The Heimlich Maneuver and the Resuscitation of Near-Drowning Victims-Reply

Abstract

In Reply.— The new standards and guidelines for cardiopulmonary resuscitation and emergency cardiac care 1 restrict the use of the Heimlich maneuver in the management of near-drowning victims to only those circumstances in which the rescuer suspects that foreign (particulate) matter is obstructing the airway. If the victim does not respond appropriately to mouthto-mouth ventilation, the rescuer is permitted to try a Heimlich maneuver on the grounds that a foreign-body obstruction may have been overlooked. The standards specifically state that attempt to remove water from the breathing passages by any means other than suction may be unnecessary and dangerous because it could eject gastric contents and cause aspiration (p 2929). The reason for the restriction is that there is inadequate scientific evidence to support the safety or efficacy of the Heimlich maneuver in this setting. Controlled studies have not shown that the Heimlich maneuver is useful in freshwater near-drowning.