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Learn More About Dr. Heimlich, the Maneuver and His Most Recent Controversial Work

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Heimlich
Dr. Heimlich with Jacob Porter
Dr. Heimlich first published his findings about the heimlich maneuver in a June 1974 informal article in Emergency Medicine entitled, "Pop Goes the Cafe Coronary." On June 19, 1974, the Seattle Post-Intelligencer reported that retired restaurant owner Isaac Piha used the procedure to rescue choking victim Irene Bogachus in Bellevue, Washington.  From 1976-1985, the American Heart Association and American Red Cross choking rescue guidelines taught rescuers to first perform a series of backblows to remove the FBAO (foreign body airway obstruction); if back blows failed, then rescuers were taught to proceed with the Heimlich maneuver (aka abdominal thrusts). After a July 1985 American Heart Association conference, back blows were removed from choking rescue guidelines. From 1986-2005, the Heimlich maneuver was the only recommended treatment for choking in the published guidelines of the American Heart Association and the American Red Cross.

The choking rescue guidelines[1] published by the American Heart Association ceased referring to "the Heimlich maneuver" and instead called the procedure "abdominal thrusts." The new guidelines stated that chest thrusts and back blows may also be effective treatments for choking.

In Spring 2006, the American Red Cross "downgraded" the use of the Heimlich maneuver[2], essentially returning to the pre-1986 guidelines. For conscious victims, the new guidelines (nicknamed "the five and five"), recommend first applying five back blows; if this method fails to remove the airway obstruction, rescuers were to then apply five abdominal thrusts. For unconscious victims, the new guidelines recommend chest thrusts, a method first recommended in a 1976 study by Charles Guildner[3] whose results were duplicated in a year 2000 study by Audun Langhelle.[4] The 2006 guidelines also eliminated the phrase "Heimlich maneuver" and replaced it with "abdominal thrust."[5]

Heimlich's promotion of abdominal thrusts as a treatment for drowning has been dogged by allegations of case fraud.[3] The 2005 drowning rescue guidelines of the American Heart Association[6] did not include citations of Heimlich's work and warn against the use of the Heimlich maneuver for drowning rescue as unproven and dangerous, due to its risk of vomiting leading to aspiration.[6]

In 2003 Heimlich's colleague Dr. Edward Patrick issued a press release stating he was the uncredited co-developer of the maneuver.[7][8]

"I would like to get proper credit for what I've done," Patrick told me. "But I'm not hyper about it." Patrick's ex-wife Joy tells a different story: Whenever my kids would say "Heimlich maneuver," he would correct them and say, "Patrick maneuver."[8]

Heimlich Flutter Valve

Heimlich is also the inventor of the flutter valve (also called the Heimlich valve[9]). Heimlich invented the valve after seeing a Chinese soldier die from a bullet wound to the chest. The valve is designed to allow air and blood to drain from a collapsed lung.

HIV Malariotherapy

Since the early 1980s, Heimlich has been an advocate of malariotherapy, the deliberate infection of a person with malaria in order to treat ailments such as cancer, Lyme disease and more recently, HIV. The treatments have to date been unsuccessful, and criticized for being both scientifically unsound and dangerous.[10] The United States Food and Drug Administration and Centers for Disease Control and Prevention have rejected malariotherapy and, along with health professionals and advocates for human rights, consider the practice "atrocious".[11][12] Sources have disclosed that the Heimlich Institute, a subsidiary of Deaconess Associations of Cincinnati, is conducting malariotherapy trials in Ethiopia, though the Ethiopian Ministry of Health was unaware of any such trials. Heimlich claims that his initial test with a small number of subjects (seven total) have produced positive results, but he refuses to disclose the location of the trials.[10] Funding for the research is drawn from private sources,[12][8] and includes no institutional review board oversight.[8]

Studies in Africa, where both HIV and malaria are common, indicate that malaria/HIV co-infection increases viral load and that malaria could increase the rate of spread of HIV as well as accelerating disease progression.[13][14] Based on such studies, Paul Farmer at Harvard Medical School described the idea of treating HIV with malaria by stating “it seems improbable. The places where malaria takes its biggest toll are precisely those in which HIV reaps its grim harvest”.[15]

References

  1. International Concensus on Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care (ECC) Science with Treatment Reccomendations (2005). "Section 1: Part 2: Adult Basic Life Support". Circulation 112 (III): 5 - 16. doi:10.1161/CIRCULATIONAHA.105.166472. Retrieved on 2005-05-02. 
  2. "The American Red Cross Unveils Innovative New First Aid and CPR/AED Training Programs". American Red Cross (2006-04-04). Retrieved on 2008-05-03.
  3. Guildner CW, Williams D, Subitch T (September 1976). "Airway obstructed by foreign material: the Heimlich maneuver". JACEP 5 (9): 675–7. PMID 1018395. 
  4. Langhelle A, Sunde K, Wik L, Steen PA (April 2000). "Airway pressure with chest compressions versus Heimlich manoeuvre in recently dead adults with complete airway obstruction". Resuscitation 44 (2): 105–8. PMID 10767497. 
  5. "The American Red Cross 2005 Guidelines for Emergency Care and Education" (PDF) 1-31. American Red Cross (2005). Retrieved on 2008-05-03.
  6. "Part 10.3: Drowning" (2005-11-25). Circulation 112 (24): 133-135. American Heart Association. Retrieved on 2008-04-04. 
  7. Patrick, EM (2005-05-28). "Dr. Edward A.Patrick & Dr. Henry J. Heimlich Regarding the Heimlich maneuver". The Patrick Institute. Retrieved on 2008-05-03.
  8. Francis, T (2005-11-10). "Outmaneuvered, Part I". Radar (magazine). Retrieved on 2008-05-02.
  9. Elliott, J (2003-03-09). "Heimlich: Still saving lives at 83", BBC. Retrieved on 2008-09-02. 
  10. Zengerle, Jason (2007-04-23). "The Choke Artist", The New Republic, pp. 23-36. 
  11. Anglen, Robert (2003-02-16). "Scientists linked to Heimlich investigated: Experiment infects AIDS patients in China with malaria", The Cincinnati Enquirer. Retrieved on 2008-01-27. 
  12. "Heimlich's Audacious Maneuver", Los Angeles Times (1994-10-30). Retrieved on 2008-01-27. 
  13. Abu-Raddad L, Patnaik P, Kublin J (2006). "Dual infection with HIV and malaria fuels the spread of both diseases in sub-Saharan Africa". Science 314 (5805): 1603-6. doi:10.1126/science.1132338. PMID 17158329. 
  14. Kublin JG, Patnaik P, Jere CS, et al (2005). "Effect of Plasmodium falciparum malaria on concentration of HIV-1-RNA in the blood of adults in rural Malawi: a prospective cohort study". 'The Lancet' 365 (9455): 233–40. doi:10.1016/S0140-6736(05)17743-5. PMID 15652606. 
  15. Nierengarten MB (June 2003). "Malariotherapy to treat HIV patients?". 'The Lancet Infectious Diseases' 3 (6): 321. PMID 12781493.
Last modified on Thursday, 03 December 2009 16:21
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