First aid and resuscitation procedures are basic skills one should learn and refresh periodically. Whilst practising, I was required to attend courses on Cardiopulmonary resuscitation and basic life support. One of the life support manoeuvres is Heimlich manoeuvre or abdominal thrust, practised to dislodge food or other object caught in the throat causing choking. This may cause airway obstruction with catastrophic outcome. In my experience, there was an occasion, I have to do it to save my friend from a distressing situation. This happened in Saudi Arabia(KSA) in 1987, soon after my qualification as the Fellow of Royal College of Surgeons(FRCS).
I was offered a surgeon’s job in King Khalid Military Hospital, Jeddah, KSA in October 1987. I accepted it because I thought it would be an exposure to a different set up in a different country. The employer sent a ticket advice and arranged for me to have KSA visa stamped on my passport. I arrived in Jeddah airport on 03/11/1987, and I was put in a luxury hotel.The hospital arranged my transport, and on the next day I joined the duty. At the reception, I was delighted to meet another Keralite doctor, Cheriyan who too got FRCS recently.When we were briefed about the job by the head of department,we were not happy, as we were to be delegated in a more junior post. That evening we met a Keralite Orthopaedic doctor, Sukumaran who invited us to his house. He described to us about the way of living in KSA. He took us for a drive and we spent some time in Jeddah beach. Coming from the UK, we found the way of living in KSA different. Although I started working and performed a few surgical operations, Cheriyan did not officially join at all, and as such he was in the hotel room throughout and was getting bored. Later we decided to revoke the contract and go back to the UK. There was a designated travel adviser in the King Khalid Military hospital who informed we can get confirmed return tickets by Saudi Airlines only on 11/11/1987. Next day, I met Dr.Sukumaran in the hospital who invited me and Cheriyan for a dinner in a Keralite restaurant.
Dr.Sukumaran came to our hotel, with his wife and picked us to the restaurant. Dr. Sukumaran seemed to be known to the proprietor of the hotel and we were given a spacious private room, and Cheriyan seated opposite to me. In KSA, one cannot expect to get alcoholic drinks, but the food was having good flavour and taste. All mouth watering Kerala delicacies were ordered. We started to talk, while enjoying the food. Suddenly I heard Cheriyan coughing, and making loud sound as if he was going to be sick. He went to the toilet in distress, and returned. He was becoming more and more agitated and he could not articulate properly. We knew he had choked on some food while talking, and Dr.Sukumaran called for an ambulance. By then I thought of the abdominal thrust manoeuvre , and without explaining I went behind Cheriyan and asked him to sit back towards me. He was tall and slightly bigger in size, but I managed to hold him around tightly from behind. I lifted my knee, and gave a thrust on the back. I have to do the thrust three times, when a small piece of bone ejected out of his mouth. Now he started to speak and thanked me.
I do not think, what I had done is the exact Heimlich manoeuvre, but it did work and I was happy that I saved a difficult situation. We did not complete eating the dinner and Dr.Sukumaran dropped us back in the Hotel. Cheriyan continued to give me good company in the hotel until we left KSA on 11/11/1987.
Dr. C.J.George
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