Red Cross Revises Tips for Helping Choking Victims

VERMONT - It's Thanksgiving Day and your family is seated around the dinner table, enjoying ample portions of turkey, stuffing, mashed potatoes and cranberry sauce. Amid the cacophony of chatter, laughter and clinking silverware, your Uncle Bob suddenly lurches to his feet, his face beet-red as he clutches his throat and gasps for air.

Someone immediately dials 9-1-1 as your Aunt Janice rushes to his aid. She clutches Bob from behind, balls up her fist in his abdomen, leans him forward slightly and gives him a few quick, upward thrusts just above the navel. Within seconds, a large chunk of white meat sails across the dinner table. A sense of collective relief spreads through the room at the disaster that was narrowly averted.

For more than three decades, the gold standard for treating a choking victim who is still conscious has been the "Heimlich maneuver" - a first-aid procedure made famous by its namesake, Ohio chest surgeon Dr. Henry Heimlich, and by countless depictions in movies and television shows. According to the Heimlich Institute of Cincinnati, the maneuver has saved tens of thousands of people.

The American Red Cross, however, recently changed its first-aid protocol to de-emphasize the use of the Heimlich for treating a conscious choking victim. According to Mike Higgins, manager of community preparedness education at the northern Vermont chapter of the American Red Cross, the new protocol recommends calling 9-1-1, then giving the person several sharp blows to the back, right between the shoulder blades, with the heel of the hand. If this doesn't clear the obstructed airway, "abdominal thrusts" should be tried next, alternating with repeated back blows, until the person breathes freely or loses consciousness.

The American Red Cross now teaches both procedures as part of its CPR and first-aid classes, and is currently revising the informational posters, pamphlets and wallet cards it gives out to restaurants and the general public. And, in keeping with the advice of most national emergency-responder agencies, the Heimlich maneuver is no longer advised as useful or beneficial for helping a near-drowning victim.

Why the switch? According to Higgins, the Red Cross reviews its first-aid protocols every five years, and it determined recently there's no evidence the Heimlich maneuver works better than back blows. Interestingly, the Red Cross doesn't even call it the "Heimlich maneuver" anymore, but uses the more anatomically descriptive "abdominal thrusts." Higgins explains that the name was changed to reflect how the procedure works physiologically.

But according to someone who's also quite familiar with the procedure, and with Dr. Heimlich himself - his son, Peter Heimlich - the change is a result of growing questions about the maneuver's safety and effectiveness, as well as the credentials of Dr. Heimlich himself. Bluntly put, the younger Heimlich has repeatedly accused his father of being "a fraud" and "one of history's great medical charlatans," while also dismissing his lifetime's medical research as "completely bogus." Peter Heimlich also accuses his father of stealing credit for the maneuver, which he claims was actually invented by another researcher.

Dr. Heimlich and the Heimlich Institute of Cincinnati stand behind the maneuver as the most effective method for dealing with choking and near-drowning incidents, according to family spokesman Bob Kraft. He dismisses Peter Heimlich's charges against his father as the ranting of a son who's been "seriously estranged" from the rest of his family for at least five years.

Apparently, the Heimlich family feud has been brewing for some time. In an interview with Seven Days from his home in suburban Atlanta, Peter Heimlich says that he and his wife, Karen Shulman, first began researching his father's career in 2001 and were distressed to discover a number of discrepancies in his research. They also found medical professionals who questioned his father's research and methods. The younger Heimlich now accuses the elder of secretly trying to "ruin the careers" of other researchers who disagreed with him or his findings.

Peter Heimlich, who admits he's not a physician, has set up a website - http://medfraud.info [1] - to expose his father's alleged fraud. In interviews and on his website, Peter Heimlich claims his father paid for a 1982 study on the ineffectiveness of back blows, which Dr. Heimlich often referred to publicly as "death blows," because he claimed they can drive an airway obstruction deeper into the esophagus.

While Peter Heimlich doesn't deny that the Heimlich maneuver is an effective method for saving the life of a choking victim, he's been on a national media crusade recently to expose his father, especially his continued advocacy of the use of the Heimlich maneuver for near-drowning victims, a practice he says "is not only useless, [but] can kill you."

Why Heimlich's attacks on his own flesh and blood? Peter Heimlich compares himself to David Kaczynski, who turned his brother in to the FBI when he suspected him of being the famed "Unibomber." Ted Kaczynski killed three people and injured 29 with mail bombs from the late 1970s to early 1990s.

"Despite universal condemnation" of the Heimlich procedure for drowning victims, Peter Heimlich says, "my father simply won't stop promoting his destructive theory. People trust him because of his famous name, and they don't understand the medical issues . . . Karen and I didn't want anyone else hurt, so we started speaking out."

Dr. Heimlich, now 87, no longer practices medicine or gives press interviews. However, according to Kraft, the Heimlich maneuver is credited with saving "well over 50,000 lives" in its 30 years of public use. Kraft points out that the American Heart Association still recommends abdominal thrusts as the first line of attack for choking victims. And, while he admits that the medical community has largely discredited the procedure's appropriateness for drowning victims, the Heimlich Institute still advocates its use.

As for the potentially slanderous attacks on Dr. Heimlich by his son, Kraft says Dr. Heimlich has no plans to file suit, noting only that Dr. Heimlich and his wife "are at the end of their lives and they're extremely sad that the relationship with one of their sons has gone so poisonous."

Kraft won't speculate about why the American Red Cross recently changed its first-aid choking protocol, except to say that "Dr. Heimlich kind of barnstormed the procedure, and I think he angered the Red Cross officials, so there's bad blood there." No pun intended.

Mike Higgins at the northern Vermont chapter of the Red Cross says he's never heard about the bad blood in the Heimlich family. As for whether abdominal thrusts or back blows work better, he recommends using whichever one works.