Doctor enters lifesaving controversy

Vero Beach Press Journal
By James Kirley staff writer
May 24, 2004

Dr. Peter Wernicki, who practices in Vero Beach, says following Dr. Henry Heimlich's advice as a first response to drowning could cause a victim to choke on vomit, aggravate any spinal injuries and may be fatal.

VERO BEACH A local doctor who serves as medical adviser to the U.S. Lifesaving Association is trying to force an end to a long-running disagreement over how best to revive a drowning victim.

A recent inquiry by Dr. Peter Wernicki of Vero Beach to Dr. Henry Heimlich of Cincinnati sought information about cases cited by Heimlich to support using the famous Heimlich maneuver as a first response for drowning.

Wernicki said following Heimlich's advice delays the beginning of cardiopulmonary resuscitation, could cause a drowning victim to choke on vomit and could aggravate any spinal injuries.

"I think Dr. Heimlich, by advocating it, is probably causing more loss of life," Wernicki said, "and we want to prevent that."

Heimlich's advice runs contrary to drowning rescue protocols taught by the American Red Cross which teaches the use of rescue breathing first.

"If efforts to ventilate the patient suggest obstruction of the airway, then the Heimlich maneuver may be performed in an attempt to clear the obstruction," said Stacy Grissom, a spokeswoman at the Red Cross' Washington, D.C., headquarters.

20-year campaign

Heimlich has campaigned more than 20 years to have lifesaving organizations adopt the maneuver bearing his name as a first step in drowning rescues. His efforts included a 1995 lecture to the lifesaving association's board of directors, followed by an article published in the association's American Lifeguard Magazine.

But the association never took Heimlich's advice and Wernicki wrote a counterpoint article in a subsequent issue of the magazine.

"I think the only person who actually recommends the Heimlich maneuver (for drowning) is Heimlich," Wernicki said, "and everybody else recommends it only if you have an (airway) obstruction."

The Heimlich Institute Web site calls mouth-to-mouth rescue breathing "the kiss of death" and says it has cost thousands of lives with heart attack and drowning victims.

"To save drowning victims, perform the same Heimlich maneuver you use for a choking victim. Repeat until water no longer flows from the lungs," the Web site advises.

"The greater problem, to me, is that Dr. Heimlich continues to go out and advocate this to anyone who will listen," said R. Chris Brewster, president of the association. "Still, no reputable medical organization endorses his decision."

Contacted by the Press Journal for comment, Heimlich sent a copy of his April 19 reply letter to Wernicki and an open letter printed in the May issue of Cornell Alumni Magazine.

"Drowning victims die because their lungs fill with water...Four Heimlich maneuvers clear the water from the lungs," Heimlich's Cornell Alumni Magazine letter stated.

Locally, supervisors for both Indian River County and Vero Beach lifeguard corps said they are trained to use rescue breathing first for drowning and the Heimlich maneuver in choking situations.

Questions raised

Wernicki wrote Heimlich March 31, reminding the Cincinnati physician his 1995 article cited two successful rescues, each by a physician using the Heimlich maneuver.

"Recent information provided to us has raised questions regarding the factual basis of...the cases you have cited that purport to show the efficacy of the Heimlich maneuver for drowning," Wernicki wrote. "We have an ethical obligation to investigate and to correct the record, if necessary."

Heimlich wrote Wernicki in his reply: "I am perplexed by your criticism, since you elected to publish my article. It is apparent that the (U.S. Lifesaving Association) also felt the need to inform its lifeguards of the alternative to the (American Red Cross) protocol."

Heimlich's letter to Wernicki cited a 1995 report of rescuing a 2-year-old boy at a Jacksonville lake by using the Heimlich maneuver. It was credited to Ron Watson at the time a city parks manager and vice president of the U.S. Lifesaving Association.

Now a commissioner in Harrison County, W.Va., Watson confirmed the incident.

"We saved him by doing (the Heimlich maneuver)," Watson said in a phone interview last week. "If I hadn't gotten the water out...the kid would have died."

Wernicki and Brewster said they have read letters and other writings posted on the Internet critical of Heimlich's efforts to advance the Heimlich maneuver for drowning rescue.

These include an anonymous letter to the presidents of four nationwide medical organizations. It questions the veracity of the two drowning cases cited in Wernicki's letter to Heimlich.

"We're trying to get at the facts behind it," Brewster said about the Internet material.