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Heimlich's Maneuver — Pros and Cons

Published online by Cambridge University Press:  28 June 2012

Karl-Wilhelm Wedel
Karl-Wilhelm Wedel
Affiliation:
From the Malteser Hilfsdienst, Bonn, West, Germany.
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Extract

In early 1975, H.J. Heimlich demonstrated external compression of the diaphragm as a first-aid measure in the event of threatening death by suffocation.

A controversial debate developed in the ensuing years. What speaks in favor of the so-called “Heimlich Maneuver,” which should be applied only when:

• the foreign substance sits too deep or too tight to be removed by other means; and

• the trachea is completely closed by the foreign substance and breathing has ceased entirely,

is the dramatic situation which leaves a helper only a few minutes to save life in view of imminent unconsciousness and threatening hypoxic cardiac arrest.

What speaks against applying the maneuver are possible lesions of the intrathoracic organs (including fractures of the osseous thorax) and ruptures of internal organs, also the application without an existing indication or inadequate mastery of the manipulation.

Type
Part II: Clinical Care Topics
Information
Prehospital and Disaster Medicine , Volume 1 , supplement S1: Disaster Resuscitology , 1985 , pp. 203
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1985

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References

1. Heimlich, HJ. A life-saving maneuver to prevent food choking. J Am Med Assoc 1975;234:398.CrossRefGoogle ScholarPubMed
2. Gordon, AS, Belton, MK, Ridolpho, PF. Emergency management of foreign body airway obstruction. Comparison of artificial cough techniques, manual extraction maneuvers, and simple mechanical devices. In Safar, P (ed). Advances in CPR. New York: Springer-Verlag, 1977; p. 39.Google Scholar
3. Guildner, CW, Williams, D, Subitch, T. Emergency management for airway obstruction by foreign material. In Safar, P (ed). Advances in CPR. New York: Springer-Verlag, 1977; p. 51.Google Scholar
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5. Redding, JS. The choking controversy. Crit Care Med 1980;8:184.Google Scholar
6. American Heart Association and National Research Council. Standards and guidelines for cardiopulmonary resuscitation and emergency cardiac care. J Am Med Assoc 1980;244:453. (Recommends teaching of sequence of ventilation attempt, clearing, back blows, abdominal or chest thrusts.)CrossRefGoogle Scholar
7. League of Red Cross Societies (P.O. Box 276, Geneva 19 Switzerland, CH–1211). Recommendations of guidelines symposium on first aid, cardiopulmonary resuscitation and cold injuries, Copenhagen, 1981. Included in Caroline, Nancy L. New Lay Instructors' Manual on Life Supporting First Aid by League of Red Cross Societies and World Federation of Societies of Anesthesiologists. (Does not teach the Heimlich Maneuver.)Google Scholar