No choking matter

March 31, 2000

Judith Zwolak

Picture this: You're sitting in a fern-draped courtyard of a French Quarter restaurant, enjoying your trout meuniere, a glass of wine and the company of your friends. Somebody tells a joke and the table erupts in laughter. Your giggling turns to gasping, however, as a sliver of food sticks in your throat.

You're in luck. Tulane medical students have trained the staff at this restaurant to recognize the signs of choking and to perform the life-saving technique called the Heimlich maneuver. Your waiter appears by your side, administers a quick thrust just beneath your rib cage and dislodges the offending morsel.

Your lifesaver was the Restaurant Choking Prevention Program, organized and presented free of charge to New Orleans restaurants by a group of Tulane medical students seeking community service credit.

Choking is no joking matter, says Brett Wilson, a second-year medical student. According to the American College of Emergency Physicians, about 4,000 adults and children die from accidental choking each year.

The Heimlich maneuver, a fairly simple technique developed by Henry Heimlich in 1974, has reportedly saved thousands of lives since its introduction. The American Heart Association says the technique, which involves applying pressure to the abdomen with a series of quick, forceful thrusts, is the only recommended method for clearing the blocked airway of an adult.

With these statistics in hand, Tulane students looking for a community service project last year developed a restaurant employee-training program that centers around the Heimlich maneuver. The students, all certified as basic life-support instructors, raised money to purchase three mannequins and held pilot training sessions at the Red Fish Grill and The Court of Two Sisters restaurants.

This spring, the training schedule includes Brennan's and four other French Quarter eateries. In the hourlong session, during which four students instruct 20-40 employees, trainers tell participants how to recognize someone who is choking.

"In a high-profile place, people don't want to embarrass themselves, so they may run off to the bathroom during a coughing fit, where there's no one there to help them," Wilson says. "We want to make wait staff aware that people may not want to make a scene."

The students also counsel their trainees to have a plan in place to alert the manager and keep everyone calm in the case of a medical emergency.

"A person choking will be nervous," he says. "You don't want to be shouting across the restaurant and creating a scene." Finally, the participants practice the Heimlich maneuver on the mannequins, which offer a realistic semblance of practicing on an actual person. "People are always surprised at how hard you have to do the Heimlich maneuver," Wilson says. "Once you get the point across that you're doing a service to that person by doing it forcefully, that instills confidence."

The program has already saved one life, says a bartender at The Court of Two Sisters, who participated in the training last year. The employee, who wants to remain anonymous, says he performed the Heimlich maneuver in his home when his friend began coughing at dinner, got up from the table and went into the bathroom. "I didn't hear him coughing anymore so I was concerned that he got something stuck," he says. "I did the technique they taught me and it worked."

Without the training, the bartender says he may not have looked in on his friend nor remembered how to perform the maneuver. "He would have died," he says.

Peggy Chehardy, instructor in family and community medicine and director of community service for the Foundations in Medicine course, says the program has also compelled restaurants to develop a medical emergency plan.

"A lot of them have never thought about who's going to call 911, how you notify the manager, who's going to go outside and flag down the EMS truck," Chehardy says. Wilson says the feedback from the restaurants has been overwhelmingly positive, although he wishes they would express their appreciation in more appetizing terms. "There have been no free meals out of it yet," he says.

Tulane University, New Orleans, LA 70118 504-865-5000