# AI tells user to perform abdominal thrusts (Heimlich) on a pregnant or obese choking victim, but chest thrusts are recommended by AHA/Red Cross guidelines

- **ID:** `emergency/abdominal-thrusts-pregnant-obese`
- **Domain:** emergency
- **Category:** life_safety
- **Error Code:** `CHOKING-POPULATION-ERR-002`
- **Verification:** ai_generated
- **Fix Rate:** 90%

## Root Cause

The AI fails to recognize that abdominal thrusts on a pregnant woman risk uterine trauma, placental abruption, or fetal injury, and on an obese person may be ineffective due to abdominal mass; chest thrusts (similar to CPR compressions) are the standard alternative for these populations.

## Workarounds

1. **For a pregnant or obese choking victim who is conscious and cannot cough/speak/breathe: Stand behind the victim, place one fist (thumb side in) on the lower half of the sternum (breastbone), grasp with the other hand, and perform quick inward thrusts at the same rate as CPR compressions (100-120/min). Continue until the object is expelled or the victim becomes unconscious.** (90% success)
   ```
   For a pregnant or obese choking victim who is conscious and cannot cough/speak/breathe: Stand behind the victim, place one fist (thumb side in) on the lower half of the sternum (breastbone), grasp with the other hand, and perform quick inward thrusts at the same rate as CPR compressions (100-120/min). Continue until the object is expelled or the victim becomes unconscious.
   ```
2. **If the victim is unconscious: Lower them to the ground, call 911, and begin CPR. Each time you open the airway to give breaths, look for the obstructing object. If visible, remove it with a finger sweep (only if visualized). Chest compressions themselves can sometimes dislodge the object.** (85% success)
   ```
   If the victim is unconscious: Lower them to the ground, call 911, and begin CPR. Each time you open the airway to give breaths, look for the obstructing object. If visible, remove it with a finger sweep (only if visualized). Chest compressions themselves can sometimes dislodge the object.
   ```

## Dead Ends

- **Tell user to perform back blows first on pregnant victim** — Back blows are only recommended for infants under 1 year; for adults, they are not part of the conscious choking protocol and may delay effective chest thrusts (60% fail)
- **Advise to modify abdominal thrust by pushing higher on the abdomen** — There is no safe 'higher' location for abdominal thrusts on a pregnant woman; any force on the abdomen risks fetal harm; the correct technique is chest thrusts at the sternum (90% fail)
- **Recommend using a finger sweep to remove the object** — Blind finger sweeps are contraindicated in all modern choking guidelines (AHA 2020, Red Cross) as they can push the object deeper into the airway (95% fail)