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Choking Victims: Debate Over Lifesaving - Groups differ in controversy over back blows

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Feb 26, 2008, 1:44:41 PM2/26/08
Choking Victims: Debate Over Lifesaving - Groups differ in controversy
over back blows

by Patrick Ferrell, Joliet Herald News, September 24, 2006

To back blow, or not to back blow?

That's the question for those looking to help choking victims. And the
nation's leaders in first aid instruction - the Red Cross and the
American Heart Association - offer seemingly contradictory
instructions on whether one should slap the back of a choking person.

Dr. Henry Heimlich, whose namesake maneuver saved countless choking
victims, gives a resounding no. Hitting somebody on the back, he
argues, could push the food farther into the throat. But his stance
against death blows, as he calls them, has since come under fire by
some, including his own son, who argues that Heimlich paid for studies
in the 1980s to give his maneuver prominence over back blows.

While the Red Cross and American Heart Association still say the
Heimlich maneuver, or "abdominal thrusts" as it's called, is the
foremost way to help somebody who is choking, they take varying stands
on whether back blows also should be given.

The heart association favors the no-back-blow argument, saying that
it's easier to simply teach one method.

But under new rules taught in rescue courses this summer, the American
Red Cross officially says yes to the back blow debate. The group says
a rescuer should first use back blows, and then move to the Heimlich
maneuver to help a choking person.

But even the Red Cross itself seems to be on two different pages with
the new rules.
"The Red Cross recommends that you don't hit people on the back when
they are choking, because it may lodge the item deeper rather than
releasing it," an official with the Red Cross of Greater Chicago wrote
in an e-mail to The Herald News.

The end results could mean confusion for a public simply wanting to
know the best first aid techniques. So, with two seemingly
contradictory sets of rules, and not everybody following those rules,
which should non-rescue professionals subscribe to?

"That's a very good question," said Capt. Mike Stromberg of the Joliet
Fire Department. "With the Red Cross and the American Heart
Association, some of their guidelines are very far apart, and this may
be one of those cases."

Joliet uses the heart association standards and has not advocated
using back blows on adults for more than 20 years, Stromberg said. For
infants, though, it's still the best way to dislodge an airway
obstruction, he said.

The New Lenox Fire Protection District also follows the no-back-blow

"I don't think the back blows would hurt anything, but I would say
just do the abdominal thrusts, for simplicity's sake," said Nick
Doerfler, the department's coordinator for first aid and CPR classes.

Every five years, a group of international medical experts reviews the
current studies in regard to first aid. Based on that group's
recommendations, the American Heart Association and the Red Cross then
update their first aid guidelines.

In 2005, the international conference reported that about 50 percent
of obstructions were not cleared with just one technique.

Thus, the Red Cross changed its guidelines to use a series of five
back blows before the Heimlich maneuver. Those guidelines went into
effect with classes taught this summer.

The American Heart Association did not add the back blow reference
because, trainers say, it's easier and less confusing to simply teach
one method.

For proof, just ask Chicago attorney Angelo Loumbas and his sister
Stephanie Natalie.
When Loumbas choked on a piece of pork in April, his father hit him on
the back several times. That didn't work, Loumbas said.

But his sister, Natalie, a health teacher at Lincoln-Way East High
School, gave him the Heimlich maneuver, instantly dislodging the piece
of pork that was unaffected by back blows.
"I know the Heimlich maneuver works," Natalie said.

Regardless of whether one follows the Red Cross or American Heart
Association guidelines, emergency responders say the best way to
protect one's family is by taking a first aid training course.

"They are almost identical," said Carol Havel, a registered nurse who
oversees Morris Hospital's education and wellness department. "Back
blows are a small part of the choking response. We don't see that as
significant. The abdominal thrusts are the primary way to relieve an

"Hollywood gives us a little distorted version of the truth," Joliet's
Stromberg said. "If you see stuff that's Hollywood based, and that's
all you know, it could distract you. You need a good training class."

For information on training classes offered through the Joliet Fire
Department, call (815) 724-3503. For classes outside of Joliet,
contact the local fire department or hospital.


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