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Published in Print: December 4, 2002, as Health Update

Health Update

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Heimlich Maneuver Training Required

Whenever and wherever a student in Ohio's Revere schools starts choking, there will be someone nearby trained to save a life. That's the idea driving the decision by the school district to train its entire staff—including teachers— in the Heimlich maneuver.

The scope of the effort in the Bath Township district goes beyond a new law in Ohio requiring that at least one staff person trained in the proven method for preventing choking deaths be present when students are eating school meals.

"We looked at our food-service operation and realized that we have quite a few teachers who monitor the cafeteria during meals," said Kevin M. Matowitz, the 2,800-student district's business director. "It just made sense to us to train everybody."

The Heimlich maneuver, devised in the early 1970s by Dr. Henry J. Heimlich, replaced back slaps and chest thrusts as the recommended method for saving a choking victim.

Those trained in the technique are instructed to press sharply and repeatedly on a victim's abdomen at a point just above the navel, but below the rib cage and the diaphragm. The motion is intended to expel air forcefully enough to dislodge an obstruction from a person's throat, while avoiding the potentially fatal bone and organ injuries associated with other methods.

The Ohio law requiring training in the Heimlich maneuver for school employees, which went into effect in September, is not the first of its kind, according to the Denver-based Education Commission of the States.

Rhode Island has a nearly identical law in place for its schools, and California requires its teachers to be trained in the life-saving maneuver. Minnesota requires that its school bus drivers be trained, and New Jersey mandates that schools post how-to diagrams of the technique.

But the Revere schools' effort appears to stand out from the pack.

"There are plenty of states that have been concerned about other health problems, like the need for widespread CPR training in schools and training for dealing with students who have seizures," said Mike P. Griffith, an ECS policy analyst. "But this is an odd one because it's strictly a food- related problem. Does the district have kids eating all over its schools?"

Most young choking victims also tend not to be of school age.

In 1999, 197 U.S. children age 14 or under choked to death, with nearly three-quarters of those victims age 4 or younger, according to the National Safe Kids Campaign, a nonprofit organization in Washington. That same year, 776 children ages 14 or under died from airway-obstruction injuries. Of those children, nearly 80 percent were 4 or younger.

Still, Mr. Matowitz said his district's comprehensive approach to Heimlich training has been well received by the staff and satisfies the concerns of parents. It takes roughly an hour to train 10 to 15 employees, slightly longer for those who work with elementary students.

"Yes, we could have trained just one or two people to be in compliance with the law, or we could be safe and train everyone," Mr. Matowitz said. "We decided to play it safe."

Next, the safety-conscious district plans to train its 300 employees in CPR and basic first aid.

Targeting Alcohol

The National Academy of Sciences hopes to deliver designs for a new campaign by spring aimed at curbing youths' alcohol consumption.

In response to a request by Congress, the private, congressionally chartered organization's National Research Council and its Institute of Medicine formed a committee of experts last summer to cull existing literature and research on prevention campaigns—such as the federal government's anti-drug ads—that are aimed at changing adolescents' behaviors.

Experts are concerned by the high percentages of adolescents who consume alcohol. For instance, 40 percent of 9th grade students reported having consumed alcohol before they turned 13 years old, according to the federal Centers for Disease Control and Prevention. Almost one-fourth of 9th graders reported binge drinking—having five or more drinks on one occasion—in the month prior to a 2001 survey by the CDC.

The academy's committee is also reviewing programs that try to curb underage drinking by reducing young people's access to alcohol through methods like tax increases, identification checks, and restriction of alcohol on college campuses.

—Darcia Harris Bowman

Vol. 22, Issue 14, Page 14

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