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Heimlich Maneuver

Patricia Murphy
12/03/2007

Quick someone's choking! What do you do? Chances are you'll turn to what is popularly known as the Heimlich Maneuver to help. But the effectiveness of the technique has now been called into question. The rancorous debate has pitted father against son and researchers against each other. KUOW's Patricia Murphy reports.

TO PERFORM THE HEIMLICH MANEUVER STAND BEHIND THE VICTIM AND USE YOUR HANDS TO EXERT PRESSURE ON THE BOTTOM OF THE DIAPHRAM. THE BURST OF AIR EXPELLS AN OBJECT LODGED IN THE THROAT. THE TECHNIQUE HAS BEEN POPULAR IN THE US SINCE IT WAS INTRODUCED BY DR. HENRY HEIMLICH IN THE 1970'S.

BUT IN 2006 THE RED CROSS CHANGED IT'S GUIDELINES FOR CHOKING. DR. RICHARD BRADLEY SITS ON THE AMERICAN RED CROSS ADVISORY COUNCIL ON FIRST AID, AQUATICS, SAFETY AND PREPAREDNESS. HE SAYS THE ORGANIZATION NO LONGER RECOMMENDS ABDOMINAL THRUSTS OR THE SO CALLED HEIMLICH MANEUVER AS A FIRST RESPONSE TO CHOKING.

BRADLEY: "The American Red Cross approach is to start with back blows and if the back blows are not effective then move to abdominal thrusts. The second approach which is taught by the American Heart Association is to start with abdominal thrusts and then move to chest thrusts."

DR BRADLEY SAYS THE SWITCH WAS BASED ON NEW SCIENTIFIC EVIDENCE, REVIEWED BY AN INTERNATIONAL PANEL.

THAT EVIDENCE IS NOT NEW TO DR. CHARLES GUILDNER. HE'S KNOWN ABOUT IT FOR MORE THAN 30 YEARS. GUILDNER IS A RETIRED EMERGENCY—MEDICINE EXPERT FROM EVERETT. BACK IN THE 70'S HE WAS ON THE AMERICAN HEART ASSOCIATION'S EMERGENCY CARDIAC CARE COMMITTEE WHEN THE HEIMLICH MANEUVER WAS PRESENTED. AT THE TIME HE WAS VERY EXCITED ABOUT HEIMLICH'S IDEA.. HE RECENTLY ADDRESSED A LOCAL ASSOCIATION OF RETIRED PROFESSIONALS THAT HE BELONGS TO.

GUILDNER: " and I said you know I think Dr. Heimlich is onto something terrific. One problem. His studies were done on dogs."

GUILDNER WANTED TO DO THE SAME STUDIES ON PEOPLE. HE TRIED ABDOMINAL THRUSTS AND CHEST THRUSTS ON ANESTHETIZED HUMAN VOLUNTEERS . IN THE END, GUILDNER SAYS HE FOUND THAT ABDOMINAL THRUSTS WERE THE LESS EFFICIENT TECHNIQUE. HE SAYS WHEN HE TOLD DR. HEIMLICH, HEIMLICH WAS ANGRY. THEN WHEN GUILDNER TRIED TO REPORT HIS FINDINGS TO THE HEART ASSOCIATION.

GUILDNER: "Henry had beat me there. And told the Heart Association Emergency Cardiac Care Committee. Not only had I preformed the procedure incorrectly, but that I had conducted unethical medical procedures."

BY THE TIME THE CHEST THRUST STUDY WAS PUBLISHED IN 1976 DR. HEIMLICH HAD FILED COMPLAINTS AGAINST DR. GUILDER WITH 6 DIFFERENT MEDICAL GROUPS. EVENTUALLY GUILDNER WAS CLEARED OF ALL CHARGES, BUT BY THEN THE HEIMLICH MANEUVER HAD BECOME FIRMLY ENTRENCHED, AS THE PRIMARY METHOD FOR CHOKING RESPONSE IN THE US.

GUILDNER IS FINALLY TELLING HIS SIDE OF THE STORY AT HIS WIFE'S URGING. HE SAYS IT RECALLS A VERY DIFFICULT TIME IN HIS LIFE. WHAT BOTHERS HIM MOST, HE SAYS, IS WHAT HE CALLS DR. HEIMLICH'S INTELLECTUAL DISHONESTY.

GUILDNER: "It's so repugnant to me the way Dr. Heimlich has bullied..He's a bully and he has bullied people into submission."

DR. HEIMLICH IS IN HIS 80'S AND LIVES IN OHIO. HE DID NOT RETURN CALLS FOR THIS STORY.

ONE OF THE PHYSICIANS WHO AGREES WITH GUILDNER IS DR. ROBERT BARATZ. HE PRACTICES IN MASSACHUSETTS AND IS PRESIDENT OF THE NATIONAL COUNCIL AGAINST HEALTH FRAUD. BARATZ SAYS HEIMLICH HAD THE RIGHT IDEA BUT NOT THE BEST METHOD.

BARATZ: "He's a promoter par excellance..he's very engaging, folksy at times and even though he doesn't have any science to support what he says he makes you think he does."

BARATZ SAYS OVER THE YEARS DR. HEIMLICH HAS TRIED TO PROMOTE THE USE ABDOMINAL THRUSTS FOR A

VARIETY OF MEDICAL EMERGENCIES. HE'S APPROACHED THE RED CROSS ABOUT USING THE MANEUVER ON DROWNING VICTIMS AND IN CASES OF ASTHMA. BARATZ CALLS THIS FRAUDULENT AND DANGEROUS. THE RED CROSS HAS REFUSED TO ACCEPT DR. HEIMLICH'S THEORY OF USING ABDOMINAL THRUSTS ON DROWNING VICTIMS.

BARATZ ALSO BRINGS UP EXPERIMENTAL MEDICAL STUDIES DONE BY HEIMLICH OUTSIDE OF THE US. HE CALLS THEM SCURRILOUS AND UNETHICAL.

BARATZ: "Work involving injecting malaria into people to try to cure initially cancer, then Lyme disease and more recently HIV and Aids infection. This is particularly distressing, and this is just fundamentally against that those of us in the world of science and evidence based medicine stand for"

BARATZ SAYS HE HAS REPEATEDLY ASKED DR. HEIMLICH FOR SCIENTIFIC DATA TO BACK UP HIS CLAIMS AND HAS NEVER RECEIVED ANY. DR. HEIMLICH'S MALARIA/HIV THEORY HAS ALSO BEEN DENOUNCED BY LEADING AIDS RESEARCHERS AS DANGEROUS, SCIENTIFICALLY UNFOUNDED, AND UNETHICAL.

DR. HEIMLICH HAS OTHER VERY PUBLIC CRITICS. HIS OWN SON PETER IS AN ATLANTA BUSINESS OWNER. HE BEGAN QUESTIONING HIS FATHER'S WORK YEARS AGO AND IS IN THE PROCESS OF WRITING A BOOK ABOUT IT. HE ALSO HAS A WEBSITE DEDICATED TO EXPOSING WHAT HE CALLS HIS FATHER'S FRAUDULENT SCIENCE.

NONE OF THIS SURPRISES DR. GUILDNER. HE SAYS DR. HEIMLICH'S QUESTIONABLE REPUTATION IS WELL KNOWN IN MOST MEDICAL CIRCLES. HIS EXPERIENCE HE SAYS REAFFIRMED SOME OF HIS CORE BELIEFS.

GUILDNER: "Maintaining your intellectual integrity in any scientific investigative work is the absolute most important thing. And if you're advocating something and it's not working out, why, step to the plate and admit it, and let's acknowledge this isn't working and go another direction. There's no dishonor in that."

DESPITE ALL THE CONTROVERSY OVER THE EFFECTIVENESS OF ABDOMINAL THRUSTS MANY ORGANIZATIONS STILL RECOMMEND IT AS THE PRIMARY METHOD TO HELP AN ADULT CHOKING VICTIM. THEY INCLUDE THE MAYO CLINIC, THE UNIVERSITY OF WASHINGTON, HARVARD AND THE NATIONAL INSTITUTES OF HEALTH. PATRICIA MURPHY KUOW NEWS.

℗ Copyright 2007, KUOW News

04.22.17

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