Maneuvering Over Heimlich

Heimlich. The word is at once terrifying and utterly reassuring. It conjures up fear, flailing and the face turning blue as an olive takes a wrong turn. Help!

At the same time, it speaks of competence, a plan, a scientifically proven punch that will send that olive sailing right back into its gin. A toast — to Heimlich!

Or maybe not.

Unbeknownst to most of the public, both the American Heart Association and the American Red Cross have quietly demoted Dr. Henry Heimlich's famous maneuver. They no longer recommend it as the first treatment for choking victims.

It's not that the maneuver is considered dangerous, or even ineffective. It's just that those organizations want you to try five old-fashioned back slaps first. Only if those whacks don't work are you supposed to try five "abdominal thrusts."

Yes, that's what they're called now. Even the name "Heimlich" has been ejected from this maneuver, like a chunk of half-chewed brisket.

This "Five-and-Five" protocol was adopted a little more than a year ago, after the Red Cross reviewed the scientific literature on choking. Does that mean we just spent 20 years doing exactly the wrong thing?

That seems impossible. Everyone knows someone who was saved by the Heimlich maneuver, from Ronald Reagan to Nicole Kidman. There was even that great story about a woman who attended a kiddie baseball game up near Buffalo, N.Y. in 1999 and saw an 11-year-old hit in the chest by a bat. He went into cardiac arrest and she saved him with CPR. Then, last year, she started choking at a restaurant. The dishwasher ran out and performed the Heimlich maneuver — saved her life.

Just as she had saved his, seven years earlier. It was that early brush with death that had convinced the young man to learn First Aid.

What the Red Cross has learned about First Aid is that, despite all those Heimlich successes, back slaps are every bit as effective — and possibly easier to remember.

The last thing the agency wants is for would-be rescuers to waste time wondering which method to try first, so it pretty much arbitrarily ordered the techniques one, two and three (number three is chest compressions).

What's weird is that suddenly there are three perfectly acceptable techniques. I grew up with the belief that back slaps were verboten — the First Aid equivalent of hitting a drowning man on the head with a cement life preserver. Nope, said American Red Cross spokeswoman Pamela King: Back slaps were always part of the protocol — in Europe.

Choke me with a foie gras sandwich. They were? Then how'd they get such a bad rap over here?

Their infamy seems to have been promoted by the guy whose name was (SET IAL) not back slap. The guy whose name was (and still is — he's 87) Heimlich.

Back blows are "death blows," Heimlich declared as he lobbied for his own maneuver's acceptance 30 years ago. In 1985, Surgeon General C. Everett Koop endorsed this view, dubbing back slaps "hazardous." After that, only the Heimlich maneuver was considered kosher.

What most people don't realize, said Heimlich's son, Peter Heimlich, is that "Koop was an old friend of my father's and he did it as a buddy favor."

Now, truth be told, son Peter spends a lot of his time debunking his dad. But it is also true that back slaps have come back from First Aid purgatory.

For his part, Dr. Heimlich still believes back slaps are "bad therapy," said his spokesman, Bob Kraft.

I'm pretty sure most people will keep using Heimlich for a while, because that's what we're all familiar with. But whether that means the doctor himself deserves a pat on the back — or a slap — is up the air.

And with any luck, so is the olive.

Lenore Skenazy is a contributing editor at the New York Sun. To find out more about Lenore Skenazy (lenore@lenoretown.com), and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate Web page at www.creators.com.

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