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Comment by danso | Hacker News Reader

From the comments section:

http://andrewgelman.com/2016/10/09/heimlich/#comment-325017

> Truth is not only stranger than fiction, it is stranger than truth. Andrew’s next-to-last sentence links to:

> “(The Heimlich manoeuvre) has never been used in Australia. Despite the claims of the extremely charismatic Dr. Heimlich, Australian resuscitation experts believe that there isn’t enough scientific evidence to support its use. So how does a medical procedure become so widely adopted without any serious scientific evidence? — The Heimlich manoeuvre by Aviva Ziegler, Australian Broadcasting Corporation, July 27, 2009”

I'm on mobile so am not able to look it up easily, but I'm assuming there are some experiments to verify beyond anecdotes whether the maneuver works, right?

Also, what do Australians use in lieu of it?

View on HN

Standard advice in Australia is:

> Bend the person well forward and give five back blows with the heel of your hand between their shoulder blades – checking if the blockage has been removed after each blow.

> If unsuccessful, give five chest thrusts by placing one hand in the middle of their back for support and the heel of the other hand on the lower part of their breastbone – checking if the blockage has been removed after each thrust.

From https://www.betterhealth.vic.gov.au/health/conditionsandtrea...

Note that thrusts may be used if simpler measures fail but these are chest thrusts, not abdominal as in Heimlich, and the person should be leaning forward, not held upright.

In Med school here (Australia) we are specifically cautioned against using the Heimlich manoeuvre and we're told to use the above techniques

My wife is a US trained physician and she saved someone using the Heimlich maneuver, so there's that.

We don't just not teach the Heimlich manoeuvre, in every first aid course I've attended, they very clearly and explicitly instruct you to not use the Heimlich.

Not sure why, but here in Brazil we only see this maneuver in American movies ad TV shows, no here uses it or would even know it has a name or how to perform it.

According to Wikipedia:

In some areas, such as Australia, authorities believe that there is not enough scientific evidence to support the use of abdominal thrusts and their use is not recommended in first aid. Instead, chest thrusts are recommended.

https://en.wikipedia.org/wiki/Abdominal_thrusts

This was on HN some time ago - apparently there is some sort of research that states that patting/whacking on the back was in fact as affective as Heimlich manoeuvre.

The general recommendation is now to start with 5 Back Blows then 5 Abdominal Thrusts (the Heimlich), repeated as necessary.

Mayo Clinic: http://www.mayoclinic.org/first-aid/first-aid-choking/basics...

European Resuscitation Council: http://ercguidelines.elsevierresource.com/european-resuscita...

Australia (and New Zealand) Resuscitation Councils: http://www.nzrc.org.nz/training/ECI/anzcor-guidelines-2016-u...

In the case of Australia/New Zealand the recommendation is to do 5 Back Blows then 5 Chest Thrusts. My understanding is that it's believed to be similarly effective but has less risk of causing internal injuries.

Especially if the object still has air passing by it since the Heimlich manoeuvre only works if there is a tight seal.

A secretary at my workplace had a piece of pork rib stuck but there was still air getting by. An ambulance was called and the medic walked over and slapped her back to remove the food.

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