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July 24, 1987, Vol 258, No. 4 >
ARTICLE | July 24, 1987

Vomiting as a Complication of the Heimlich Maneuver FREE

James P. Orlowski, MD
[+] Author Affiliations

Reprint requests to Pediatric and Surgical Intensive Care Unit, The Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH 44106 (Dr Orlowski).


JAMA. 1987;258(4):512-513. doi:10.1001/jama.1987.03400040110033
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References

THE HEIMLICH maneuver has recently been adopted as the standard treatment for the obstructed airway in children, adolescents, and adults.1 These same standards and guidelines caution that the Heimlich maneuver should only be used in near-drowning situations when the rescuer suspects that foreign matter is obstructing the airway or the victim does not respond appropriately to mouth-to-mouth ventilation. Heimlich and his colleagues2-5 have been calling for the maneuver to be the first line of treatment for near-drowning victims, to remove water from the lungs and airways. Others have argued that the routine performance of the maneuver without first demonstrating airway obstruction with foreign matter is a waste of valuable time and might produce complications.6-9

This case report describes a neardrowning victim whose first step of treatment with the Heimlich maneuver resulted in emesis with aspiration, which complicated what otherwise should have been a routine resuscitation.

Report of 

REFERENCES

1 +
 Standards and guidelines for cardiopulmonary resuscitation and emergency cardiac care . JAMA 1986;;255:2841-3044.
2 +
Heimlich HJ, Hoffman KA, Canestri FR:  Foodchoking and drowning deaths prevented by external subdiaphragmatic compression . Ann Thorac Surg 1975;;20:188-195.
3 +
Heimlich HJ, Uhley MH:  The Heimlich maneuver . Clin Symp 1979;;31:3-32.
4 +
Heimlich HJ:  The Heimlich maneuver: First treatment for drowning victims . Emerg Med Serv 1981;;10:58, 60-61.
5 +
Heimlich HJ:  Subdiaphragmatic pressure to expel water from the lungs of drowning persons . Ann Emerg Med 1981;;10:476-480.
6 +
Modell JH:  Is the Heimlich maneuver appropriate as first treatment for drowning? Emerg Med Serv 1981;;10:63-66.
7 +
Ornato JP:  The resuscitation of near-drowning victims . JAMA 1986;;256:75-77.
8 +
Ornato JP:  Special resuscitation situations: Near-drowning, traumatic injury, electric shock, and hypothermia . Circulation 1986;;74( (suppl IV) ): IV-23-IV-26.
9 +
Modell JH:  Near-drowning . Circulation 1986;; 74( (suppl IV) ):IV-27-IV-28.
10 +
Orlowski JP:  Prognostic factors in pediatric cases of drowning and near-drowning . Ann Emerg Med 1979;;8:176-179.
11 +
Dean JM, Kaufman ND:  Prognostic indicators in pediatric near-drowning: The Glascow Coma Scale . Crit Care Med 1981;;9:536-539.
12 +
Conn AW, Edmonds JF, Barker GA:  Cerebral resuscitation in near-drowning . Pediatr Clin North Am 1979;;26:691-701.
13 +
Giammona ST:  Drowning: Pathophysiology and management . Curr Probl Pediatr 1971;;1:3-34.
14 +
Modell JH, Davis JH:  Electrolyte changes in human drowning victims . Anesthesiology 1969;;30: 414-420.
15 +
Modell JH, Davis JH, Giammona ST, et al:  Blood gas and electrolyte changes in human near-drowning victims . JAMA 1968;;203:99-105.
16 +
Orlowski JP, Abulleil MM, Phillips JM:  Effects of tonicities of saline solutions on pulmonary injury in drowning . Crit Care Med 1987;;15:126-130.
17 +
Tabeling BB, Modell JH:  Fluid administration increases oxygen delivery during continuous positive pressure ventilation after freshwater near-drowning . Crit Care Med 1983;;11:693-696.
18 +
Fuller RH:  Drowning and the post immersion syndrome: A clinicopathologic study . Milit Med 1963;;128:22-36.
19 +
Fuller RH:  The clinical pathology of human near-drowning . Proc R Soc Med 1963;;56:33-38.
20 +
Pearn J:  The management of near-drowning . Br Med J 1985;;291:1447-1452.
21 +
DeBoer J, Biewenga TJ, Kulpers HA, et al:  The effects of aspirated and swallowed water in drowning: Sea-water and fresh-water experiments on rats and dogs . Anesthesiology 1970;;32:51-59.
22 +
Sellick BA:  Cricoid pressure to control regurgitation of stomach contents during induction of anesthesia . Lancet 1961;;2:404-406.

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1 +
 Standards and guidelines for cardiopulmonary resuscitation and emergency cardiac care . JAMA 1986;;255:2841-3044.
2 +
Heimlich HJ, Hoffman KA, Canestri FR:  Foodchoking and drowning deaths prevented by external subdiaphragmatic compression . Ann Thorac Surg 1975;;20:188-195.
3 +
Heimlich HJ, Uhley MH:  The Heimlich maneuver . Clin Symp 1979;;31:3-32.
4 +
Heimlich HJ:  The Heimlich maneuver: First treatment for drowning victims . Emerg Med Serv 1981;;10:58, 60-61.
5 +
Heimlich HJ:  Subdiaphragmatic pressure to expel water from the lungs of drowning persons . Ann Emerg Med 1981;;10:476-480.
6 +
Modell JH:  Is the Heimlich maneuver appropriate as first treatment for drowning? Emerg Med Serv 1981;;10:63-66.
7 +
Ornato JP:  The resuscitation of near-drowning victims . JAMA 1986;;256:75-77.
8 +
Ornato JP:  Special resuscitation situations: Near-drowning, traumatic injury, electric shock, and hypothermia . Circulation 1986;;74( (suppl IV) ): IV-23-IV-26.
9 +
Modell JH:  Near-drowning . Circulation 1986;; 74( (suppl IV) ):IV-27-IV-28.
10 +
Orlowski JP:  Prognostic factors in pediatric cases of drowning and near-drowning . Ann Emerg Med 1979;;8:176-179.
11 +
Dean JM, Kaufman ND:  Prognostic indicators in pediatric near-drowning: The Glascow Coma Scale . Crit Care Med 1981;;9:536-539.
12 +
Conn AW, Edmonds JF, Barker GA:  Cerebral resuscitation in near-drowning . Pediatr Clin North Am 1979;;26:691-701.
13 +
Giammona ST:  Drowning: Pathophysiology and management . Curr Probl Pediatr 1971;;1:3-34.
14 +
Modell JH, Davis JH:  Electrolyte changes in human drowning victims . Anesthesiology 1969;;30: 414-420.
15 +
Modell JH, Davis JH, Giammona ST, et al:  Blood gas and electrolyte changes in human near-drowning victims . JAMA 1968;;203:99-105.
16 +
Orlowski JP, Abulleil MM, Phillips JM:  Effects of tonicities of saline solutions on pulmonary injury in drowning . Crit Care Med 1987;;15:126-130.
17 +
Tabeling BB, Modell JH:  Fluid administration increases oxygen delivery during continuous positive pressure ventilation after freshwater near-drowning . Crit Care Med 1983;;11:693-696.
18 +
Fuller RH:  Drowning and the post immersion syndrome: A clinicopathologic study . Milit Med 1963;;128:22-36.
19 +
Fuller RH:  The clinical pathology of human near-drowning . Proc R Soc Med 1963;;56:33-38.
20 +
Pearn J:  The management of near-drowning . Br Med J 1985;;291:1447-1452.
21 +
DeBoer J, Biewenga TJ, Kulpers HA, et al:  The effects of aspirated and swallowed water in drowning: Sea-water and fresh-water experiments on rats and dogs . Anesthesiology 1970;;32:51-59.
22 +
Sellick BA:  Cricoid pressure to control regurgitation of stomach contents during induction of anesthesia . Lancet 1961;;2:404-406.

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