THE AMERICAN
HEART ASSOCIATION (AHA):
The AHA says they don't know which treatment is best - back blows,
chest thrusts, or abdominal thrusts - but they recommend only
abdominal thrusts even though their guidelines state that the
treatment may result in "life threatening complications."
(Columbus
Dispatch, 11/5/06) The AHA says they base their treatment
recommendations on 2005 ILCOR (International Liaison Committee
on Resuscitation) guidelines.
THE AMERICAN
RED CROSS (ARC): In 2006,
the ARC made the first major change in choking rescue in 20 years
and no longer recommends the Heimlich maneuver as the first treatment
response. The ARC now recommends first performing five back blows;
if that doesn't remove the obstruction, proceed with five abdominal
thrusts. (The ARC no longer uses the term "Heimlich maneuver.")
In
this e-mail, an ARC representative informed me that their
recommendations are based on 2005 ILCOR guidelines.
(For a comprehensive state-by-state
list of news reports about the Red Cross update, click
here.)
THE CANADIAN
RED CROSS (CRC): The
CRC recommends only abdominal thrusts for most choking victims.
In
this e-mail,
a CRC representative informed
me that their recommendations are also based on 2005 ILCOR
guidelines.
Meanwhile,
in Australia, they've
dropped the Heimlich maneuver and replaced it with chest thrusts
based on - yes - the same 2005 ILCOR guidelines.
Going to the
source, here's what the
most recent ILCOR guidelines (12/29/05) say about foreign body airway obstruction
(FBAO). "Defininative" is probably not a word that
springs to mind:
Treatment
Recommendation
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. Unconscious victims should receive CPR. The finger
sweep should be used in the unconscious patient with an obstructed
airway only if solid material is visible in the airway. There
is insufficient evidence for a treatment recommendation for an
obese or pregnant patient with FBAO.
Presumably
the public is entitled to unambiguous first aid information,
especially it comes to a relatively simple medical condition
like choking, one which which has been the subject of considerable
interest over the past 30 years. Why then so much uncertainty
in the ILCOR guidelines? Why different guidelines from different
first aid training organizations? Even the American Red Cross
and Canadian Red Cross are not in sync, yet both claim they based
their positions on the same 2005 ILCOR guidelines. Is the physiology
of US citizens different from Canadians?
Facts prove
much of the responsibility for this mess falls squarely into
the laps of two American medical icons, my father and former
US Surgeon General C. Everett Koop, who, 20 years ago, jointly
scammed the US medical organizations in order to manipulate first
aid guidelines. In my opinion, the current confusion is the direct
result of their willful, unethical misconduct.
In July 1985, my father ("America's
most famous doctor" according to The New Republic) and
the late Dr. Richard L. Day of Yale University presented a research
study to an American Heart Association conference. The study
allegedly proved that backblows were dangerous, pushing objects
deeper into the airway. A few months later, Surgeon General Koop,
("America's family doctor" according to himself) issued
a widely-reported Public Health Statement urging the AHA and
the American Red Cross to teach only the Heimlich maneuver for
choking rescue and that all other methods were "hazardous,
even lethal." As a result, the AHA rewrote choking rescue
guidelines to teach nothing but the Heimlich maneuver.
Two decades later, our research
uncovered that my father clandestinely paid for the Yale study,
a fact which has since been reported in a number of articles.
Details
here.
As for Dr. Koop (who now heads
the Koop Institute
at Dartmouth), in 1985 he failed to inform anyone that he and
my father were old friends and that he issued his statement as
"a
buddy favor," as I told syndicated columnist Lenore
Skenazy.
Recently Dr. Koop has avoided
reporters who've tried to ask him about his relationship with
my father and why he used the office of the US Surgeon General
to promote my father's interests. For more on the "Koop
maneuver," click any of these photos: