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In this issue, Montgomery1 criticizes Heimlich's article2 published last year and goes on to cast doubt on the Heimlich maneuver and Heimlich's fear of back blow. Valid research on choking is difficult, and impossible to conduct in children because it would be unethical. Experimental and anecdotal data concerning adults, although scarce, do exist. The reader is referred to Gordon et al,3 Ruben and MacNaughton,4 Redding,5 and Day et al.6
The last of these four studies introduces measurement of the ballistic forces on the neck in response to the momentary straightening of the spine induced by a back blow. A supraglottic foreign body would be expected to be forced downward with more than three times the pull og gravity.