What do President Ronald Reagan, Elizabeth Taylor, Cher, Goldie Hawn and Homer Simpson have in common?
All had their lives saved thanks to the Heimlich manoeuvre, which turns 50 today.
In fact, Homer’s rescue by his pal Lenny even helped save the life of a young boy.
But until June 1, 1974, if a person was choking, the best they could hope for was a few slaps on the back – something some doctors believe may actually lodge the food more tightly in the airway.
Enter Cincinnati surgeon Henry J Heimlich. On learning that almost 4,000 people a year were dying in the US from choking – making it the sixth most common cause of accidental death – he decided something had to be done.
After some thought, he realised a better way to tackle choking was to use the lungs themselves to help dislodge the blockage. However, he couldn’t test this on humans, so turned to beagles.
Pop Goes the Café Coronary
Choking is nicknamed the café coronary, because it not only looks similar to a heart attack, but happens when people are eating.
To replicate this in his beagles, Dr Heimlich first used tubes that would block most of their airway, then tried to save them – and succeeded, he said, reporting no dogs were harmed in the trials.
He found the best way was to press the dog’s diaphragm, compressing the lungs, which violently dislodged the blockage. He then fed the beagles oversized pieces of meat and tested his new manoeuvre on those that choked, again, apparently saving them all.
Following his canine case studies, Dr Heimlich then unveiled his new move to the world in an informal essay termed ‘Pop goes the Café Coronary’ in the June edition of Emergency Medicine.
Dr Heimlich explains in his essay that a ‘sudden forceful compression of the lungs will increase the air pressure within the trachea and larynx and thus eject the offending bolus like the cork from a Champagne bottle.’
Keen to spread the word, Dr Heimlich spoke to reporters and explained what the procedure was. In the Corpus Christi Times and other papers, the Heimlich manoeuvre went public.
It only took a few days for it to save someone’s life.
A newspaper article from the York Dispatch, on June 22, 1974, revealed that the article helped a man save the life of a woman who had nearly choked to death on a piece of chicken.
She survived after a retired Seattle restaurateur, Isac Piha, has read the article just days before and used the method proposed by Dr Heimlich two or three times.
It was a year later, in 1975, when Dr Heimlich wrote a peer reviewed academic paper on the method, where it was officially called the ‘Heimlich Maneuver’ [sic].
50 years of the Heimlich
Today, some organisations, including the British Red Cross, prefer to call the manoeuvre something descriptive like abdominal thrusts, as it is less intimidating for people looking to learn, and easier to remember if they ever have to put it into practice.
Dad-of-one, Charlie, from Sunderland, was out for a meal with friends when a lady at a nearby table in the restaurant began to choke. He noticed that her friend was frantically hitting her on the back and others at the table were shouting for help.
Charlie quickly introduced himself to the woman and told her he was trained in first aid.
After realising the back blows didn’t seem to be working, he told her he would start to give her abdominal thrusts by putting his arms around her waist and, with a clenched fist, pulling sharpy inwards and upwards.
After the third abdominal thrust, the food which was stuck in her throat, was dislodged and she could breathe again.
How to help someone choking
Only give the Heimlich to someone who is conscious and choking. Someone who is choking may be clutching at their chest or neck and won’t be able to speak, breathe or cough. Follow the steps below to help:
1. Encourage them to cough If they are mildly choking, coughing is usually enough to help clear the blockage If they are unable to cough, move to step 2.
2. Give up to five back blows.
Help the person lean well forward and hit them firmly on their back between the shoulder blades with the heel of your hand, checking after each blow whether the blockage has cleared.
Back blows create a strong vibration and pressure in the airway, which is often enough to dislodge the blockage. Dislodging the object will allow them to breathe again. If back blows do not dislodge the object, move on to step 3.
3. Give up to five abdominal thrusts. Hold the person around the waist with both hands, placing a clenched fist above their belly button and below their breastbone. Pull sharply inwards and upwards. Abdominal thrusts squeeze air out of the lungs and may dislodge the object.
For someone who is pregnant or obese, it is recommended that you thrust them on their breastbone instead.
4. If they are still choking, call 999. Continue with cycles of back blows and abdominal thrusts until the object dislodges, or help arrives.
*Always seek urgent medical advice on behalf of the person choking, such as through the non-emergency helpline or by attending hospital, if you have given abdominal thrusts to an adult or child.
Source: British Red Cross
He said: ‘There were tears rolling down the face of the woman. Her face was getting redder and redder. Her friend was crying and shouting “please help her”.
‘I started doing abdominal thrusts and whatever was in her throat came out after the third one. It was such a relief to hear her take a breath.’
Reflecting on his experience, Charlie said: ‘It was so scary but also humbling. I’ve been thinking about it none stop since it happened. It just shows how first aid training is worth every penny as it really can save somebody’s life.’
It is also possible to do the Heimlich manoeuvre to yourself too.
The NHS advises to position your own hands in the standard position for the abdominal manoeuvre with the thumb side of the fist over the fleshy part of the abdomen, above the navel.
Then perform thrusts on your own abdomen up to the maximum force you can take. Leaning on a chair or countertop can help.
What to do for a child who is choking
It is important not to perform the Heimlich on infants that are 12 months or younger, and if a child is under five, or weighs less than 20 kilograms you should first try alternative methods.
The British Red Cross says to give a child five back blows instead. Hold the child face-down along your thigh with their head lower than their bottom. Hit them firmly on their back between the shoulder blades up to five times.
If that does not work, give up to five chest thrusts. Turn the baby over so they are facing upwards. Place two fingers in the middle of their chest just below the nipples. Push sharply downwards up to five times.
If they are still choking, repeat the steps until they can breathe or the ambulance comes.
The Heimlich on TV – right and wrong
How many times have you seen a TV show where someone is choking, and another person runs behind them and grabs them by the belly to lift them up?
Don’t do that.
When the manoeuvre is done wrong, it can severely injure someone, with studies showing how the Heimlich can damage internal organs and arteries.
However, there are some shows and instances where it could have really worked. In Sex and the City, Miranda chokes while eating a takeout and gives herself a Heimlich manoeuvre on a moving box.
In The Simpsons episode ‘Homer at the Bat’, Lenny sees a Heimlich manoeuvre poster, featuring a man coughing up an entire lobster, just as Homer is choking on a donut next to him.
The episode is credited with saving a ten year old’s life. In 2007, the Sunday Express reported that Aiden Bateman, 10, saved his friend’s life by performing the Heimlich manoeuvre after he had learned it from The Simpsons.
School staff reportedly feared for Alex Hardy’s life when he was choking on his lunch, but Aiden recalled the poster from the episode, and said: ‘It just came into my head, and I did it.
‘I put my arms around Alex’s back and [pulled] his stomach in.
‘He was going purple and the veins has started coming up on his head – I was shaking afterwards.’
Alex is just one of the hundreds of thousands of lives Dr Heimlich is credited with saving, as the procedure is known around the world
The surgeon died aged 96 in 2016 after complications from a heart attack, but thanks to him, many who may also have lost their lives have lived to tell the tale – and hopefully pass on how to do the Heimlich manoeuvre.
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