DNJ 2-12-07

Feb 12, 2007, Daily News Journal, Murfreesboro, TN

Red Cross Recommends Back Blows Before Heimlich

By COLLEEN CREAMER ccreamer@dnj.com (615)278-5131 You're at a restaurant, and you notice someone is choking. Knowing what you think you know, you grab the afflicted diner from behind and deliver the now familiar thrust to the diaphragm to dispel the food. Right? Not so fast. The American Red Cross's recommended protocol for treating choking victims is to first deliver blows to the back and then use "abdominal thrusts" as a secondary method. The Red Cross has not used the term Heimlich maneuver in years, but it hasn't been very vocal about its downgrade to a second line of defense that it made official last year. Pamela King, spokeswoman for the American Red Cross, said guidelines could change every five years when critical-care experts convene to take a look at them. "Different evidence comes up and with different recommendations," King said. Calls on the change made to local Red Cross offices were referred to the national headquarters. There is no clear evidence which technique is better, though the Heimlich maneuver alone claims many victories. In January, Claire Robinson, a fifth-grader at Northfield Elementary in Murfreesboro, took stock when her buddy Madison Mooneyham began choking on her lunch. She effectively performed the Heimlich on Madison and saved her life. Her sister had taught it to her the week before, and she had even practiced it on her stuffed animals. The only known study comparing Dr. Henry Heimlich's method, which he developed in 1974, and back blows was performed by three Yale scientists, Richard L. Day, Edmund S. Crelin and Arthur B. DuBois, in the 1980s. The Heimlich method was adopted by the Red Cross in 1985 after an American Heart Association conference at which Day presented findings that backed the idea that blows drive food deeper into the windpipe. "The paper itself states that it was funded by the Dysphasia Foundation and the Dysphasia Foundation changed its name shortly after the paper was published to The Heimlich Institute," said Heimlich's son, Peter. Peter Heimlich said his father "bought" the study during which researchers measured air pressure at the mouths of volunteers receiving either back blows or abdominal thrusts.

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His father, said Peter Heimlich, referred to back blows as "death blows," but had no science to back up those claims and used "brass-knuckle media tactics" to rid references to them in literature. "He went on a 10-year campaign to discredit the competition, which was back blows and chest thrusts," said Peter Heimlich. Peter Heimlich also maintains that the American Red Cross is dragging its feet in getting the information out about the new protocol. 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." MTSU nursing professor Suzanne Provost said the school has known of the new guidelines for some time. "We have followed suit in terms of changing what we are teaching people, to go with the back blows first in accordance with what the national groups are currently putting forward as guidelines," Provost said. Still, the Heimlich maneuver is so ingrained in people that it will likely remain the most-used method during emergencies. And, if done properly, it can be successful. Claire Robinson and Madison Mooneyham, at least, are proof the Heimlich maneuver works.