title: Purging using the Heimlich maneuver among children and adolescents with eating disorders.
abstract: This case report describes five independent cases of children and adolescents assessed for eating disorders who disclosed using the Heimlich maneuver as a purging technique. The maneuver is meant to be used only in life or death situations, likely once or less in any person's lifetime. A child or adolescent with an eating disorder may be using it to self-induce vomiting on a daily basis, increasing the risk of complications, including potential damage to major organs of the body. Asking patients who purge to elaborate on the methods with which they purge can provide clinicians with fuller information, improving their ability to select appropriate medical tests and interventions. Thorough investigations of physical complaints during the patient assessment may be warranted, including examining patients for possible rib fractures, hemorrhages, perforations of the hollow viscous, and other forms of blunt abdominal traumas.
authors.affiliation: Southlake Regional Health Centre, Newmarket, Ontario, Canada.|Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Boachie
authors.affiliation: Southlake Regional Health Centre, Newmarket, Ontario, Canada.|School of Nursing, Faculty of Health, York University, Toronto, Ontario, Canada.
authors.forename: Edigna
authors.initials: E
authors.lastname: Kusi Appiah
authors.affiliation: School of Nursing, Faculty of Health, York University, Toronto, Ontario, Canada.
authors.forename: Michelle
authors.initials: M
authors.lastname: Jubin
authors.affiliation: Southlake Regional Health Centre, Newmarket, Ontario, Canada.|Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Karin
authors.identifier: http://orcid.org/0000-0001-7486-6972
authors.initials: K
authors.lastname: Jasper
mesh_terms: D000293:Adolescent; D002648:Child; D001068:Feeding and Eating Disorders / Q000523:psychology*; D005260:Female; D059746:Heimlich Maneuver / Q000523:psychology*; D006801:Humans; D014839:Vomiting / Q000523:psychology
keywords: Heimlich maneuver; adolescents; children; purging; self-induced vomiting