THE MANOEUVRE THAT SAVED A MILLION LIVES

By Healthovation Team

Superstars in Healthcare

March 19, 2020

Working on several theories, Heimlich came up with the simple yet brilliant procedure that made use of the air trapped in the chest to push the object with force out of the trachea. The technique involved putting one’s linked hands in a fist around the patient and exerting sharp upward abdominal thrusts, just below the ribs and above the navel.

This gratifying moment in May 2016 meant a great deal to the man who had saved Patty’s life. Dr. Henry Heimlich, the man who saved Patty’s life so seemingly effortlessly, was the surgeon who had given his name to the simple procedure that has saved the lives of thousands of choking victims all over the world.

While he had demonstrated the maneuver that he invented many, many times over the years, Dr. Henry – who was at the time 96 years of age – did not recall having performed it till that moment, to actually save a patient in an emergency real-life situation. “That moment was very important to me,” Heimlich spoke during a telephonic conversation to The Guardian magazine. And he sat there smiling a huge smile, as members of the staff and other residents gathered around, relieved at the fortunate turn of events.

While Heimlich maintained that his technique was well suited for resuscitating drowning victims as well as for both acute and preventive treatment of asthma, the American Red Cross does not support using the maneuver for drowning.

In fact, even for a choking victim, the first-aid procedure laid down by the Red Cross recommends first doing five back slaps and only then five Heimlich abdominal thrusts.

What is the Heimlich Procedure?

The procedure that had saved the situation was the Heimlich – a maneuver that was designed by Dr. Henry in 1974 to dislodge obstructions in choking victims. Prior to this, the accepted procedure was to thump the patient on the back – a process that in most cases was simply not successful. Another of the recommendations for saving choking victims, in earlier days, involved slitting open the trachea in the neck with a knife. Unfortunately, in one incident a physician in his hurry had accidentally slit the victim’s carotid artery in the process, causing her to bleed to death.

Working on several theories, Heimlich came up with the simple yet brilliant procedure that made use of the air trapped in the chest to push the object with force out of the trachea. Experimenting on anaesthetized dogs, Dr Heimlich perfected the technique. It involved putting one’s linked hands in a fist around the patient and exerting sharp upward abdominal thrusts, just below the ribs and above the navel. The obstruction would be dislodged and pop right out of the victim’s mouth.

He had tried and tested many theories before arriving at this one. It was obvious that the technique should be simple; as when a victim is choking, the responder has less than four minutes to save them from death or permanent brain injury. The right instruments could perhaps not be found handy in an emergency, so it should be a technique that did not require any special equipment. Calling 911 was also not an option, as emergency teams would inevitably be too late to respond. The procedure he perfected was simple, as it could be easily taught to and performed by anyone; and also had an overwhelming rate of success during experiments.

News Gets Around!

Heimlich published his theory in a US medical journal, and word quickly spread. Readers across the world started using this technique on choking victims and news of successful results spread like wildfire. When the Journal of the American Medical (JAMA) published an editorial, the procedure was referred to, for the very first time, as the “Heimlich Maneuver”.

Subsequently, in October 1975, his first scientific article on the Heimlich Maneuver, “A Life Saving Maneuver to Prevent Choking,” appeared in JAMA, with an addendum: the Heimlich Maneuver had been endorsed by the American Medical Association Commission on Emergency Medical Services! Today, it is something that is so commonplace that you can find it on posters in many US restaurants and being taught in First-Aid courses at schools. It has even found its way in popular TV sitcoms like The Big Bang Theory.

In 1985, the U.S. Department of Health and Human Services, in a Declaration endorsed by Surgeon General C. Everett Koop advocated that the Heimlich was the “only method that should be used for the treatment of choking from foreign body airway obstruction.” As Dr. Koop stated, “The Heimlich Maneuver is safe, effective and easily performed by the average person. It can be performed on standing or seated victims and on persons who have fallen to the floor. It can be performed on children and even on one’s self.”

The Heimlich on Infants

The traditional Heimlich maneuver is just too rough to be safely used on infants or children under one year of age. So, a special technique was developed for use on infants. Suitable only for use on choking infants who are conscious, the procedure is done by placing the infant face down on an adult’s forearm, with the head lower than the body. Five forceful blows should be delivered to the back between the shoulder blades. Immediately after this, if the foreign object is not expelled, the infant must be turned over and supported on the adult’s thigh. Using only the middle and ring fingers, the adult must then give five quick downward thrusts on the infant’s breastbone and watch to see whether the object appears in the infant’s mouth. The process is repeated till the object comes back to the child’s mouth, when it can be safely removed.

Heimlich’s other Inventions and Theories

While the Heimlich Maneuver is what made him famous, this brilliant surgeon has a slew of other inventions and theories under his belt.

In 1955, when he was working as a thoracic surgeon in Montefiore Hospital in the Bronx, he proposed a method of using part of a patient’s stomach to repair a damaged esophagus which was called the Reversed Gastric Tube esophagus replacement operation. Another invention was a device for draining fluid from open chest wounds, using a simple flutter valve to prevent backflow and allowing the patient’s lungs to fill with air. This was found to be a lifesaver during the Vietnam War, as it helped many wounded soldiers on the battlefield.

Over the course of his career, he became involved in working to solve patients’ swallowing problems, and this led to the development of the much-famed Heimlich Maneuver.

Subsequently in the 1980s, he was responsible for inventing the micro-trach transtracheal catheter, which allows people with serious lung conditions to receive oxygen more smoothly and easily.

Criticism of the Heimlich Maneuver

In later years there has been some criticism of the procedure. While Heimlich maintained that it was well suited to resuscitating drowning victims and for both acute and preventive treatment of asthma, the American Red Cross does not support using the maneuver for drowning. In fact, even for a choking victim, the first-aid procedure laid down by the Red Cross recommends first doing five back slaps and only then five Heimlich abdominal thrusts. There have also been cases where performing the Heimlich Maneuver on a drowning victim did not help, but in fact caused additional damage.

Additionally, medical experts have cast aspersions on the maneuver’s effectiveness as a treatment for asthma. An article published in Modern Medicine in 1997 noted that asthma is a disease of chronic inflammation and the Heimlich Maneuver is not capable of treating this inflammation. However, it could help to clear the mucous plugs that form in the lungs due to asthma.

All said and done, choking is often deadly. It is a fact that the Heimlich Maneuver has saved the lives of over 50,000 people already and continues to do so.

Dr. Henry Heimlich, the man who saved Patty’s life so seemingly effortlessly, was the surgeon who had given his name to the simple procedure that has saved the lives of thousands of choking victims all over the world.

He was at the time 96 years of age but did not recall having performed the technique on an actual patient till that moment. “That moment was very important to me,” Heimlich spoke to The Guardian magazine.

Later Life and Awards

In 1984, Heimlich was honoured with the Albert Lasker Public Service Award. “Ever since I decided to be a doctor, I have wanted to help people,” Heimlich said. “I have seen people dying needlessly when in most cases, a simple technique was the solution.”

The last few years of his life were spent in a peaceful assisted living centre in Cincinnati. The famed doctor died in 2016, in the knowledge that his legacy will live on after him with his famed procedure continuing to save lives around the world.

 

 

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