Doctor makes push for Heimlich maneuver to guard against drowning

      Dr. Henry Heimlich is waging another campaign to spread the Heimlich maneuver -- this time to stop people from drowning.
      The surgeon believes the Heimlich maneuver -- already used to prevent choking deaths -- has a better success rate at reviving potential drowning victims than cardiopulmonary resuscitation or mouth-to-mouth resuscitation, and is easier for the general public to correctly administer.
      "It's so very obvious," said the doctor, 77, speaking by telephone from his nonprofit Heimlich Institute Foundation in Cincinnati. "You can't get air into the lungs until you get the water out."
      But Heimlich says he is encountering resistance from large institutions, such as the American Red Cross, that train swimmers in lifesaving techniques. Heimlich says the same thing happened during his campaign 20 years ago to popularize the abdominal-thrust maneuver for choking emergencies.
      For its part, the Red Cross is waiting for formal reviews that approve Heimlich's technique.
      "He's one doctor, but we have to listen to the consensus (of doctors)," explains Heather McMurtrie, a spokeswoman for the national Red Cross office. "Until the leading medical bodies change their standards, we can't change our standards. There are lots of doctors with opinions out there."
      McMurtrie was referring to the National Academy of Science Institute of Medicine and the American Heart Association's Emergency Cardiac Care Committee. Neither group has yet approved the Heimlich maneuver as a first response for treating a drowning victim who isn't breathing.
      But Heimlich maintains, "Many drowning victims have been saved by rescuers performing the Heimlich maneuver, even after CPR failed," according to an article he wrote in an autumn 1996 issue of the newsletter of The National Swimming Pool Foundation. In addition to expelling water from the lungs, the maneuver's "pushing up on the diaphragm jump-starts breathing."
      At least one nationally known aquatic safety organization has chosen to follow Heimlich's lead.
      Ellis & Associates of Texas, which trains the safety staffs of many water parks -- including Wet 'n Wild in Las Vegas -- teaches lifeguards to perform the Heimlich maneuver as a first, rather than second, resort. The Heimlich can even be performed in water, before the guard moves the victim out of the pool.
      Tammy Nace, aquatics director at the Bennett Family YMCA in Las Vegas, says it teaches rescuers to perform CPR on a drowning victim who isn't breathing and has no heartbeat.
      The latest Red Cross manual tells rescuers to treat a drowning victim who is not breathing with mouth-to-mouth resuscitation first. If the breaths do not go in after several attempts, only then should the rescuer administer up to five abdominal thrusts.
      In the meantime, precious seconds that can mean the difference between life and death are wasted, argues the doctor, who worked many years as a thoracic surgeon.
      "Of drowning victims who were unconscious, not breathing and without a pulse -- 87 percent of those treated with the Heimlich maneuver survived, compared to 28 percent when CPR was used without the (Heimlich) maneuver," according to a 1995 press release about data collected by Ellis & Associates. At that time, it was the training company's latest information.
      Parents and neighbors -- not trained lifeguards -- are often first on the scene of a drowning, and they are usually less familiar with the CPR technique than the Heimlich maneuver.
      Heimlich does not characterize his relationship with the American Red Cross as adversarial. But large organizations, he notes, are prone to change slowly. Heimlich began promoting the Heimlich maneuver for choking in 1974, but the Red Cross kept teaching "back slaps" to treat choking until 1986. That same year, the Red Cross adopted the Heimlich maneuver as its second resort for treating drowning.
      According to Heimlich, court settlements have already been reached in certain cases of drowning deaths, in which swimming facilities were required to pay sums because their lifeguards did not immediately do the Heimlich maneuver, but did CPR instead.
      Heimlich no longer practices medicine, but does research at his institute. Currently he is studying whether the Heimlich maneuver can help bring an asthmatic person out of a severe attack. Asthma is a disorder in which the person has difficulty getting air out of the lungs. Blockage is caused by airways that have tightened and narrowed, as well as by mucus.
      He also is interested in learning whether the maneuver has applications in clearing the lungs of people with cystic fibrosis.