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Why were
backblows eliminated from US choking rescue guidelines in 1986,
then reinstated 20 years later? Read "Slick
tactics, intimidation" and sausage-making: a brief history
of US choking rescue guidelines...and will chest thrusts replace
the Heimlich maneuver?
Updated June 25, 2008
I. Why are US first aid organizations
failing to inform the public about how to rescue choking victims?
II. Comprehensive list of all news reports about the
2006 choking guidelines update, alphabetized by state
by Peter M. Heimlich
I. Why are
US first aid organizations failing to inform the public about
how to rescue choking victims?
My father introduced the Heimlich
maneuver in June 1974. It was quickly adopted by US first aid
organizations who recommended that backblows should be first
be applied to choking victims; if the backblows failed, rescuers
were advised to proceed with the Heimlich manuever.
For the next decade, my father
went on a widely reported media campaign he called "backblows
are deathblows." Without any evidence, he claimed backblows
were dangerous and demanded that the American Red Cross and American
Heart Association remove them from their first aid training guidelines.
(Why? As one reporter suggested to me, my father wanted "to
win the choking rescue crown.")
In July 1985, his campaign
succeeded. As
widely-reported at the time by many news outlets, US first
aid organizations dropped backblows and agreed to teach only
the Heimlich maneuver.
Fast forward 20 years. In
Spring 2006, the American Red Cross (ARC) reinstated backblows
as the first treatment response and - just like the pre-1985
guidelines - if the backblows failed, rescuers were instructed
to follow-up with abdominal thrusts. The ARC also officially
eliminated the use of the term "Heimlich maneuver."
Likewise, the American Heart Association completely
revamped their choking rescue treatment recommendations:
Chest thrusts, back blows/slaps,
or abdominal thrusts are effective for relieving FBAO in conscious
adults and children >1 year of age, although injuries have
been reported with the abdominal thrust. There is insufficient
evidence to determine which should be used first. These techniques
should be applied in rapid sequence until the obstruction is
relieved; more than one technique may be needed.
These changes mean re-training
the public, new posters in restaurants, and revising various
first aid training statutes. That seems like a big news story.
In order to inform the public, you might expect the Red Cross
and Heart Association would issue press releases so that the
media may efficiently inform the public that "backblows
are back."
According to a Red Cross representative,
the following are the only press releases their organization
has sent out.
4/4/06 - The
American Red Cross Unveils Innovative New First Aid and CPR/AED
Training Programs
12/14/06 - The
American Red Cross Shares Tips for a Happy Holiday
11/15/07 - Red
Cross Talks Turkey About Thanksgiving Safety
It's difficult to imagine
less informative press releases. They not only fail to highlight
the importance of the change, the information is buried. In fact,
the term "Heimlich maneuver" is not even mentioned.
Upon receiving these, how would a busy assignment editor or reporter
recognize the importance of the information or its news value?
Nevertheless, since mid-2006
the choking rescue update story has been reported by dozens of
print and TV news outlets. (Page down.) But if you think the
first aid organizations generated these stories, you'd be wrong.
I'm responsible for virtually
all of them. Let me explain.
Choking stories are popular
human interest subject for reporters, especially rescues, which
turn
up almost daily somewhere in the world. As part of our research,
I track these stories via Google News and other news search engines.
If I come across an interesting item, I often contact the reporter
and ask them if they're aware of the Red Cross/Heart Association
updates.
Out of scores of such contacts,
only two reporters had heard about the update before I
told them. Of those two, one had taken a Red Cross class two
weeks earlier. Most say, "How come I haven't heard about
this?" to which I usually answer, "I don't know. Ask
the Red Cross and the Heart Association." In the interests
of informing their readers & viewers of this potentially
lifesaving information, a number of them have gone on to report
the story.
In other words, apparently
the only way for the public to learn the best way to save a choking
rescue instructions is by paying to attend a class, taking the
initiative to visit the first aid organization's web sites, or
by coming across a story which made its way into print or onto
the airwaves because of me!
What's going on here? Why
has it fallen to me, an author researching my father's career
to be doing the job of the communciations departments of the
Red Cross and Heart Association?
In any event, below is a comprehensive,
regularly-updated, alphabetized state-by-state listing of every
known print & broadcast report about the choking rescue updates.
Check your state to see how few (if any) news outlets have reported
the story. You may be surprised!
SPECIAL NOTE: My father introduced
the Heimlich maneuver in Cincinnati in 1974 and still lives there.
He's a local icon who has been the subject of literally hundreds
of local media reports over the past 30 years. Nevertheless,
despite being repeatedly notified over the past two years by
me and others about the Red Cross/Heart Association update, not
one Cincinnati TV or radio station or daily newspaper has reported
the story.
1988-89 Cincinnati Bell
phone directory
II. Comprehensive list of
all news reports about the 2006 choking guidelines update, alphabetized
by state
*Stories which include information about
how my father and a Yale researcher used a dubious 1982 research
study to defraud a 1985 American Heart Association committee
and manipulate national first aid guidelines in favor of the
Heimlich maneuver. Click
here for more information about that.
**Stories which include information about
how former US Surgeon General C. Everett Koop apparently colluded
with my father to manipulate national first aid guidelines in
favor of the maneuver. Click
here for more information about that.
*** Stories in which I criticize
the first aid organizations for failing to inform the public
about the 2006 update.
National
& International News Outlets
November 13, 2006 - Voice
of America News, Basics
of First Aid: What to Do Until Medical Help Arrives
May 26, 2008 - Voice of America
(Special English News), Learning
First Aid: What to Do Until You Reach Medical Help
*July 18, 2007 - Heimlich's
Son Pushes to Discredit Famous Dad by JR Santo, ABC News,
The Blotter
In another significant setback,
the use of the Heimlich maneuver on choking victims has been
quietly downgraded by the American Red Cross. In new guidelines,
the Red Cross recommends a series of five back slaps as the first
course of action, followed by five Heimlich maneuver thrusts...Dr.
Heimlich refused to speak to ABC News..."Every study in
this shows that back slaps drive the food deeper and do not save
lives, that only the Heimlich maneuver saves lives," eldest
son Phil Heimlich told ABC News on behalf of his father. At the
1985 Red Cross and AHA conference, however, only one study was
cited that showed back slaps can be dangerous when used on choking
victims. That study had been funded by Dr. Heimlich through an
institution called the Dysphagia Foundation Inc., which was later
renamed The Heimlich Institute....
Arkansas
June 19, 2008
- Hold
That Heimlich,
Arkansas Times
California
March 9, 2008 - Hundreds
Take Time to Learn CPR at Free Red Cross Class by John
Driscoll, The Eureka Times-Standard
Connecticut
*October 23, 2006 - New Haven Register,
Red
Cross Reverses Policy on Choking Aid by Abram Katz
April 10, 2007 - Red
Cross Deviates from Heimlich Maneuver by Anne Pallivathuckal,
Journal Inquirer
(Peter Heimlich) says that
the Heimlich maneuver works, but "the question is whether
it is the best method." Peter contends that the maneuver
gained widespread prominence because of his father's media blitz,
even while other methods were found to be more effective. Peter
cites the work of Charles Guildner, a doctor who studied chest
thrusts as a method for rescuing choking victims in the mid-1970s.
Guildner did a series of tests to compare the effectiveness of
using abdominal thrusts versus chest thrusts by measuring airflow.
His findings showed that chest thrusts were more effective. A
more recent study in Norway that tested the effectiveness of
chest thrusts using cadavers replicated Guildner's findings,
Peter says. The AHA in its journal, "Circulation",
cites this study, in which randomized trial maneuvers to open
the airway in cadavers was tested. The AHA journal also mentions
other studies that show that higher sustained airway pressures
can be generated using the chest thrust rather than the abdominal
thrust.
Illinois
September 24, 2006 - Joliet
Herald News, Choking
Victims: Debate Over Lifesaving - Groups differ in controversy
over backblows
While the Red Cross and American
Heart Association still say the Heimlich maneuver, or "abdominal
thrusts" as it's called, is the foremost way to help somebody
who is choking, they take varying stands on whether back blows
also should be given. The heart association favors the no-back-blow
argument, saying that it's easier to simply teach one method.
But under new rules taught in rescue courses this summer, the
American Red Cross officially says yes to the back blow debate.
The group says a rescuer should first use back blows, and then
move to the Heimlich maneuver to help a choking person. But even
the Red Cross itself seems to be on two different pages with
the new rules.
November 16-17, 2006 - ABC7
Chicago I-Team Special Report, The
Maneuver by Chuck Goudie
December 20,
2006 - SuperStation WGN-TV, Chicago, Heimlich
Maneuver Now 2nd Choice for Choking Rescue
Indiana
September 15, 2006 - WNDU-TV,
South Bend, Guidelines
for Saving Choking Victims Have Changed by Kari Huston
Iowa
August 1, 2007 - Learning
the Basics by Melissa Regennitter, Muscatine Journal
Kentucky
August 22, 2007 - Choking
Response Had All the Right Rescue Moves by Tom Dekle,
The Kentucky Standard (Bardstown)
Maine
February 1, 2007 - Ellsworth
American - What
Is the Best Way to Help Choking Victims? by James Straub
Maryland
October 12, 2006 - Cecil Whig,
Red
Cross Expands Choking Treatment by Jane Weaver
March 27,
2007 - Cecil Whig, Woman
Claims Pet Pooch (Toby) Gave Her the Heimlich by Scott Goss
As strange
as (Debbie) Parkhursts story might sound, Toby's actions actually
followed the emergency measures recommended for choking victims
by the American Heart Association and the American Red Cross.
Both agencies recommend first aid responders use a series of
five back blows followed by a series of five abdominal thrusts,
otherwise known as the five and five.
March 29,
2007 - WJZ (CBS-TV, Baltimore) Dog's
Life-Saving Heimlich Contradicts Red Cross by Jessica Kartalija
Michigan
December 12, 2006 - The Grand
Rapids Press, Backslaps
Dislodge Heimlich Maneuver Here by Paul R. Kopenkoskey
"As a choking rescue
treatment, it (the Heimlich maneuver) is effective saving thousands
of lives," acknowledged Peter Heimlich, owner of a wholesale
fabric business in Atlanta. "That's not my beef. "The
serious question is, is it the best rescue treatment for choking?
The back blows are less invasive. They're not going to hurt anybody.
Abdominal thrusts, aka the Heimlich maneuver, can break a rib,
damage internal organs." Peter Heimlich accuses his famous
father of a 10-year misinformation campaign, touting his method
while maligning back blows as death blows. "In Europe, they've
been teaching back blows followed by abdominal thrust for 30
years," said Peter Heimlich. "They never heard about
it killing people. No one is being sued like mad."
Reached at his home in Cincinnati
last week, Heimlich, 87, referred questions to his spokesman,
Robert Kraft. "Dr. Heimlich's maneuver has proved itself
over the last 30 years because of the lives it has saved,"
Kraft said. Heimlich continues to assert it's a medical faux
pas to use back blows to save a choking victim, he said. "Back
blow drives a food deeper into the throat rather than expel it,"
Kraft said. (Dr. Robert) Baratz calls that, "pure nonsense.
" The Red Cross' new guidelines for conscious victims recommend
first applying backslaps. If that fails to remove the airway
obstruction, abdominal thrusts are recommended. For unconscious
victims, the new guidelines recommend chest thrusts, a method
first recommended in a 1976 study by Dr. Charles Guildner, whose
results were duplicated in a year 2000 study by Dr. Audun Langhelle.
January 9, 2007 - Nurse
Uses Heimlich Maneuver to Save Choking Diner by Jennifer
Linn, Ludington Daily News
March 21, 2008 - Choking
Rescue Advice Changes; Red Cross Recommends Classes by
Lisa Carolin, Ann Arbor News
One of the key messages the
Red Cross wants people to know is that the Heimlich maneuver
is no longer the first thing one should do to help a choking
victim. In March of 2006, the American Red Cross reinstated back
blows as the first treatment response..."It changed from
doing abdominal thrusts to doing a combination of back blows
with the victim being bent over,'' says Brothers. "You do
a combination of five back blows, then have the victim stand
upright for a series of five abdominal thrusts and then repeat
the cycle.''
Minnesota
January 26, 2007 - Minneapolis
Star-Tribune, Heimlich
Family Divided Over Doctor's Reputation by Kim Ode
December 19, 2007 - Red
Cross Tips for Happy Holidays by Marie Plaskett, Winona
County Red Cross Executive Director, Winona Daily News
New
Jersey
August 14, 2007 - Controversial
Maneuver: Heimlich's claim that his famous procedure can save
near-drowning victims is disputed by many, including his own
son by Mike Riley, Asbury Park Press
New
Mexico
October 21, 2006 - KOB-TV,
Albuquerque, Red
Cross Changes First Aid Training for Choking by Todd
Dukart
New
York
*January 9, 2007 - The Citizen, Auburn
NY, First
Aid Update by David Wilcox
Back blows
were advocated by the Red Cross as the best way to rescue a choking
victim until Cincinnati-based physician Henry J. Heimlich began
a media campaign for the maneuver he invented. It was adopted
by the Red Cross following a 1985 conference of the American
Heart Association, whose lead the Red Cross often follows in
establishing first aid guidelines. At that conference, Dr. Richard
Day presented a choking rescue committee with the results of
a study finding that back blows do indeed drive food further
down the windpipe. The Heimlich maneuver subsequently replaced
back blows as the recommended method of removing food from the
throats of choking victims. However, Heimlich's son, Peter, points
out that Day's research was devoid of scientific objectivity.
What my father and Dr. Day failed to divulge was that my father
had clandestinely funded the study and had a close relationship
with Day....
**February 21, 2007: New York Sun Maneuvering Over
Heimlich by Lenore Skenazy (nationally syndicated column)
February 28,
2007 - WSYR (ABC-TV, Syracuse, NY) Doctor
on Call
by Carrie Lazarus
North
Carolina
October 19, 2007 - Heimlich
Family Maneuvers by W. Terry Smith, The Daily Southerner,
Tarboro
Ohio
August 3, 2006 - The Cincinnati
Beacon, The
Heimlich Remover: David Pepper, or the Red Cross? by
Jason A. Haap (FIRST
PUBLISHED REPORT OF THE RED CROSS UPDATE)
November 1, 2006 - Cincinnati
CityBeat, Proofreaders
Are Sorely Missed by Ben L. Kaufman
*November 5, 2006 - Columbus Dispatch,
Red
Cross Revises Tips on Helping the Choking by Misti Crane
**April 2007 - A
New Maneuver
by Pamela Mills-Senn, Cincinnati Magazine, April 2007:
Dr. Roger
White, who chaired panel discussions on the management of foreign-body
airway obstructions and who currently serves as consultant and
professor at the Mayo Clinic, told me via e-mail that neither
(Dr.) Heimlich's antics nor concerns over the AHA's (American
Heart Association) and the ARC's (American Red Cross) reputations
had anything to do with the decision (to eliminate backblows
in favor of the Heimlich maneuver)....However, in a 2004 e-mail
to Peter Heimlich (who corresponded with White using a pseudonym),
White is significantly less blase about Dr. Heimlich's role:
"There was never any evidence here," White wrote. "Heimlich
overpowered science all along the way with his slick tactics
and intimidation, and everyone, including us at the AHA caved
in."
Oregon
October 20, 2007 - Heimlich
Hero Goes National by Sanne Specht & October 23,
2007 - Because
We Like Ruining Your Fun, The Mail Tribune, Medford
Pennsylvania
June 3, 2007 - Blows
are Back by Jo Ciavaglia, Bucks County (PA) Courier Times:
With little public fanfare
nearly two years ago, the Red Cross resurrected back blows as
the first choking rescue response, reversing its long published
guidelines promoting abdominal thrusts - better known as the
Heimlich maneuver. The policy change has been called the most
significant in decades, with major implications for emergency
and first-aid education and training.
South
Carolina
September 24, 2007 - Do
You Know What to Do When Someone is Choking? There Has Been a
Change in the Techniques Taught by the Red Cross by Scott
Powell, The Gaffney Ledger
Tennessee
* *** February 12, 2007 - Daily News Journal
(Gannett, Murfreesboro, TN), Red
Cross Recommends Back Blows Before Heimlich by Colleen
Creamer
Peter Heimlich also maintains
that the American Red Cross is dragging its feet in getting the
information out about the new protocol.
(Red Cross spokeswoman Pamela)
King disagrees. At the local and national level, she said, efforts
are being made to let people know. "I know I have done several
media releases," said King. "Our chapters are going
out to their local communities. Anyone who is trained now you
are taught the new skills. So, they are in all of the new Red
Cross programs. We've got materials, posters and wallet cards."
Texas
October 21, 2007 - The
Tale of Choking and Wall Street by Lynn Walker, Times-Record
News, Wichita Falls
Utah
July 11, 2007 - New
Emergency CPR Procedures, KUTV (CBS affiliate), Salt
Lake City
In the last few years, lifesaving
rescue procedures have changed. If someone was choking, we used
to administer several abdominal thrusts until the object came
out, but now. “Now it’s a combo of back blows and abdominal
thrusts,” says Cheryl Gren of the Salt Lake Chapter of the
American Red Cross. Five blows to the back, five abdominal thrusts,
for babies, five blows to the back and five chest thrusts.
Vermont
November 22, 2006 - Seven
Days, Burlington, VT, Red
Cross Revises Tips for Helping Choking Victims by Ken
Picard
Virginia
May 18, 2005 - Heimlich's
Use Debated as Best Method for Aid by Jim Hall, Fredericksburg
Free Lance-Star
The Heimlich maneuver may
or may not be the best way to aid a conscious, choking adult.
It depends who you talk to. Someone trained in American Heart
Association techniques will recommend the Heimlich. But someone
trained by the American Red Cross will tell you to give five
back blows first, then do the Heimlich--if necessary. Sorry,
the Red Cross doesn't call it the Heimlich anymore. They say
give five "abdominal thrusts."
Washington
December 3, 2007 - Heimlich
Maneuver by Patricia Murphy, KUOW-FM, (Seattle public
radio)
Wisconsin
November 7, 2006 - Madison
Capital Times, Big
Changes in Red Cross CPR Guidelines by Amy Mertz
November 24, 2006 - WAOW-TV,
Wausau, Experts
Say: If Choking, Don't Use Heimlich Right Away!
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