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The fine article by Paul Stevenson (Aug. 28) will save lives because the public has been informed that the same easy-to-learn Heimlich maneuver that has saved 50,000 choking victims can also save drowning victims. As he pointed out, all medical organizations recommend using the Heimlich maneuver for treating drowning victims. Some say use the Heimlich first: "You can't get air into the lungs until you get the water out." Others claim, "You cannot remove large amounts of water with the Heimlich maneuver," therefore, use mouth-to-mouth first.

Since 1986, American Heart Association Guidelines published in the Journal of the American Medical Association and followed by the Red Cross, have endorsed using the Heimlich maneuver for drowning after mouth-to-mouth has failed. But there was no limitation on how long ineffective mouth-to-mouth should be continued. Consequently, for eight years, rescuers continued useless mouth-to-mouth for 10-15 minutes and numerous children died of brain damage due to prolonged lack of oxygen. This year, Red Cross Washington, D.C., headquarters spokesperson Ann Stingle said the Red Cross recommends giving just two breaths - "We're talking just a few seconds" - then performing the Heimlich maneuver.Trained emergency personnel have a wide range of capabilities including inverting a tube into the windpipe to suction water from the lungs and deliver oxygen. There are 250 million Americans, however, who are not trained in CPR but know how to perform the Heimlich maneuver or can learn it in one minute.

The Heimlich maneuver is the only method proven to empty the water from the lungs without using instruments and does so in 10 seconds. Since most child drownings occur in residential swimming pools, untrained parents and neighbors are the first on the scene.

It is gratifying to receive an ever-increasing number of reports of drowning children saved by the Heimlich maneuver. A letter came last week from the United States Lifesaving Association. The writer said, "It should be an accepted standard of care to medically intervene a drowning victim with the Heimlich maneuver prior to performing the more advanced maneuvers of CPR and rescue breathing. After all, isn't an airway full of seawater considered obstructed? Don't you have to displace the seawater prior to filling the lungs with air?"

He continued, "In 1993 we had (in one city) six near-drownings that had a pulse but were breathless. On four of the victims, I performed the Heimlich maneuver and after the application, spontaneous respiratory effort returned without the use of a bag valve mask. The other two victims required extensive maneuvers which included mouth-to-mouth, oralpharyngeal airway and bag valve mask." Lifeguards are also pleased that the Heimlich maneuver eliminates the risk of contagion from mouth-to-mouth.

Henry J. Heimlich, M.D., Sc.D.


Heimlich Institute