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Saving a life on Mount Everest with the Heimlich maneuver.

The Heimlich maneuver has saved countless lives in restaurants and other eating places, but when Indiana mountain climber David Carter found himself choking to death on his own lung secretions while ascending Mt. Everest, it was the Heimlich maneuver that saved his life.

One of the greatest hazards of high-altitude mountain climbing is pulmonary edema. Above 10,000 feet, decreased oxygen in the air causes increased pressure in the lungs' small blood vessels as they compensate for lack of oxygen, forcing plasma and other fluid from the blood vessels into the tiny air sacs in the lungs (the alveoli), drowning the victim in his own secretions if not immediately treated by getting the climber to lower altitude. Even with supplemental oxygen, the lungs do not function normally, and secretions tend to accumulate if the climber is unable to remove them by coughing. As a recent "Nova" broadcast on PBS dramatically showed, the area just below the summit of Mt. Everest is littered with bodies of climbers who have died from pulmonary edema, and which remain there because other climbers at that altitude are too weak to carry them down or even to bury them.

Carter, who successfully conquered Mt. Everest last year, almost died while descending from the summit when he was too weak to clear his congested lungs by coughing. Solid chunks of material that had formed in his lungs suddenly blocked his trachea (windpipe). His colleague frantically radioed the team doctor at the base camp, who then instructed him to do Heimlich maneuvers on Carter until the airway cleared. After repeated Heimlich maneuvers, Carter began to breathe more freely, and he was then able to continue his descent.

There are other, less dramatic situations in which the procedure has been of enormous benefit. Chronic asthma sufferers, for example, are able to perform the Heimlich maneuver on themselves, to force out air and secretions trapped in lung spaces that have lost their elasticity. When the lining of the bronchi (the main intake tubes of the lungs) swells during an asthmatic attack, the patient must exert excessive pressure to expel air from the lungs. In time, the smaller air sacs (alveoli), whose elastic walls normally expel air after expanding, lose their elasticity, trapping the air along with secretions that form because of excess pressure in the blood vessels, or from chronic low-grade infection.

The result is a progressive decrease over time in effective lung space. By self-application of the Heimlich maneuver, the patient can get rid of this air and secretions, thereby acquiring more "breathing room." To do so, they make a fist with one hand and put it just above the bellybutton and below the rib cage. Putting the other hand over their fist, they push upward for a few minutes. Asthmatics using the Heimlich maneuver every other night before retiring experience significant relief of their symptoms. Mothers can use the same technique on their children whose chest muscles and diaphragm are too weak to force out secretions on their own from chronic lung conditions.
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Author:Brown, Edwin W.
Publication:Medical Update
Date:Aug 1, 1998
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