My local news had a segment the other night talking about CPR for drowning victims and training that lifeguards get for working at community pools and whatnot. The story said that one of the major lifeguard certification agencies trains lifeguards in a technique that is “unsafe” and not recommended by the American Red Cross or doctors.
The technique in question is to perform five abdominal thrusts (i.e. Heimlich Maneuver) on the victim prior to beginning chest compressions (CPR).
The reporter spoke with the Red Cross and some doctor and was told it wasn’t recommended and to proceed with chest compressions right away. The reporter tried contacting the guy who runs the certification agency, and tracked him down at his home. That interview was not handled well by the guy.
What he could have done was said, “I’d prefer not to talk on my porch, but call the office number and set up an appointment and I’ll be happy to address your concerns,” or perhaps “I’d rather not speak on camera until I consult with an attorney,” or even “No comment”. Instead, he chose to launch into a tirade, calling the Red Cross imbeciles stuck in the 1950s and getting rude, insulting, and nasty with the reporter.
Or he could have actually explained the concept, as below.
They also commented that the State of Utah made them send out a notice to all lifeguards trained there to not do the abdominal thrusts. The State of Texas apparently doesn’t have state licensing or state control over lifeguard training, so they don’t have any way to enforce a change currently.
The thing about drowning victims is that they typically have their lungs full of water. The point of CPR is to circulate oxygenated blood to keep the brain alive. However, having the lungs full of water will prevent oxygen from getting into the blood, so the chest compressions would be pointless and counterproductive until the lungs are cleared of water. I would think the intent of the abdominal thrusts is to clear the lungs.
So my question is what is the recommended procedure for clearing the lungs, if not abdominal thrusts? Turn them on their side or stomach for a minute to let the water drain? That isn’t starting compressions immediately. Using the chest compressions to squeeze out the water? While that will provide some lung bellowsing and is why the recommended technique for CPR has largely dropped rescue breathing in favor of maintaining chest compressions, that seems unlikely to be fully effective in clearing the lungs, and delay the ability to oxygenate the blood.
Why not use abdominal thrusts? It’s safer than chest compressions, which often break ribs.