Paso Robles water park lifeguards use discredited Heimlich maneuver

August 22, 2011


The Heimlich maneuver is most commonly associated with saving choking victims as a way to dislodge whatever foreign object is obstructing the airway. But, the use of the maneuver on drowning victims has been widely discredited and experts say it can actually do harm.

Nevertheless, the lifeguards at the Ravine Water Park in Paso Robles continue to be trained to use a technique called dangerous by numerous experts, and water park owner Jay Walsh said he doesn’t plan changing the lifeguard protocol any time soon.

“We subscribe to that protocol, and we like the way it has worked in the past,” Walsh said. “We’re comfortable with the procedure for now.”

The failed analysis with the abdominal thrusting for drowning is that the victim is choking on water. This was disproved by studies which found that the victim experiences a laryngospasm, during which the larynx closes to prevent water from entering the lungs of a drowning victim.

Cardiopulmonary resuscitation (CPR), therefore, is more effective because the drowning victim is experiencing a lack of oxygen — not choking. CPR forces the needed oxygen into the lungs, as opposed to forcing what little oxygen remains in the lungs out with abdominal thrusts.

The protocol Walsh referred to comes for the water park’s lifeguard certification company — National Aquatic Safety Company (NASCO). Walsh said his lifeguards have been certified by NASCO for the past five years, and although he said he has “heard discussion in the industry regarding various procedures,” he isn’t ready to part with NASCO procedures.

“To tell you the truth we are just following the NASCO protocol right now,” he said. “Until it changes from the NASCO guys, we will continue to use their system.”

Other organizations, such as The American Red Cross and the International Life Saving Federation, discredit the Heimlich as a way to rescue drowning victims. The American Red Cross even calls it “unnecessary and potentially dangerous.”

When asked about the use of the Heimlich on drowning victims, Walsh said they refer to it as more of an abdominal thrust that the lifeguard chooses to use, as opposed to a “chest thrust,” which is more reminiscent of CPR.

“I’ve seen and heard of it working multiple times over the past few years,” Walsh said. “It’s worked so many times, that’s why we keep using it.”

The American Red Cross would disagree though. The Advisory Council on first aid and safety for the American Red Cross concluded from scientific studies in 2006 that the Heimlich maneuver is neither effective nor a safe method for attempting water removal from the airway or lungs of drowned people.

NASCO founder and President John Hunsucker, who holds a Ph.D. in mathematics and engineering, stands behind his teaching of the Heimlich maneuver. After numerous media outlets reported unfavorably on his methods, he has refused to talk with the media.

In 2007 Hunsucker told the Huston Press, “Nobody knows more about water parks than me. Eventually I’ll wear them down and everybody will be doing it. These so-called medical experts … Screw ’em. What do you want me to do, walk in lockstep?’”

Walking “in lockstep” might prove to be the most effective way to save lives, based on the numerous findings of the American Red Cross and other scientific studies.

One last critic of the Heimlich maneuver who would agree with eliminating the abdominal thrusts from lifeguarding is Peter Heimlich, the son of Heimlich maneuver-founder Henry Heimlich.

Peter Heimlich created a website that criticizes the Heimlich and his father for the effectiveness of the maneuver.

“Facts indicate that in 1974 my father, who knew nothing about the physiology of drowning, simply dreamed it up,” Peter Heimlich says on the website. “My research uncovered that from 1974-2003 my father and a physician from Potomac MD used cronies to fabricate a string of cases in which drowning victims were allegedly rescued by the use of the maneuver.

“To encourage the public to perform the procedure, the cases were planted in the media and then my father published them in medical journals.”

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Mugwump, you are so dangerously wrong. You are a lacky for the medical establishment. You clearly can’t see or smell politics and big egos being the reason this skill is not taught. Read Mountainman’s posts, and also consider these answers to the criticism’s of abdominal thrusts with cpr for drowning:

1. Criticism: It makes victims vomit.

Answer: Train Lifeguards to administer with precision and control. Harder is not better. This can be trained. Never administer with the victim on their back, which increases chances of harm from vomit aspiration. Only use when the victim is first contacted (again, see Mountainman above) or if not done at that time, then out of the water with the victim facing down, laying on stomach, lifeguard’s fist between victim’s “heimlich spot” under ribs, and the ground. Push moderately several times on victim’s mid back, then follow normal CPR protocol.

2. Criticism: It delays CPR (and oxygen).

Answer: If done in water during execution of rescue, absolutely no delay. (See Mountainman’s comments) Again, the lifeguard can’t do CPR in the water, but he/she can do a few controled thrusts. If done on pool deck or sand, as described above, it delays CPR ventilations 8 – 10 seconds. Worth the risk vs. forcing water in airway, not yet in lungs, deeper, into the lungs.

3. Criticism: Major players (ARC, American Heart Association, Emergency medicine experts) disqualify use based on what they call ineffectiveness or possibility of injury.

Answer: All research on drownings can only be partially “scientific”, and based on assumptions, since no one volunteers to drown, with their airway and lungs closely observed during the process. If a victim survives, and abdominal thrusts were used in conjunction with CPR, or the victim recovers so quickly that further CPR isn’t needed, it is dismissed as “anacdotal, not scientific”, and when they autoopsy a drowned person, submerged 10 minutes or more, (unsurvivable) and find lots of water in the lungs, and if it is disclosed that the lifeguard tried abdominal thrusts (taking 8 – 10 seconds) before CPR, they will say the thrusts caused the drowning. Folks, we can’t turn back the clock in any drowning situation and add the trusts if not used, or see what happens without them. Thus, honest, non-politically motivated anacdotal evidence is valuable, and should be analyzed over time. The major players (ARC, etc) are biased, hate Heimlich, fearful of law suits, and blinded by experts with huge egos who don’t actually realize what is, and isn’t being done by lifeguards. Talk to more people who have had their hands, and faces on drowning and near drowning victims. Finally, the researchers who continue to insist that little or no water gets into the lungs of drowning victims, do some research on delayed drownings (unofficial, non-medical term), when victims seem to be revived to some degree, even conscious, then die of respiratory failure sometime in the next 48 hours. Happens plenty. Could some of that water been removed before ventilations? Again, no do overs, so no proof, so no risk for the ARC, but ventilations without thrusts contributes to some fatal outcomes, I’m sure, but no one wishes to add those cases to the discussion.