Using the Heimlich Maneuver® for Asthma

How the Heimlich Manuever Helps Asthma Victims
by Dr. Henry J. Heimlich and Jane Heimlich

(Editor's Note: Dr. Heimlich, a Cincinnati physician, is the famed inventor of the Heimlich Maneuver and his wife, Jane, is the author of "What Your Physician Won't Tell You". The following article was especially written for Allergy Hotline.)

At a conference five years ago, a woman raised her hand and related an unexpected incident. "My sister is an asthmatic," she said. "One day when I was visiting, she suddenly couldn't breathe and was turning blue. The only emergency measure I knew was the Heimlich Maneuver. I did it -- she immediately took a deep breathe -- and recovered." Soon after that, I received a letter from the mother of a four-year-old girl describing the onset of an asthma attack. In this case, the attack was so severe the child could not even inhale her medication. "I was about to rush her to the emergency room, but I knew there wasn't time." Almost instinctively, she performed the maneuver and the child began breathing normally.

To understand the effectiveness of the maneuver in asthma, let's take a quick look at what happens during an asthma attack.

Asthma attacks, which consist of prolonged spells of wheezing and shortness of breath that can be fatal, occur when muscles surrounding the airway contract, narrowing the air passages, the linings of which are chronically swollen and inflamed. Mucus fills the airway and acts as a valve, i.e., when the asthmatic breathes in, the airway opens up and air slides around the mucous plugs. On exhaling, mucous plugs clog narrowed airways and the air cannot get out. Trapped stale air distends the lungs, making both inhalation and exhalation difficult.

Pushing up on the diaphragm with the Heimlich maneuver compresses the lungs, expelling trapped air and the flow carries away mucous plugs, thus clearing the airway and ending the asthma attack.

The Heimlich Maneuver is best known for saving choking victims. Since I introduced it in 1974, more than 50,000 lives have been saved by its use in the United States alone. In performing the maneuver, you press up on the diaphragm, which compresses the lungs, causing a flow of air that expels a choking object that is blocking the airway.

More recently, the maneuver has been shown to save the lives of drowning victims. For 35 years, the use of mouth-to-mouth for treating drowning has been a tragic error. You cannot get air into water-filled lugns. Administering pressure on the diaphragm jump starts breathing. The maneuver in drowning is recommended by the National Pool and Water Park Assn. (Ellis and Associates), which certifies lifeguards to use it as the first step in treating drowning victims.

Our job now is to spread the word about using the maneuver in asthma. There is no time to waste. According to the National Institute of Allergy and Infectious Diseases of the National Institutes of Health (NIH), more than 15 million Americans suffer from asthma. Fourteen Americans die during asthmaattacks every day, exceeding 5,000 deaths each year. Last year, 22 children died of asthma attacks in one New York City hospital emergency room, despite the availability of endotracheal intubation, a procedure wrought with complications.

There is evidence that the Heimlich Maneuver can also prevent an asthma attack from occuring. Studies show that performing the maneuver on a regular basis keeps the lungs free of mucus. Asthmatics have been taught to perform the maneuver on themselves and mothers perform it on their children several times each week. (Frequency depends on the severity and the number of attacks each patient experiences.) Reports of patients, ranging from age four to an 82-year-old physician, say that the maneuver not only prevents an asthma attack but even wheezing does not occur.

At present, physicians in different parts of the country are teaching asthma patients to use the maneuver prophylactically, as well as in an emergency. As more asthmatics learn about this technique, it will reduce the need for asthma drugs, which are not only costly but can cause deadly reactions.

When performed on asthmatics, the Heimlich Maneuver need only be done very gently because you are expelling air and mucus, not a solid choking object or water. If you use the Maneuver to overcome or prevent an asthma attack, please share your experiences with us at the Heimlich Institute.

Heimlich Maneuver for Cystic Fibrosis
The Heimlich Maneuver has now been proven to expel mucus from the lungs. In cystic fibrosis, the primary problem is obstruction and infection of the lungs due to the accumulation of thick mucus. Several times each day these patients are tilted in various positions. They are pounded on the back and front of the chest to get rid of the mucus and prevent complications of cystic fibrosis. It seems scientifically logical that the Heimlich Maneuver can be used effectively for this purpose. If successful, a great advantage would be that patients could perform the Maneuver on themselves, thus making them more independent. The Heimlich Institute intends to encourage studies for that purpose.