Heimlich H J, Patrick E A
Heimlich Institute, Cincinnati, OH 45208.
Postgrad Med. 1990 May 1;87(6):38-48, 53. doi: 10.1080/00325481.1990.11716329.
The American Red Cross (ARC) and the American Heart Association (AHA) advocated backslaps, chest thrusts, and abdominal thrusts for 10 years after the Heimlich maneuver was introduced in 1974. Even after the Surgeon General in 1985 declared these methods to be "hazardous, even lethal," the ARC and the AHA continue to recommend backslaps and chest thrusts for infants under 1 year of age. ARC and AHA instructional materials that advocate use of these methods have not been recalled, and the public has not been warned of the dangers. One cause of the confusion about backslaps is the flawed belief that gas pressure alone removes a foreign body. In addition, there is lack of understanding that, compared with the Heimlich maneuver, the backslap produces an insignificant amount of the energy required to expel an object from the airway. In fact, the energy produced by the backslap drives the foreign object in the wrong direction, toward the lungs, while the energy produced by the Heimlich maneuver drives the object away from the lungs, toward the mouth. Backslaps and chest thrusts should be publicly recalled as a treatment for choking infants before further deaths and injuries occur. The Heimlich maneuver is the best rescue technique for treating choking victims of all ages.
1974年海姆立克急救法问世后，美国红十字会（ARC）和美国心脏协会（AHA）在长达10年的时间里一直提倡使用拍背、胸部按压和腹部按压法。即使在1985年美国卫生局局长宣布这些方法“危险甚至致命”之后，美国红十字会和美国心脏协会仍继续推荐对1岁以下婴儿使用拍背和胸部按压法。提倡使用这些方法的美国红十字会和美国心脏协会的教学材料并未被召回，也未向公众警告其危险性。对拍背法存在困惑的一个原因是存在错误观念，即仅靠气压就能排出异物。此外，人们还缺乏这样的认识：与海姆立克急救法相比，拍背产生的能量微乎其微，根本不足以将异物从气道排出。事实上，拍背产生的能量会将异物朝着错误的方向，即肺部推进，而海姆立克急救法产生的能量则会将异物从肺部朝着口腔方向排出。在造成更多伤亡之前，应公开召回拍背和胸部按压法作为窒息婴儿的治疗方法。海姆立克急救法是治疗各年龄段窒息患者的最佳急救技术。
