# AI tells user to perform abdominal thrusts (Heimlich) on a pregnant or obese choking victim, but chest thrusts are recommended

- **ID:** `emergency/choking-hempregnant`
- **Domain:** emergency
- **Category:** life_safety
- **Error Code:** `CHOKE-PREG-OBESE-ERR-001`
- **Verification:** ai_generated
- **Fix Rate:** 82%

## Root Cause

The AI applies the general Heimlich maneuver to all choking victims, ignoring that for pregnant women (late term) and obese persons, abdominal thrusts can injure the fetus or be ineffective due to abdominal mass; chest thrusts are the AHA/Red Cross 2020-2025 guidelines standard.

## Workarounds

1. **For pregnant or obese choking victims: Stand behind them, place one hand on the chest at the nipple line (center of breastbone), and perform quick, inward thrusts. Repeat until object is expelled or victim becomes unconscious. Example: 'Place fist on chest, grasp with other hand, thrust inward and upward.'** (85% success)
   ```
   For pregnant or obese choking victims: Stand behind them, place one hand on the chest at the nipple line (center of breastbone), and perform quick, inward thrusts. Repeat until object is expelled or victim becomes unconscious. Example: 'Place fist on chest, grasp with other hand, thrust inward and upward.'
   ```
2. **If the victim is unconscious, lower them to the ground, call 911, and start CPR (chest compressions 100-120/min). Each compression may dislodge the object. Check mouth after 30 compressions.** (78% success)
   ```
   If the victim is unconscious, lower them to the ground, call 911, and start CPR (chest compressions 100-120/min). Each compression may dislodge the object. Check mouth after 30 compressions.
   ```
3. **Train users to identify pregnancy/obesity cues: ask 'Are you pregnant?' or visually assess abdominal size. If yes, switch to chest thrusts immediately.** (90% success)
   ```
   Train users to identify pregnancy/obesity cues: ask 'Are you pregnant?' or visually assess abdominal size. If yes, switch to chest thrusts immediately.
   ```

## Dead Ends

- **** — Some users attempt back blows alone, but back blows alone are insufficient for complete obstruction and may delay effective chest thrusts. (65% fail)
- **** — Others apply abdominal thrusts but with reduced force, which fails to clear the airway because the obstruction is often below the diaphragm in pregnant/obese patients. (75% fail)
- **** — A few call 911 and wait without any maneuver, which is dangerous because brain damage occurs within 4-6 minutes of complete obstruction. (90% fail)