SYNOPSIS: From this
June 9, 2008 news report:
(Former Presidential candidate
Mike Huckabee) told Fox News on Monday he didn't think twice
when he stepped in and gave (Robert) Pittenger the "Heimlich
Maneuver" - pressure on the abdomen to dislodge the food.
"I just happened to look up and I saw somebody patting on
the back...I knew that the worst thing you can do is pat someone
on the back if they're choking," Huckabee said, noting that
he had taken emergency medical training when he was younger.
Except for between 1986-2005,
backblows were the primary choking response taught by US first
aid organizations. Currently, both the American Red Cross (ARC)
and the American Heart Association (ARC) approve the use of backblows
as an acceptable treatment response. So why do former Governor
Huckabee and many others believe that backblows are dangerous?
Facts prove that with no medical
evidence to support his claim, my father Dr. Henry Heimlich introduced
the idea in 1975. For the next decade, he used the media
to aggressively circulate the idea in an effort to eliminate
backblows from the first aid guidelines of the AHA and ARC via
an emotion-driven campaign he called "backblows
are deathblows."
In 1982, the journal Pediatrics
published a research study published by three Yale-affiliated
physicians which affirmed my father's claims. In July 1985, my
father and the lead author of the study presented it at an AHA
national conference. A few months later, then-US Surgeon General
C. Everett Koop issued a widely-reported public statement that
all choking rescue methods other than the Heimlich maneuver,
including backblows and chest thrusts, were "hazardous,
even lethal." In his statement, Koop recommended that the
AHA and ARC remove these methods from their choking rescue treatment
recommendations. A short time later, the AHA and ARC followed
his advice.
Roger White MD chaired the
1985 American Heart Association (AHA) committee which recommended
that backblows be removed from AHA guidelines. From the "Panel
recommendations" section of Foreign
Body Airway Obstruction: Considerations in 1985 by Dr.
White, published in the December 1986 issue of Circulation, the
AHA journal:
The most persuasive data presented
for review were those of Day and associates cited above.
20 years later, our research
turned up two facts.
1. My father clandestinely
funded the Yale study. Neither he nor the authors of the study
shared that information with the AHA or ARC. After first being
informed of this fact, Dr. White wrote:
There was never any evidence
here. Heimlich overpowered science all along the way with his
slick tactics and intimidation, and everyone, including us at
the AHA caved in. (Cincinnati
Magazine, April 2007)
The New
Haven Register, the Columbus
Dispatch, the Daily
News Journal (TN), the Auburn
NY Citizen, and Cincinnati
Magazine have reported stories about my father's clandestine
funding of the Yale study
2. Re: US Surgeon General
Koop, as I told NY Sun columnist Lenore Skenazy:
"Koop was an old friend
of my father's, and he did it as a buddy favor." (source)
More on the tainted Yale study
below. More on Koop's "buddy favor" here.
A research study which was
influential in changing national choking rescue protocols in
favor of the Heimlich maneuver was funded by my father's own
foundation. He and the author of the study, the late Richard
L. Day MD, did not diclose this fact to the 1985 American Heart
Association committee at which the study was presented. They
also neglected to reveal to the committee that they were personal
friends who had been in close touch before, during, and after
the study was completed.
The July 1982 issue of "Pediatrics"
contained an article entitled, Choking:
The Heimlich Abdominal Thrust vs. Backblows: An Approach to Measurement
of Inertial and Aerodynamic Forces by Richard L. Day,
MD, Edmund S. Crelin, Phd, and Arthur B. DuBois, MD. (Day and
Crelin
are dead, but Dr.
DuBois still works at Yale University.) This paper described
a research study showing that backblows force objects deeper
into the throats of choking victims, a study which Heimlich
has described as scientific proof of the superiority of the
Heimlich maneuver over backblows, which he has repeatedly characterized
as "deathblows."
Dr. Day - then a 79 year old
retired pediatrician and Yale emeritus professor - and my father
were both members of the July 1985 American Heart Association
Committee on Management of Foreign-Body
Airway Obstruction, at which the Day study was presented.
(This was the same national AHA Conference at which the Heimlich
maneuver for near-drowning rescue was considered, but by a different
committee.) This followed many years of contention regarding
backblows, much of it the result of an aggressive public campaign
conducted by Heimlich &
Patrick against the National
Academy of Sciences, the AHA, and the American Red Cross, a campaign
which included accusing the agencies of participating in a conspiracy
to cover-up scientific evidence.
The 1985 AHA committee decided
that the Heimlich maneuver should be the sole choking rescue
method taught in national rescue protocols, partly relying on
the Day study. From the published AHA Standards
and Guidelines from the conference:
Data were presented at the
conference that suggest that, as a single method, back blows
may not be as effective as the Heimlich maneuver in adults. (The Day study in Pediatrics is cited
here.) Because of these data, and in an effort to simplify
training, the Heimlich maneuver is the only method recommended
at this time. More research and investigation are necessary.
Roger White MD chaired the
1985 American Heart Association (AHA) committee which recommended
that backblows be removed from AHA guidelines. From the "Panel
recommendations" section of Foreign
Body Airway Obstruction: Considerations in 1985 by Dr.
White, published in the December 1986 issue of Circulation, the
AHA journal:
The most persuasive data presented
for review were those of Day and associates cited above.
The Day study also influenced
the American Medical Association's Council on Scientific Affairs
to recommend changing national rescue protocol for choking victims.
From a December 1986 letter to JAMA
by Dr. John H. Moxley III, the chairman of the council:
The Heimlich maneuver was
recommended as the preferred technique for the removal of a foreign
body from an obstructed airway in both adults and children...The
preference for the Heimlich maneuver in most cases resulted from
a reconsideration of the data by Day et al, who concluded that,
theoretically, back blows can displace displace supraglottic
foreign bodies downward into the throat or larynx...."
The end of Day's 1982 article
in Pediatrics includes this funding acknowledgment:
This work was supported in
part by The Dysphagia Foundation, Inc. Cincinnati, the Crippled
Children's Aid Society, New Haven, CT, and National
Institutes of Health grant HL 23959.
Neither my father nor Day
informed the 1985 AHA committee that the Dysphagia Foundation
was my father's own foundation, used to fund his projects since
its inception in 1961. (Corporate documents list the
directors as Heimlich, his wife, Paul Winchell (a television
ventriloquist and personal friend of Dr. Heimlich), an attorney,
and Dr. Heimlich's father.)
The Dysphagia
Foundation became The Heimlich Institute in 1982, the same
year Pedriatrics published the Day study.
A June
7, 1982 letter from my father to Dr. Day acknowledges Heimlich's
clandestine funding of the Day study:
We are certain that your funds
were well spent and appreciate the opportunity to support your
good work. No receipt is necessary.
No receipt indeed.
After the 1985 AHA Conference,
Dr. Day's co-author Dr. Arthur DuBois wrote this whimsical pseudo
press release, Dr. Dick Day
Deals Death-blow to Back Blows which gaily observed:
Defying giants of the American
Heart Association's prestigious Committee on Emergency Treatment
of Airway Obstruction, scientific gun-slinger Day took on the
Committee in a medical shoot-out that included other notables
in the field of resuscitation. At the end, the Committee, eating
its own words, almost choked on its previous recommendations
of back blows and had to be given a verbal Heimlich maneuver
by Dr. Heimlich himself who, luckily, was on hand for just that
purpose.
Challenged by proponents of
'back-slaps, or chest thrusts', Heimlich swept aside such alternatives
to his life-saving procedure. Heimlich said that his procedure
was in use in Japan and China, and its efficacy had never been
questioned....But it was Day, wearing the white hat, who provided
the scientific measurements that destroyed the back blow and
dismayed its proponents, who by then were wearing the black hats.
Medical progress, said Day,
depends on scientific experiments and statistical validity of
properly collected information, not anecdotes. He offered the
results of scientific experiments conducted in the John B. Pierce
Foundation Laboratory in New Haven. Day and DuBois found that
the compression of air in the lungs, measured using a body plethysmograph
method, lasted for only 1/100 second after a back blow, whereas
the compression of air from a Heimlich maneuver was greater,
and much longer in duration. The Pierce Foundation group also
showed that acceleration of the foreign body from a back blow
was in the wrong direction according to Newtonian forces, and
therefore theoretically could wedge a foreign body in the larynx.
...The Dallas medical shoot-out
resulted in a victory for the white hats, Drs. Day, Heimlich,
and (Dr. Edward A.) Patrick, supported by an emotional appeal
by Dr. (Trevor) Hughes for adoption of the Heimlich as a standard
training procedure for housewives. The black hats retreated to
their Committee room to lick their wounds and rewrite their recommendations
for emergency treatment of choking.
After first being informed
of that my father secretly funded the Yale study, Roger White
MD, chairman of the 1985 American Heart Association committee
(and presumably considered one of "the black hats"
by Dr. DuBois), wrote:
There was never any evidence
here. Heimlich overpowered science all along the way with his
slick tactics and intimidation, and everyone, including us at
the AHA caved in. (Cincinnati
Magazine, April 2007)
From Red
Cross Reverses Policy on Choking Aid by Abram Katz, New
Haven Register, October 23, 2006:
For years, the American Red
Cross recommended the abdominal thrust, a posterior hug with
a fist just below the sternum, popularly known as the Heimlich
maneuver. This stand was supported in part by a 24-year-old study
at Yale University, which appears to have been assisted by the
object of the study, Dr. Henry J. Heimlich himself. While critics
of Heimlich cast doubt on the Yale study, Yale is the only institution
that has conducted a follow-up investigation, and apparently
no other institution has attempted to compare the effectiveness
of the Heimlich maneuver to back blows
...The connection between
Heimlich and the Yale scientists appears to pose at least the
appearance of a conflict of interest. But (Dr. Arthur) DuBois,
the only surviving author and professor of epidemiology emeritus
at the Yale University Medical School, said Heimlich was not
involved with the study...."Our lab work still stands up,"
he said.
Heimlich did not answer questions
about the new Red Cross recommendations when he was contacted
in his home in Cincinnati. He also did not return phone calls.
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