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Updated: Aug 7, 2026

A Novel Rescue Technique for Difficult Intubation and Difficult Ventilation
Published on: January 17, 2011
The Heimlich maneuver. Best technique for saving any choking victim's life
1Heimlich Institute, Cincinnati, OH 45208.
Insights
Backslaps and chest thrusts are dangerous for choking infants, despite continued recommendations by the American Red Cross (ARC) and American Heart Association (AHA). The Heimlich maneuver is the safest and most effective technique for all choking victims.
Area of Science:
- Emergency Medicine
- Cardiopulmonary Resuscitation
- Pediatric Emergencies
Background:
- The American Red Cross (ARC) and American Heart Association (AHA) previously recommended backslaps, chest thrusts, and abdominal thrusts.
- These methods were recommended for a decade after the introduction of the Heimlich maneuver in 1974.
- Despite being declared hazardous in 1985, ARC and AHA continue to recommend backslaps and chest thrusts for infants.
Purpose of the Study:
- To highlight the dangers of backslaps and chest thrusts for choking infants.
- To advocate for the recall of ARC and AHA instructional materials promoting these methods.
- To emphasize the superiority of the Heimlich maneuver for all choking victims.
Main Methods:
- Review of historical recommendations by the American Red Cross (ARC) and American Heart Association (AHA).
- Analysis of the biomechanics and energy transfer of backslaps versus the Heimlich maneuver.
- Critique of existing instructional materials and public warnings regarding choking first aid.
Main Results:
- Backslaps and chest thrusts generate insufficient energy to expel airway obstructions effectively.
- The energy from backslaps can propel foreign objects toward the lungs, unlike the Heimlich maneuver.
- ARC and AHA instructional materials have not been recalled, and the public remains unaware of the risks.
Conclusions:
- Backslaps and chest thrusts pose significant risks and should be publicly recalled for infant choking treatment.
- The Heimlich maneuver is the most effective and safest rescue technique for choking victims of all ages.
- Continued public education on the dangers of outdated methods and the benefits of the Heimlich maneuver is crucial.
Abstract:
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.
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