Absence of evidence:
Dr. Richard M. Bradley, a member of the Red Cross' Preparedness, Health and Safety Services advisory council and an associate professor of emergency medicine at the University of Texas Medical School at Houston said:
To the best of my knowledge, after doing a pretty thorough literature search, no controlled studies exist comparing back blows to abdominal thrusts or anything else.
The inventor of the Heimlich maneuver, Henry Judah Heimlich, a thoracic surgeon, believes some of those lives could have been saved by his maneuver versus slapping someone on the back, he insisted:
I don't want to fight the Red Cross. But I don't want people dying needlessly.
However, it seems that Heimlich lacks evidence:
QuackWatch, closely affiliated with the National Council Against Health Fraud, said:
Heimlich and his spokespeople have regularly stated that "thousands of lives" have been saved by use of abdominal thrusting. However, they have produced no objectively collected, widely accepted data to support the claim. During the past year, the National Council Against Health Fraud has asked Heimlich several times for details on his allegedly successful cases, but he has produced nothing.
In addition, AUSTRALIAN RESUSCITATION COUNCIL published a paper in 2010 saying that there is not enough scientific evidence to support the use of abdominal thrusts and their use is not recommended in first aid. (2)
Moreover, Dr. Robert S. Baratz, a Certified Medical Review Officer and a Clinical Assistant Professor of Medicine, emergency medicine has published a paper saying:
For years Henry Heimlich and his associates have promoted abdominal thrusts, the so-called Heimlich maneuver, as a first measure in the treatment of near-drowning. Despite a lack of data, studies, and physiological or medical sense ,abdominal thrusts have been advocated by Dr. Henry Heimlich, regularly, in multiple venues. Heimlich’s advocacy is based on his opinion, using arguments, described by reporter Pamela Mills-Senn, who wrote an extensive review on the matter, and quoted recently, as “circular, using his own pronouncements to validate his theories.”
William Terry Ray, director of the University of Cincinnati College of Nursing's Nurse Anesthesia program, looked at 40 years of research. The reviews concluded that a person may have to use the back blows as well as abdominal thrusts to relieve the obstruction, depending on what caused the person to choke.
No definitive study exists to support Heimlich's theory that slapping someone on the back can push an obstruction further down the throat. The literature on this is not conclusive either.
Studies cited in a review of research projects "used animals, cadavers
and anecdotal evidence." But not living human subjects.
While the Absence of Evidence is not Evidence of Absence, I found that the Heimlich maneuver (see below):
- caused life-threatening complications reported in 32 cases reports.
- may cause injury, vomiting and aspiration and delay CPR for drowning victims.
- highly likely to cause bruising to the abdomen.
- may cause serious injuries, including fracture of the xiphoid or ribs.
Heimlich has also been at odds with the Red Cross over his claims that the maneuver could help drowning victims and someone suffering an asthma attack, surprisingly, later AHA warned against the use of the Heimlich maneuver for drowning rescue, and they said (4) :
Attempts to remove water from the breathing passages by any means other than suction (e.g. abdominal thrusts or the Heimlich maneuver) are unnecessary and potentially dangerous. The routine use of abdominal thrusts or the Heimlich maneuver for drowning victims is not recommended.
There is no evidence that water acts as an obstructive foreign body. Maneuvers to relieve FBAO [Foreign Body Airway Obstructions] are not recommended for drowning victims because such maneuvers are not necessary and they can cause injury, vomiting and aspiration and delay CPR.
The AHA Guidelines were based on a series of referenced scientific articles.
In 2006, The Red Cross changed their recommendation, ending their promotion of Heimlich maneuver as the primary treatment for choking. They said:
Highlights of the skills changes, as a result of the new data,
include: for CPR, students will now be instructed to perform cycles of
30 chest compressions and two breaths; and to aid a conscious choking
victim, utilize a series of five back blows and five abdominal
Moreover, life-threatening complications associated with use of abdominal thrusts have been reported in 32 case reports. (1)
For example: even when done correctly, Heimlich maneuver can injure the person on whom it is performed. Bruising to the abdomen is highly likely and more serious injuries can occur, including fracture of the xiphoid process or ribs. (3)
To keep this answer objective, I will not give a conclusion.
(1) Koster RW, Sayre MR, Botha M, Cave DM, Cudnik MT, Handley AJ, Hatanaka T,
Hazinski MF, Jacobs I, Monsieurs K, Morley PT, Nola JP, Travers AH. Part 5: Adult
basic life support: 2010 International consensus on cardiopulmonary resuscitation and
emergency cardiovascular care science with treatment recommendations. Resuscitation
(2) "Australian(and New Zealand) Resuscitation Council Guideline 4 AIRWAY". Australian Resuscitation Council (2010). Retrieved 2014-02-09.
(3) Broomfield, James (2007-01-01). "Heimlich maneuver on self". Discovery Channel. Retrieved 2007-06-15.
(4) "Part 10.3: Drowning". Circulation (American Heart Association) 112 (24): 133–135. 2005-11-25. doi:10.1161/CIRCULATIONAHA.105.166565. Retrieved 2008-04-04.