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Heimlich maneuvre has no scientific evidence

The Heimlich manoeuvre is an established first aid technique for removing a blockage, commonly from food. First aid courses in Australia do not teach the technique as the evidence for the efficacy of the technique is lacking. The Australian recommendation is to relax the person so that they can cough and to dislodge the blockage through solid thumps on the back.

First aid instructors need to spend time in almost every first aid class to counter the cultural dominance of the Heimlich manoeuvre.

The Australian Broadcasting Corporation’s “The Health Report” investigates the evidence for and against the Heimlich manoeuvre with interviews with Dr Henry Heimlich and with one of Dr Heimlich’s critics, his son Peter. Peter describes his father as a celebrity doctor.

A Wikipedia article on choking includes the following quote from a 2005 article in the Cincinatti Magazine:

“According to Roger White MD of the Mayo Clinic and American Heart Association (AHA), “There was never any science here. Heimlich overpowered science all along the way with his slick tactics and intimidation, and everyone, including us at the AHA, caved in.”

The relevance of this podcast is very important for OHS professionals as an indication of the competence and validity of first aid training providers.

The podcast also raises other relevant issues concerning evidence-based decision-making, the manipulation and power of the media, and the credibility of subject-matter experts.

The podcast is a fascinating medical tale, a family saga and, perhaps, a case study for media students, but mostly as a precautionary tale for OHS professionals.

Kevin Jones

New old US research into driving and talking

The New York Times has revealed research on the hazards of driving and using mobile phones that was withheld since 2003. The newspaper understandably focuses on the intrigue that prevented the report from being released but the content of the report has the potential to substantially change how companies “manage” the hazard of their staff using mobile phones whilst driving.

The report, obtained through Freedom of Information and made available on the newspaper’s website, was a substantial project for the National Highway Traffic Safety Administration and, according to NYTimes:

“The research mirrors other studies about the dangers of multitasking behind the wheel. Research shows that motorists talking on a phone are four times as likely to crash as other drivers, and are as likely to cause an accident as someone with a .08 blood alcohol content.”

The full report is available by clicking on the image in this post.

Kevin Jones

BHP Billiton’s safety record is again in the Australian media

BHP Billiton’s production report has generated some OHS-related interest in the Australian business media on 23 July 2009, but not all. [SafetyAtWorkBlog has written several pieces about BHP Billiton‘s safety record]

The company’s iron ore production has fallen short of its May 2009 guidance. Iron ore is the only division where production has dropped. The Age newspaper reports that the five deaths “forced a production slowdown” and noted the Western Australian government’s review of BHP’s safety management.

Malcolm Maiden’s commentary in the same newspaper mentions the BHP production results but describes the five workplace fatalities as “production glitches”. He writes

“Production glitches for both companies [BHP Billiton & Rio Tinto] might have been handled better if their iron ore operations were merged, as is now proposed.”

Safety management may have been improved. Rio Tinto’s OHS performance is considerably better but the description of the fatalities as “production glitches” is cold.

This contrasts considerably with the coverage provided to the BHP results by the Australian Financial Review (AFR) which listed the issue on the front page with the headline “Poor safety record hits BHP output” (full article not available online without a subscription). AFR says

“the safety issues overshadowed better than expected results from BHP’s petroleum and metallurgical coal units….”

There was no overshadowing according to the writers in The Age.

The AFR article identifies a raft of safety matters that illustrates well the OHS status of BHP Billiton and emphasises just how serious the workplace fatalities are.

“Tensions with the WA government [over a variety of issues, including safety] have escalated…”
Seven BHP workers died in Australia and South Africa in 2008/09.
“Eleven BHP staff… died while on the job in 2008.”
On 22 July 2009 WA Minister for Mines & Petroleum, Norman Moore, praised BHP’s efforts to improve safety but said “It is very difficult to understand sometimes why fatalities occur within the safety frameworks that operate in most major mining companies…” said on 22 July 2009

Warren Edney, an analyst with the Royal Bank of Scotland and occasional media commentator, spoke in relation to the safety record of BHP’s Pilbara operations, where five workers died. He said in the AFR article:

“It’s better than Chinese underground coalmining but that’s not a big tick, is it?… In part you’d say that we’ve undergone this mining boom in WA so you’ve got workers who haven’t had the safety brainwashing that other parts of the workforce may have had over the last 10 years. Part of it reflects that and part of it may be that people get pressed to do things quicker.” [my emphasis]

It seems odd to compare the safety performance of an open-cut Australian iron ore mine with “Chinese underground coalmining”. Similarly describing safety education and training as “safety brainwashing” is unusual. SafetyAtWorkBlog has contacted the Royal Bank of Scotland for clarification of Warren Edney’s comments.

The AFR has almost been leading the Australian media pack on reporting of safety management in 2009, partly due to the OHS harmonisation regulatory program and its impact on business costs. This may also be due to some of the concerns about increased union activity on worksites under the new industrial relations legislation. The AFR should be congratulated for discussing the OHS context of BHP’s iron ore production figures and providing a front page prominence.

Kevin Jones

Category: media

Heimlich maneuvre has no scientific evidence

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New old US research into driving and talking

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