The choking child: back bangers against front pushers.

me urgently into his bedroom, where I found him deeply cyanosed and making ineffectual respiratory efforts. Some older visiting children had given him a "gob stopper." With thoughts racing through my mind of where in the house would I find a knife sharp enough to attempt emergency tracheostomy, I turned him upside down over my knee and banged his back with the side of my fist several times. Never have I been more relieved than when I saw that sweet roll across the bedroom floor. That is my sole experience of managing this emergency, and until recently I was unaware of the controversy that has raged about its correct management since Heimlich described his method of abdominal compression.' Discussion with colleagues suggests that this ignorance is widespread.