Debate over how to help choking victims
You’re dining in a restaurant when someone at a table nearby starts choking. As they gasp for air — and help — a bystander rushes to their aid.
If the bystander in this dramatic scene were trained in first aid at the American Red Cross, then the choking victim could be in trouble, say Janet and Phil Heimlich, adult children of the late Dr. Henry Heimlich, whose namesake maneuver to help choking victims was developed in 1974.
Current Red Cross guidelines advise administering five blows to a conscious choking victim’s back with the heel of the hand, and then performing abdominal thrusts — the Heimlich maneuver. Heimlich, who said his technique saved thousands of lives, spent decades condemning the mixture of methods, arguing that the blows could actually drive an object lodged in someone’s windpipe deeper into the airway.
New campaign: Heimlich, who died in 2016 at 96, also maintained that there wasn’t scientific evidence proving the back blows actually work. Citing this, and recent high-profile uses of the Heimlich maneuver, Janet and Phil Heimlich this month launched their “Hug, Don’t Hit” campaign to educate the public on the technique’s significance. The announcement is the latest development in a long-running disagreement between some members of the Heimlich family and the Red Cross.
“Kids as young as 5 and 6 years old have been able to perform the maneuver,” Phil Heimlich said. “It’s clear, there are like four basic steps, and that’s why rescuers of all ages have been able to perform it.”
The Red Cross said it hasn’t found evidence supporting the idea that the Heimlich alone is better at preventing choking – the fourth leading cause of accidental death in the country.
“This recommendation is based on reviews of scientific literature suggesting that back blows, abdominal thrusts and chest compressions are equally effective, and that using more than one method could be more effective in helping to dislodge an object when a person is choking,” Don Lauritzen, a spokesman at the organization’s national headquarters, said in a statement. “To be clear, the Red Cross doesn’t discount the use of abdominal thrusts — but we have found no scientific evidence stating that this one technique is more effective than the others.”
Change: Between 1986 and 2006, the Red Cross recommended the Heimlich maneuver to assist choking victims. But in 2006, it began advising the combined back blow and Heimlich maneuver approach it does today. The year before, a consensus conference held by the International Liaison Committee on Resuscitation determined that chest thrusts, back blows and abdominal thrusts were all effective for relieving choking in conscious adults and children older than 1. Still, the committee could not decide which one of the tactics should be used first.
At least one study, published in 1982, found “a back blow could transform the situation into one of complete blockage.” The study however, has been challenged: It was partially funded by a nonprofit organization Heimlich founded.
Other leading U.S. medical and first-aid groups, including the American Heart Association, the American College of Emergency Physicians and the National Safety Council all advise people to use Heimlich-style abdominal thrusts only, but not for children under a year old.
Local doctors follow this protocol, too, and advise using the Heimlich in almost every instance of choking, given the narrow window one has to act.
“I’m an emergency physician,” said Dr. John Purakal, an emergency doctor at University of Chicago Medicine. “The Heimlich maneuver is the only thing we ever got formal training in.”
Heimlich’s technique is also the only thing Dr. Maura McKay, medical director at the Northwestern care center at Central DuPage Hospital, was trained in as well, during basic life support certification courses many doctors take through the American Heart Association.
“The only time you do back slaps is in an infant,” McKay said. “But never for adults.”
Most Americans who aren’t medical professionals have been able to easily save lives by using the Heimlich in emergency situations, said Janet and Phil Heimlich.
“The Heimlich maneuver is what most people use,” said Janet Heimlich, adding that she’s set online alerts to notify her of reported uses of the technique.
“It’s just part of our culture,” she said.