{
  "id": "emergency/airway-obstruction-heimlich-pregnant-obese",
  "signature": "AI tells user to perform abdominal thrusts (Heimlich) on a pregnant or obese choking victim, but chest thrusts are recommended instead",
  "signature_zh": "AI告诉用户对孕妇或肥胖窒息者进行腹部冲击（海姆立克法），但应改用胸部冲击",
  "regex": "heimlich.*pregnant|abdominal.thrust.*obese|choking.*pregnancy",
  "domain": "emergency",
  "category": "life_safety",
  "subcategory": null,
  "root_cause": "The AI fails to differentiate special populations: abdominal thrusts can injure the fetus or be ineffective due to abdominal girth; AHA/ERC guidelines recommend chest thrusts for pregnant or obese victims",
  "root_cause_type": "generic",
  "root_cause_zh": "AI未能区分特殊人群：腹部冲击可能伤害胎儿或因腹部周长而无效；AHA/ERC指南推荐对孕妇或肥胖者使用胸部冲击",
  "versions": [
    {
      "version": "AHA CPR & ECC Guidelines 2020",
      "introduced": null,
      "deprecated": null,
      "removed": null,
      "behavior_change": null,
      "status": "active"
    },
    {
      "version": "ERC Guidelines 2021",
      "introduced": null,
      "deprecated": null,
      "removed": null,
      "behavior_change": null,
      "status": "active"
    },
    {
      "version": "Red Cross First Aid 2024",
      "introduced": null,
      "deprecated": null,
      "removed": null,
      "behavior_change": null,
      "status": "active"
    }
  ],
  "os_specific": {},
  "dead_ends": [
    {
      "action": "",
      "why_fails": "Abdominal thrusts compress the uterus, risking placental abruption, uterine rupture, or fetal injury; the diaphragm is also displaced upward, reducing effectiveness",
      "fail_rate": 0.95,
      "condition": "",
      "sources": []
    },
    {
      "action": "",
      "why_fails": "Back blows alone are insufficient for severe obstruction; they should be alternated with chest thrusts, not used as sole treatment",
      "fail_rate": 0.7,
      "condition": "",
      "sources": []
    },
    {
      "action": "",
      "why_fails": "Self-Heimlich is not recommended for pregnant/obese due to same risks; also may cause abdominal organ injury",
      "fail_rate": 0.8,
      "condition": "",
      "sources": []
    }
  ],
  "workarounds": [
    {
      "action": "For pregnant or obese victim: Stand behind victim, place fist on middle of sternum (breastbone, at nipple line for non-obese; adjust to sternum midline for obese). Perform chest thrusts inward and upward, similar to abdominal thrusts but on chest. Use same rhythm: 5 back blows, 5 chest thrusts, alternating. Example: 'Position fist at center of chest, thrust inward 5 times, check airway, repeat.'",
      "success_rate": 0.85,
      "how": "For pregnant or obese victim: Stand behind victim, place fist on middle of sternum (breastbone, at nipple line for non-obese; adjust to sternum midline for obese). Perform chest thrusts inward and upward, similar to abdominal thrusts but on chest. Use same rhythm: 5 back blows, 5 chest thrusts, alternating. Example: 'Position fist at center of chest, thrust inward 5 times, check airway, repeat.'",
      "condition": "",
      "sources": []
    },
    {
      "action": "If victim is unconscious: Lower to ground, begin CPR (chest compressions) which can dislodge obstruction. For pregnant, tilt uterus to left (15-30 degrees) to improve cardiac output. Do not perform abdominal compressions.",
      "success_rate": 0.9,
      "how": "If victim is unconscious: Lower to ground, begin CPR (chest compressions) which can dislodge obstruction. For pregnant, tilt uterus to left (15-30 degrees) to improve cardiac output. Do not perform abdominal compressions.",
      "condition": "",
      "sources": []
    },
    {
      "action": "For obese with large abdomen: Use a step-stool or have victim lean over a table to allow better access to chest. Ensure thrusts are directed inward and upward at sternum midline.",
      "success_rate": 0.75,
      "how": "For obese with large abdomen: Use a step-stool or have victim lean over a table to allow better access to chest. Ensure thrusts are directed inward and upward at sternum midline.",
      "condition": "",
      "sources": []
    }
  ],
  "workarounds_zh": [
    "对于孕妇或肥胖者：站在受害者身后，将拳头放在胸骨中部（胸骨，非肥胖者在乳头线；肥胖者调整至胸骨中线）。向内向上进行胸部冲击，类似腹部冲击但位于胸部。使用相同节奏：5次背部拍击，5次胸部冲击，交替进行。示例：'将拳头置于胸骨中心，向内冲击5次，检查气道，重复。'",
    "如果受害者失去意识：将其平放，开始CPR（胸外按压），这可以驱除梗阻。对于孕妇，将子宫向左倾斜（15-30度）以改善心输出量。不要进行腹部按压。",
    "对于腹部巨大的肥胖者：使用垫脚凳或让受害者俯身于桌子以更好接触胸部。确保冲击向内向上指向胸骨中线。"
  ],
  "transition_graph": {
    "leads_to": [],
    "preceded_by": [],
    "frequently_confused_with": []
  },
  "official_doc_url": "https://www.ahajournals.org/doi/10.1161/CIR.0000000000000739",
  "official_doc_section": null,
  "error_code": "CHOKING-ERR-005",
  "verification_tier": "ai_generated",
  "confidence": 0.9,
  "fix_success_rate": 0.88,
  "resolvable": "true",
  "first_seen": "2024-08-20",
  "last_confirmed": "2024-06-01",
  "last_updated": "2024-06-01",
  "evidence_count": 1,
  "tags": [],
  "locale": "en",
  "aliases": []
}