In children above 1 year, 5 abdominal thrusts should be substituted in place of the chest thrusts on the second cycle, and alternated with chest thrusts on subsequent cycles.
This procedure is not performed in infants because of the risk of rupturing abdominal viscera.
In a conscious child a Heimlich manouvre may be performed with the child in the upright position. Alternatively however, in an unconscious child, a similar procedure may be performed with the patient supine. The heal of one hand is placed in the middle of the upper abdomen and 5 sharp thrusts should be delivered towards the diaphragm.
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