Texas Lifeguards Are Still Taught Potentially Harmful Technique
So it's one of those gorgeous Houston July days where it's 98 degrees and 1,000 percent humidity, and your kid wants to go to the public pool with his friends. An hour later, he's in the deep end with a charley horse, succumbing to panic. A few seconds later, he's officially drowning.
Photo by Daniel Kramer Is the chicken sacrifice before or after the Heimlich?
On the left side of the pool is a lifeguard who is certified by the American Red Cross and has been taught to give CPR to a drowning victim as soon as he or she is out of the pool. On the right side is a lifeguard certified by an outfit out of Dickinson, which teaches lifeguards a thoroughly discredited bit of hokum that delays CPR and could cause your kid to aspirate vomit into his lungs. Who do you want diving in there? Some states don't allow lifeguards to be taught voodoo, but Texas officials leave it up to individual pool owners and operators. Don't you, as a parent, feel secure?
Here's the deal: Unlike the American Red Cross, the American Heart Association, the United States Lifeguard Coalition and the International Life Saving Federation, a Texas-based company called NASCO still teaches lifeguards to administer abdominal thrusts to drowning victims while they're in the water. The aforementioned authorities say that this procedure is at best non-beneficial and at worst detrimental.
As illustrated by the Press's Todd Spivak in 2007, while most medical and aquatic experts have stated that applying the Heimlich maneuver to a drowning victim delays, if only for a few seconds, the all-important CPR.
Also, experts say that the Heimlich could cause a victim to aspirate vomit into his lungs.
Photo by Daniel Kramer NASCO founder John Hunsucker will gladly tell you where you can stick your "science."
But John Hunsucker, founder of Dickinson-based National Aquatics Safety Company (NASCO), doesn't have much use for mainstream scientific opinion. He's a professor emeritus at the University of Houston and, according to NASCO's website, holds degrees in mathematics, physics and engineering.
"These so-called medical experts -- screw 'em," Hunsucker told the Press in 2007.
But NASCO isn't some obscure company whose adherence to faulty science is of no practical application to the real world: it's one of the nation's largest lifeguard certification agencies for water parks, and Hunsucker has won awards from the National Water Safety Congress and the Council for National Cooperation in Aquatics. As we wrote in 2007, Hunsucker "was elected to the World Waterpark Association Hall of Fame, and, in 2005, he was recognized by Aquatics International magazine as among the industry's most influential people."
In a statement on NASCO's website, the company claims to be "on the cutting edge of lifeguarding technology. We publish our work and are open about what we do. Because of this, we will be, and have been, attacked by others whose technology and protocols lag significantly behind ours and by some of the press whose desire is to create controversy where none should exist."
It further states, "During the rescue process, we do five and only five abdominal thrusts while the victim is still in the water. These thrusts delay extrication between four to six seconds. The intent of these thrusts is to begin to initiate respiration."
The company claims to have "a fatality rate of 0.00635 per 100,000 guests in our facilities over the time period studied." (The "time period studied" is not specified in the company's statement.)
Regardless, teaching prospective lifeguards to give the Heimlich has drawn criticism from one of the Heimlichs himself -- Peter, son of Dr. Henry Heimlich, who gave his name to the technique. The younger Heimlich has been one of the most vocal critics of his dad's practices, going so far as to call out the old man on a medical fraud watchdog site.
Naturally, Heimlich was concerned when he saw that Texas officials allow NASCO to teach the Heimlich maneuver to lifeguards. The Texas Department of State Health Services requires lifeguards to "hold a current American Red Cross 'Lifeguard Training' certificate, or the equivalent certification from an aquatic safety organization."
Department spokeswoman Christine Mann told us in an email, "We have no role in determining whether or not NASCO training is equivalent to [American Red Cross]."
That responsibility "is with the individual facility owners or operators," Mann explained.
Heimlich wrote to Dr. David Lakey, the commissioner of the Texas Department of State Health Services, this month, asking that the agency look into all NASCO-trained facilities to see if lifeguards are receiving training that truly is equivalent to the American Red Cross. (Heimlich made it clear that he has "no knowledge or concerns regarding any other aspects of NASCO's operations" and only limited his concern to the abdominal thrust issue.)
Heimlich also advised Lakey of a 2013 decision by the Utah Department of Health not to allow NASCO to certify lifeguards in Utah, because the abdominal thrust protocol did not meet that state's Red Cross equivalency mandate.
"After careful analysis, we find that the training offered by NASCO is not equivalent to the Red Cross," a Utah health official wrote NASCO. "We find that the evidence presented is not sufficient to make a change that deviates from national standards and therefore does not meet the rule standard which requires equivalency."
One might think that a company whose dogged devotion to a technique it considers a superior life-saving measure, science be damned, would tell Utah to stick it, because why teach inferior methods when lives are in the balance? Nope. NASCO simply told Utah officials it would nix the Heimlich from its training in that state, and Utah gave the green light.
Two years before that, on the heels of a Washington Post investigation, the Northern Virginia Regional Parks Authority also eliminated Heimlich training for drowning victims.
Texas also requires American Red Cross equivalency, but a Texas Department of State Health Services spokeswoman told us in an email that it's up to "the individual facility owners or operators to determine if the lifeguards they hired have training and certification that is equivalent to [the Red Cross]."
Mann also wrote, "One possibility for addressing Mr. Heimlich's desire for NASCO to modify its training may be with the CDC. The CDC is developing a draft Model Aquatic Health Code that might address resuscitation techniques. However, I would verify this with the CDC." (We're not sure what difference that would make, since, in Texas, it's still up to pool operators to decide what's equivalent to the American Red Cross.)
When we shared Mann's response with Heimlich, he told us via email: "Based on the DSHS statement, there's a hole in the state public safety net. But instead of addressing and perhaps improving the situation, Dr. Lakey's agency simply passes the buck to the CDC. Don't families who swim in Texas public pools and water parks deserve better than that?"
We're pretty sure it's a rhetorical question, but we're going to go ahead and answer it anyway: Yes, families in Texas do deserve better.