Don’t be a spectator when your best buddy swallows a fist-size piece of steak and it stops halfway down. Simple choking can escalate into a life-threatening condition in seconds. You’re going to want to get his back, literally.
That said, take care not to rush in prematurely. A person can often clear his own throat. If your wingman can still speak or make noise, air is flowing and you need to let nature take its course. If his face goes beet red and he goes silent, it’s definitely time to do your thing.
Get someone to call 911 (better to look stupid than be a pall bearer). Stand to the side and a little behind him (get him standing too) and cinch his gut so that he bends over slightly. Using the heel of your hand, deliver five solid blows right between his shoulder blades. Don’t worry about hurting him; this is his life we’re talking about.
Most of the time, the blows will clear the airway. But sometimes, it will take a bit more effort to get him breathing again. If he continues to choke, pull a Heimlich by getting behind him and circling you arms around his torso. Make a fist with the thumb pointed in and position it right at your patient’s belly button. Grab the outside of the fist with the other hand.
Now pull toward yourself with a sudden jerk so that you’re compressing into the chest cavity. Repeat several times. Chances are you’ll clear the airway. If you don’t, and the ambulance hasn’t arrived yet, you’re probably going to need to do some CPR (page 144). Mouth to mouth. While that is certain to test the limits of your friendship, just think about how big he is going to owe you.
First Option: A blow between the shoulder blades
Second Option: The Heimlich Maneuver
You don’t have to be a lifeguard to make a rescue in the water. You just have to recognize signs of trouble and be a fairly strong swimmer.
A drowning person will look far different from someone who’s just gracelessly struggling to swim. Telltale signs include the person fighting to keep her head above water, flailing her arms, and an inability to stay afloat. You’re not going to have a lot of time; if you think she may be in trouble, start swimming toward her. If she tells you to go away, no harm, no foul.
Grab any possible floatation device—a life preserver, life jacket, or even one of those bright orange floats real lifeguards use. It may seem like a pain to swim with, but it’ll help when you reach the victim. If anybody else is around, ask them to call 911.
Swim straight at the person, keeping her in view. Unless she actually slips below the surface, in which case keep your eye on the spot you last saw her. That will be your dive-down location.
When you reach the person, she’ll be freaking. Position yourself behind her. Drowning victims are often so panicked that they slap a death grip on their rescuer, dragging the poor soul down. Loop your arms under her armpits. If you’ve got a floating device, jam it between the two of you if she’s flailing, or let her hold onto it if she’s calm. Use your free arm to start stroking back to shore or to the nearest boat.
Once you get the person on land or in a craft, get her under a blanket and check for signs that she swallowed a lot of water. Any person who has come close to drowning should be checked out by emergency medical personnel.
Kids. If there is a way to turn something totally benign into something dangerous, they’ll find it. To a kid, staircase balusters are jailer’s bars, through which a head needs to go.
Problem is, once a kid’s head has been contorted to go through the impossibly tiny space between balusters, the International Law of Bizarro Physics states there shall be no easy way to reverse the process. Be the good uncle and defy that law.
You could grease the little tyke’s head with shampoo, soap, or another slippery substance. But that rarely works, and in the meanwhile, the child will start to panic, realizing he has gotten himself into a serious pickle and may spend the rest of his days as some kind of banister freak, laughed at and derided by former school chums and family alike. The parents often follow suit, picturing the glowering accusatory faces of the child protective services enforcers.
Curtail all that tomfoolery by working on the bars. If the bars are wood, cut one at top and bottom to free the child. The baluster can be replaced with a little work, but a child on the verge of meltdown is not so easily fixed.
If the rails in question are metal, get your hands on a long pry bar (crow bar, barbell pole, etc.) and pry the bars apart slightly, just enough to allow safe removal of the head. Two adult men may even be able to create enough separation by pulling on the bars. If neither solution works, find an expandable, accordion-style tire jack, collapse it all the way, place it sideways between the bars, and crank it open until the head slides free.
Remember the code, real man: Never leave someone behind. Sometimes the injured just have to be moved, and sometimes it’s up to you to move them. Of course, if the victim has sustained a serious spinal injury, you’ll want to move them only if you absolutely have to, to save their life.
You have two options: lifting and carrying, or crafting an emergency stretcher. Carry a person by yourself in the “fireman’s” carry (duck and pick him up as he faces you so that his waist is resting on your shoulder).
Enlist the aid of bystander and you’ll have more options. Make what is known as a “pack saddle” by grabbing your right wrist with your left hand to form an L. The carrier across from you does the same and you grab each other’s left wrist with your free right hands, to form a square seat. The injured person rides, but must be conscious.
Carry an unconscious person by facing the other carrier, and both of you grabbing the opposite person’s wrist and shoulder (left to right in both cases). This creates a cradle in which an unconscious person lays.
You can also create a stretcher to drag alone or carry between two people. You need two handles, roughly six feet long. Solid tent poles, branches, or cot rails will do. Spread out a blanket and divide the blanket lengthwise into thirds, by placing the handles across the blanket, one-third the length from each end. Now fold the outside left third over to the right, and the outside right third over the left. Lay the person on top, and his weight will hold the blanket in place. As an alternative, you can thread the handles through a sturdy shirt (buttoned if it’s a button-up style) or through the legs of pants.
The bad news: stunning Victoria Secret models rarely collapse, lying motionless in dire need of a long round of cardiopulmonary resuscitation. The worst news: It’s usually the overweight guy in the corner, the one with the skin condition and bad breath, who grabs his chest and drops like a stone, in dire need of a long round of cardiopulmonary resuscitation. The good news: save that guy’s life by keeping his heart going until it can beat on its own or help arrives, and you have just added a big long row of bricks to your mansion in heaven.
The actual process of CPR is fairly simple. When someone collapses and stops breathing, call 911. Then go to work. First off, begin chest compressions. Put whatever hand you write with in the middle of his chest, fingers splayed. Put your other hand on top and interlock your digits. Keep your elbows locked and thrust down, compressing the chest 2 inches—you may feel some snapping and popping, but keep it up in a steady rhythm. If you’ve never been trained in the CPR process, the American Heart Association recommends you limit your efforts to compressing the chest until help arrives, or the person regains consciousness.
If you have been trained, you know to check his breathing after 30 chest compressions. Determine if any air is going in an out, check his airway for obstructions and remove any you find. Then tilt his head back and lift his chin. Pinch off his nostrils so that they are entirely closed, and put your mouth covering his (yes, dude, really). Breathe deep into his mouth, with two separate breaths. Grossed out? C’mon pal, you’ve kissed worse. If he doesn’t come back to the land of the living, start 30 more chest compressions, and repeat.