The table maneuver: a procedure used with success in four cases of unconscious choking older subjects.

Background: confronted with an unconscious choking victim, it is recommended to call an ambulance and start mouth-to-mouth and cardiopulmonary resuscitation (CPR). We describe a procedure called the "table maneuver" that was successful in relieving foreign-body airway obstruction in 4 cases of choking in unconscious elderly patients over a 6-year period in the same long-term care facility.

Methods: the patients ranged in age from 70 to 89 years and were cyanosed and unconscious after choking while having a meal at a table. In a first attempt in 1 case, after failure of the Heimlich maneuver in 2 cases, and in combination with CPR in 1 person in cardiac arrest, the choking person was laid down on the table in prone position with the head facing downwards, with the arms hanging over the table, and then given sharp blows between the scapulas with the heel of the hand.

Results: after a few back blows in 3 cases, and in combination with CPR in 1 case, the patients forcefully spit out the foreign body (pieces of beets, Brussels sprouts, a croissant soaked in milk, or pieces of banana) without either early or late complications.

Conclusion: these 4 case reports show that the table maneuver is a potentially life-saving technique that could be applied to patients with severe choking caused by foreign-body airway obstruction who fail to respond to the Heimlich maneuver and other conventional treatments.