John Hunsucker is not a medical doctor. This is one of the first points his many critics tend to make.
They make it because Hunsucker, who runs Houston-based NASCO (National Aquatic Safety Company), the third-largest lifeguard training organization in the nation, teaches a rescue technique that has been dismissed as useless and even dangerous by seemingly every authority on drowning. Before starting CPR on drown victims, NASCO-trained lifeguards perform the Heimlich.
Since mid-May, there have been three drownings at NASCO-client parks. In at least one, the Heimlich was used as the first step in resuscitation.
"For somebody to continue to do this and to teach it is foolish and borders on the insane," Dr. James Orlowski, the chief of pediatrics at University Community Hospital in Tampa, Fla. and an expert on drowning, tells Hair Balls.
"You've got the International Liaison Committee on Resuscitation, the American Heart Association, the American Red Cross and the Institute of Medicine all coming out to say the Heimlich has no role in resuscitating drowning victims."
Orlowski and others point out that the Heimlich can lacerate or rupture organs and cause vomiting, and the aspiration of vomit into the lungs, which is extremely harmful. They say it also wastes precious time, as brain damage can occur within minutes.
"Every second counts in a situation where the individual is not breathing," Orlowski says, noting that the Heimlich has even been down-graded as the first response for choking by the Heart Association and Red Cross (in favor of back slaps).
The Press published a feature story about Hunsucker, who did not respond to requests for comment for this article, and his controversial technique in 2007. In what has been his most extensive interview in recent years, Hunsucker said of his critics, "Screw 'em. What do you want me to do, walk in lock-step?"
Dismissing Hunsucker, a professor emeritus of mathematics and engineering at the University of Houston, as a non-medical quack is no easy task. As the Press described in 2007, he is considered a pioneer in water safety, has helped to create water-rescue techniques now used by first-responders in Houston and elsewhere, and has won numerous honors for his work.
To questions about the Heimlich's effectiveness on drown victims, he typically points to the scoreboard, as he did in an Austin Chronicle article this January: "Since the company's inception in 1974, he says, only one life has been lost during a rescue attempt by a NASCO-trained life guard."
(Hunsucker's critics refuse to accept this premise. "I know of no independent audits of his success rates," says B. Chris Brewster, president of the United States Lifesaving Association. "That's like having Coke tell you that Coke is the best cola in the world." When the Press asked Hunsucker for any unpublished data in 2007, he said there was none.)
Some NASCO clients -- such as the cities of Dallas and Rowlett, which recently came under fire for hiring the company to train their lifeguards -- have attempted to distance themselves from controversy by stating that they use NASCO training but not the Heimlich (Dallas) or use the Heimlich only when transporting the victim from the water (Rowlett).
NASCO itself seems to be giving the Heimlich a smaller role. In its current contract with the city of Dallas, which was approved on March 3, it states that "[f]or a victim removed from the water who is obviously not breathing, we teach lifeguards to do five and only five Heimlichs before attempting rescue breathing."
Yet the most recent version of the NASCO textbook, which can be downloaded from its Web site, states that "abdominal thrusts" (the word Heimlich no longer appears) must be done only "in the water and while moving to the extrication point. This will help to insure a clear airway and work as a crude form of respiration."
This is still in violation of all accepted practices, according to drowning experts.
"It's definitely delaying [CPR]," Orlowski says. "What we teach life guards is that you start breathing victims as soon as we get to them, even if that's in the pool."
The Heimlich was not used in an August 1 drowning in Sandusky, Ohio, according to press reports. A spokeswoman at El Paso's Wet N' Wild Water World, where a 14-year-old boy drowned in May, did not respond to requests for comment.
Andy Maurek, operations manager at the Water World in Denver, Colo., where a 48-year-old man drowned on July 21, says his park follows NASCO protocols directly -- and that it did so in this case.
"We did the Heimlich while we were in the water. When we pulled him out, we began our CPR procedure," Maurek tells Hair Balls.
Hunsucker's critics believe this could be the next and crucial step in removing the Heimlich from NASCO training entirely.
"It would appear at this point that the emperor has no clothes," Brewster says. "You put yourself at tremendous legal risk, because you're essentially practicing medicine outside the confines of approved process. I mean it's essentially human experimentation."
Water World, at least, remains unfazed.
"We've been with NASCO for 20 years, and we just have the utmost confidence," says Joann Gomez, a Water World spokeswoman, noting that this was the family-owned park's first drowning in 30 years and 11 million visitors.
"It's certainly worked for us."
According to public documents, NASCO had several Houston-area clients from 2004 to 2008 -- Waterworld in Houston, Splashtown in Spring and Palm Beach at Moody Gardens in Galveston, along with the cities of Deer Park and Palm Beach.