breathing.

5 Repeat this Heimlich maneuver until the obstruction pops loose or medical help arrives.

If you ever choke on food and cannot breathe, clutch your throat with our hand. That's the universal sign forchoking, and it might bring someone to your aid. If there is no one nearby, perform the Heimlich maneuver on yourself by pulling your fist into your upper abdomen, or you can bend over the back of a chair and force it against your belly.

Thrusts to the abdomen can cause ribfractures and other injuries. Use only mannequins or other training devices to proactice or demonstrate Heimlich maneuvers.