Friday, April 13, 2012

Beartooth NBC (Montana) celebrates National Heimlich Maneuver Week, but in Australia it's "Not 'round here, mate!"


From Abdominal Thrust, a Helena, Montana TV news report that aired yesterday:
In tonight's your Health Report, Beartooth NBC’s Jessica Hoppe shows how to perform the Heimlich Maneuver properly and why it's so important....This year April 8 through April 14 is designated as National Heimlich Maneuver Week to celebrate the technique and educate others about it.
Based on this newspaper article last year, it's unlikely the celebration will ever catch on in the land down under (emphasis/asterisk added).
As the assistant CEO of St John Ambulance Australia's Queensland branch, it has been (Stephen Dean's) job to teach and train people across the resuscitation industry.

He proved his devotion to teaching and developing resuscitation techniques when he became a member of the Australian Resuscitation Council (ARC) 21 years ago.

In that time, Stephen has been involved in developing guidelines, policies and training materials for the council of which he is now chairperson for the Queensland branch.
..."In the US, they still advocate the Heimlich Manoeuvre for choking but in Australia, we believe the evidence shows it is dangerous* and so our guidelines don't promote it," Stephen said.
Aviva Ziegler (source)
And from Aviva Ziegler's "Heimlich manoeuvre" audio documentary, first aired by the Australian Broadcasting Corporation in July 2009, and which you owe it to yourself to check out because it's terrific (emphasis/asterisks added):
Aviva Ziegler: (You) might be shocked to learn that the Heimlich manoeuvre appears to have never been accepted practice in Australia. We are one of the only countries in the world where it's not officially on the books. This is a typical Australian first aid training course held by the St John Ambulance.

Trainer: The learning outcomes for this session is we should be able to firstly identify a person who is choking, if somebody is gagging with something partially obstructed in the upper airway we should ask the person to relax and encourage them to cough. Our research has been proven on a conscious casualty a good cough is generally better than anything else. Now if the good cough is not effective we then have to hit that person, we give them what we call back slaps, he's leaning forward, in the centre of the shoulder blades in an upwards direction I would give him five nice solid slaps. If that is unsuccessful we should place a hand in the centre of the back on the sternum and we just press down sharply five chest thrusts and if that is unsuccessful we alternate between the two.

...Aviva Ziegler: As you will hear later, the assertion that back slaps are dangerous is probably only in Dr Heimlich's mind. But anecdotally it seems that the Heimlich manoeuvre can save lives. So if we are the only country not using it, who's right, them or us? Professor Ian Jacobs from the University of Western Australia is Chair of the Australian Resuscitation Council and a member of the International Liaison Committee in Resuscitation.
Professor Ian Jacobs (source)
 Ian Jacobs: There is actually very little or no evidence to support the Heimlich manoeuvre and the literature is awash with reports of harm and this includes things such as fractured sternums, ruptured livers and other serious consequences of this Heimlich manoeuvre.*

Apart from a few case reports there is no other evidence to support what Henry Heimlich has advocated. There's no published data of any substantial nature except for a few case reports and lots of TV programs and there were substantial reports in the literature of harm.

Trainer: A question that often comes up in our courses is to why we don't do the Heimlich manoeuvre in Australia. So are you all aware of that where they get that sort of a bear hug squeeze from behind? OK, the reason it's not taught is the simple fact that research conducted here in Australia and also overseas has proven that it can be dangerous because there's a risk of damaging internal organs such as the spleen, the liver, pancreas etc.* We follow the policy statements as laid down by the Australian Resuscitation Council, they are saying that if there was any clinical evidence to prove that it was effective they'd put a policy on it and we would have it in our book. Any other questions?

Note: A previous version of this item included the case report articles in a different format. I changed it to this embedded Scribd document for ease of updating.