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Many choking victims survive the experience because of an emergency technique first discussed informally by Dr. Henry J. Heimlich in 1974. Heimlich himself did not invent the technique, but had heard of a restaurant owner who used abdominal thrusts to rescue a choking customer. Dr. Heimlich became convinced of the lifesaving importance of abdominal thrusts and advocated its widespread use by the general public. The process of administering sharp abdominal thrusts to remove foreign objects or food from a choking victim's windpipe or throat became known as the Heimlich maneuver.
Since 1974, the Heimlich maneuver has been credited with saving thousands of lives. The technique itself can be learned in a matter of minutes, and for many years has been included in the training curriculum of lifeguards, restaurant workers, and first responders. Many students learn the Heimlich maneuver in mandated health classes. For many people, their first instinct when confronted with a choking victim would be to use the Heimlich maneuver to clear the obstruction.
The abdominal thrust, or Heimlich maneuver, begins with an assessment of the choking victim. If a choking victim can still talk or cough, his or her airway is not entirely blocked and other techniques such as firm back slaps between the shoulder blades can be attempted first. If the victim cannot speak or cough, then the Heimlich maneuver should be attempted. Because the Heimlich maneuver can cause damage to internal organs and bones, it should never be practiced at full strength on a non-choking volunteer.
The rescuer should make a fist with one hand and place it just below the victim's rib cage but above the navel area. The rescuer should reach around the victim's back and bring the other hand to meet the fist, roughly a reverse hugging position. The rescuer should then thrust his or her fist forcefully in a back then upward direction. This may have to be repeated several times until the obstruction is forced out of the victim's airway. Essentially, the Heimlich maneuver is a forced cough created by compressing the diaphragm and increasing lung pressure.
There are a number of risks involved with the Heimlich maneuver, however, and many professional medical associations have started to recommend other methods besides abdominal thrusts, especially for drowning victims. The amount of potential damage to internal organs and bones even if the Heimlich maneuver is performed properly has become a concern in recent years. An alternative method called the mid-chest thrust is now thought to produce more air pressure with a much lower chance of injury. A number of professional emergency medical associations have also begun to downplay the use of the traditional Heimlich maneuver in favor of other procedures for drowning victims.
Dr. Heimlich has also become a controversial figure in medical and humanitarian circles for his reported interest in malaria therapy as a potential cure for AIDS/HIV and other questionable medical procedures. A fellow physician has also alleged that he helped Dr. Heimlich develop the maneuver which bears his name, but has never received public credit for his contributions. While many people around the world still use the Heimlich maneuver to save choking victims, Heimlich's suggested use for drowning victims or even asthmatics continues to be controversial.
I worked in food service most of my adult life, and I remember when the Heimlich maneuver became required training for anyone who worked around customers. I've seen people choke on food a few times, but the rule was that if they could still cough or breathe, we weren't supposed to do the Heimlich maneuver. It worked best when the victim's airway was completely blocked. If we did it and it wasn't necessary, we could cause some serious injuries. Broken ribs were not uncommon.
I actually got to meet Dr. Heimlich when he was staying at the hotel I worked at as a dining room host. He was in town to receive a humanitarian award, which would later bear his name. I believe it was his estranged son who was behind the campaign to discredit his more recent medical research. After that story went public, the name of the humanitarian award was changed, too.
I have a not-so-fond memory of the Heimlich maneuver. I got sick during the last two weeks of a required health class and missed out on CPR and Heimlich maneuver training. The instructor and I didn't get along very well to start with, and she said I would have to come back the following semester and take the last two weeks of class over again before I could pass the class.
When it came time for the Heimlich maneuver training, she decided to use me as the choking victim. Ordinarily, instructors aren't supposed to use full force when doing the compressions, but she really let me have it. She shoved her fist into my abdomen and did five quick upward thrusts. Each time, the air came out of my lungs and I thought I was going to vomit. She told the class that the sound of air rushing out was a sign that the technique was working.
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