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New member
Apr 22, 2005
Hi all,
I am going to go help take care of my brother, who has ALS (doesn't have a vent or PEG, but uses a wheelchair and BiPAP and needs help with a lot of things) for 10 days while my parents are traveling.

I might be a bit paranoid, but I was wondering if there's anything I need to know about first aid for my brother. i.e. if he chokes on anything, will regular Heimlich maneuver work? if he has trouble breathing what should I do (i.e. besides calling 911)?

Any suggestions are appreciated. Thanks.
The regular Heimlich maneuver should work if needed but don't squeeze too hard at first. Depending how weak his muscles are you don't want to hurt him. If he falls and goes unconscious he will need mouth to mouth breathing. I assume with a Bipap his breathing muscles are compromised. I used to kid my daughter the paramedic that I was going to get DO NOT LAY FLAT tattooed on my forehead. If I lay flat I stop breathing for the most part and have told my wife and everyone that if I go unconscious tell whoever gets there first ie fire, ambulance that they have to bag me right away. Or get me into a sitting or upright position and I may breathe on my own. Ask your brother when he gets there if he chokes very often and what he does to clear it. You may have to do nothing other than be there to catch the food when it pops out. Chances are you don't have anything to worry about. Talk to your brother he knows best what is going on. You'll do fine.
We had a nurse come in to the house and show us how to do the Heimlich for people in the wheelchair. It was handy... she was a VON.
I can answer that one. Victorian Order of Nurses. They are a home care nursing organization in Canada. Similar to Red Cross Home Care and CCAC which is Community Care Access Center. They all provide home nursing care when needed.
This should be a great bonding experience for the both of you. Let it be a time of joy and laughter that the two of you will always treasure. I'm sure your brother really won't be as difficult to look after, as you may fear. One problem that you may not anticipate is a choking episode. I have several family members and friends that panic every time I choke and will start the Heimlich maneuver when it really isn't necessary. So, I'll tell them upfront what to do if I start choking. I'm normally on good behavior (i.e. I tend to be extra careful what & how I eat) when someone is watching me that is unfamiliar with my choking problems.

Here is an excellent article by Diane Huberty that all PALS & CALS should read about the different types of choking. I normally get the Damn-Near Heimlich Choke or The Foodless Sneaky Choke
All Choked Up

Pat McClellan

Courage doesn't always roar. Sometimes courage is the quiet voice at the end of the day saying, "I will try again tomorrow."
Hi Pat,
I just wanted to let you know that I really appreciate all the different websites you have left so far. They are very informative and worth reading. It is nice to have people on the forum who are well educated in ALS and can share their knowledge and/or information that they have gathered.
Take care,
Thanks, Pat.
There are a couple of really good articles on rhat site. Information on choking that can be passed on to friends. I get the foodless sneaky choke, which is very scary for someone seeing it for the first time. It does not happen very often, thankfully.
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