| Thursday, August 03, 2006
Posted by The Dean of Cincinnati
Hamilton County’s next Commissioner, David Pepper, adopted the slogan “The Heimlich Remover” for his election campaign, but it also looks like the American Red Cross decided to follow suit—revising their procedure for giving first aid to chocking victims. Contrary to the claims of Cincinnati’s world famous doctor, it looks like back slaps might really be the way to go.
According to the 2005 Guidelines published by the American Red Cross, back blows should actually be used before abdominal thrusts (aka, The Heimlich Maneuver) when responding to a choking victim. Here is an excerpt from their report:
If a person cannot cough forcefully, speak or breathe, the person may be choking. There are several techniques for clearing an obstruction: back blows, abdominal thrusts and chest thrusts. Because there is no evidence which technique is better and there is clear evidence that in many victims if one method does not work another method sometimes does, the technique for conscious choking is a series of back blows followed by abdominal thrusts (p. III-6). In addition when you approach a victim from the front, as taught, you are in a natural position to deliver back blows first.
Back Blows and Abdominal Thrusts
The responder should take a position slightly behind the victim. Provide support by placing one arm diagonally across the chest and lean the person forward.
The responder should firmly strike the person between the shoulder blades with the heel of the other hand five times. If the back blows do not dislodge the object, give five abdominal thrusts. Continue to give sets of five back blows and five abdominal thrusts until the object is dislodged and the person can cough forcefully speak or breathe, or until the person becomes unconscious.
The timing on this is interesting for other reasons, too. While The Cincinnati Beacon just became aware of these 2005 guidelines, it would be curious to know when Dr. Heimlich learned about them. In a June 9, 2005 email from Dr. Heimlich’s press agent, Bob Kraft wrote the following:
“You may also remember that it wasn’t until 1985 that the medical establishment acknowledged that the maneuver was the best treatment for choking. The previous recommended protocol is now discredited.”
What is the discredited protocol to which Kraft refers? Back blows, which Henry Heimlich and Company used to call “death blows” while trying to muscle the maneuver into accepted procedures?
But what really causes injuries or death? Back blows, or the maneuver? Check out these searches of PubMed, a medical research resource:
*search for ”heimlich maneuver injury”
*search for ”back blows injury”
To at least this untrained eye, it looks like the Heimlich Maneuver has been plagued with a questionable history of injuring choking victims. When all along, it seems true that the most natural human instinct—slapping the back of a choking person—might actually be the best and least obtrusive approach.
Bob Kraft called the “previous protocol” discredited. What do these new developments say about the credibility of the Heimlich Maneuver?
Cincinnati’s world famous doctor may be on his way out, just like his son’s political career. Funny how these things work.
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