8/3/2019 "Heimlich maneuver endorsed (by Surgeon General C. Everett Koop)," Washington Post, 10/2/85

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Surgeon General Calls It 'Only Method' to Aid Choking Victims

By Cristine RussellWashington Post Staff Writer

About five years ago. Dr. C. Everett Koop saw hisyoung grandson choking while eating. He quicklymoved behind the child, put his arms around him and,with a quick thrust of his clasped fist into the boy's abdomen, dislodged a large chunk of meat that "shot aboutfour feet across the room."

Yesterday, as the U.S. surgeon general, Koop endorsed the life-saving Heimlich Maneuver "as the onlymethod that should be used for the treatment of choking from foreign body airway obstruction* and proddedthe American Red Cross and American Heart Association to move more <ju ickly hi adopting it exclusively.

Noting that "more than .3,000 people die from choking in the United States each year,* mostly while eating, Koop said that "the best rescue technique in anychoking situation is the Hfeimlich Maneuver."

He urged that other methods be dropped immediately as "hazardous, even lethal," particularly the traditional use of sharp blows to the back that he said can drive aforeign object even deeper into the throat.

In doing so, Koop jumped into the middle of a long-

running controversy in the public health communityover the place of the Heimlich Maneuver in first aidprocedures.

The technique is named after Dr. Henry J. Heimlich,a physician at Cincinnati's Xavier University who developed the life-saving "hug* in the early 1970s and hassince widely promoted it as the best method of saving achoking victim.

But the health organizations who advise the publicand the medical profession on first aid have been slowerto adopt his stance and for the past decade have recommended that four sharp blows to the back be attempted first before the "abdominal thrust."

In July, after a national conference reviewing theirguidelines, the American Red Cross and the AmericanHeart Association made a joint announcement that theadvisory panel had recommended "exclusive" use of the

Heimlich abdominal thrust. Their press releases saidthat the change was being made to simplify teaching of first aid, but maintained that both back blows and theabdominal thrust are effective.

Yesterday, spokesmen for both groups repeated thatview, saying that the recommendation on the HeimlichManeuver is still under review and is not expected to beadopted officially until early next year.

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"Dr. Koop and Dr. Heimlich are not giving the process quite the chance it deserves," responded Red

Cross senior vice president Dr. Lewellys Barker.Koop said in an interview that he felt the need to act

more quickly after receiving letters from Heimlich andUniversity of Cincinnati professor Edward A. Patrick,as well as his knowledge of the value of the procedure."I felt that I couldn't stand around and wait."

Patrick, who has performed research showing that'the back slap can drive a foreign object downward, complained to Koop that the "lives of many Americans areendangered as the result of Red Cross first aid instruction" and said "it is urgent that you inform the publicthrough the media of the back slap danger."

Heimlich said by* telephone that he was concernednot only by the slowness of the first aid groups' response, but by their "denial that the back slap is unsafe."

His procedure uses the large volume of air in a choking victim's lungs to help expel a foreign object if a rescuer presses sharply and repeatedly on the victim's abdomen with one balled fist wrapped in the oppositehand.

The blow is administered at a point just above the navel but below the rib cage and the diaphragm. It can beused on a standing or sitting victim who is conscious orunconscious as well as be self-administered. While itcan be used on children, Koop said yesterday that "back slapping is still the recommended method for treatingchildren under 1 year of age held in a head-down position."

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