Health

Wednesday, Sep 25 2013 06:39 PM

Community leader saved from choking recalls harrowing incident

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    Pauline Larwood. Photo courtesy of the Kern Community College District.

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    By Casey Christie / The Californian

    In this 2012 photo, Pauline Larwood and her husband, Dr. Tom Larwood, lead the way during a Valley Fever Awareness walk at the Kern County Museum.

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    By Rachel Cook/ The Californian

    Retired pulmonologist Thomas Farrell Jr. said his friend Dr. Royce Johnson used this knife that Farrell usually carries in his pocket to perform a tracheotomy on former Kern County supervisor and valley fever activist Pauline Larwood at a restaurant Monday evening when she choked on a piece of meat.

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BY RACHEL COOK Californian staff writer rcook@bakersfield.com

Pauline Larwood usually doesn't eat steak but she recalled that the filet mignon she was dining on at a downtown restaurant Monday night was "really good."

Until she started to choke.

Related Info

HOW TO HELP A CHOKING VICTIM

While abdominal thrusts commonly known as the Heimlich maneuver are recognized as effective in dislodging food or other objects from the throat of a choking victim, the Red Cross recommends a combination of techniques be used by rescuers.

The organization's Guidelines for Emergency Care and Education recommend using cycles of five back blows and five abdominal thrusts to treat conscious, choking children and adults. A review of the scientific literature suggested that back blows, abdominal thrusts and chest compressions are equally effective. Additionally, the use of more than one method can be more effective to dislodge an object. These findings are consistent with those of international resuscitation societies.

The Red Cross doesn't discount the use of abdominal thrusts. Rather, the organization includes back blows, abdominal thrusts and chest compressions in its training because there is no clear scientific evidence to say that one technique is more effective than the others when treating a choking victim.

For more information, go to redcrosschat.org/2013/01/22/choking-101

Source: American Red Cross

"I remember the lodging, having my bite of steak stuck in my throat and turning to my husband to see if he could do a Heimlich on me and it didn't work. Then I felt other arms around me but then soon after that I blacked out," she said.

Speaking Wednesday from her shared room at Mercy Hospital Downtown with a voice raspy from the incident, Larwood said she didn't remember anything about what happened as doctors performed an emergency tracheotomy on her using a folding pocketknife with an approximately 3 1/2-inch blade and a pen.

The story of her dinnertime rescue and the quick thinking of everyone involved has captured the interest of people around the country and the world.

Larwood and her husband, Tom, were dining with politicians, physicians and some of the nation's top public health officials at The Mark in Bakersfield after the first day of a two-day symposium on valley fever when she began choking. The Larwoods have been big advocates in efforts to move valley fever causes forward.

After two Heimlich maneuver attempts failed, Pauline Larwood began turning blue. Another valley fever expert and personal friend, Dr. Royce Johnson, Kern Medical Center's chief of infectious disease and professor of medicine at UCLA, called for a knife. Using a friend's pocketknife he made an incision in Larwood's throat.

Dr. Paul Krogstad, a professor of pediatrics and pharmacology at the David Geffen School of Medicine at UCLA, said Tuesday that he broke a pen and inserted the hollow cylinder of it as a breathing tube in the opening Johnson made. He said Johnson blew into the tube and Dr. Thomas Frieden, the director of the Centers for Disease Control and Prevention, checked Larwood's pulse.

Frieden said Johnson "very rapidly jumped in (and) saved her life. It's really (Johnson) that was a hero there."

"He saved my life. I'm so thankful for that," said Larwood, Kern County's first female supervisor and a current Kern Community College District trustee.

She said she learned the details of what happened while she was unconscious when she read a story about the episode Wednesday in The Californian.

Larwood does not recall anything after she passed out until she woke up and was able to partially sit up and spit out the piece of steak. A woman was holding in place the pen that had been put in her neck.

"I don't remember the knife or the neck," she said. "It's just as well."

Larwood, 71, said she has trouble swallowing, a lingering effect from having polio at the age of 8. Back then, she was treated at a children's hospital in Ohio and fed intravenously for several weeks until she was able to swallow again.

Tom Larwood said he had performed the Heimlich maneuver once before on his wife at a restaurant, a life-saving technique he thinks everyone should know.

Pauline Larwood said her difficulty swallowing has increased as she has gotten older but Monday's scare was the worst experience yet.

"I was in the right place for that to happen if it was going to happen," she said.

Johnson, who declined comment, and his friend, Dr. Thomas Farrell Jr., accompanied the Larwoods to the hospital and stayed until things settled down. Pauline Larwood said she was disappointed that night when she realized she'd miss the rest of the symposium.

At Mercy, doctors soon removed the pen cylinder and Larwood was breathing on her own and given stitches to close the hole in her throat. She looked well Wednesday afternoon as she sat upright in a hospital bed, occasionally coughing and using a suction tube to clear her throat as she spoke.

Larwood will remain in the hospital until she can swallow on her own. She was being given antibiotics to prevent infection and her sore throat had improved, but Wednesday afternoon she still could not eat on her own and felt she was developing a cold.

A large vase of bright purple and yellow flowers sent by state Sen. Jean Fuller, R-Bakersfield, stood at her bedside and a couple visitors waited in the hallway.

"Not a lot of people knew about (the incident) until it was in the paper," she said.

Tom Larwood said having a close personal relationship with a person can make it harder to do surgical procedures on them, but he said Johnson just dealt with the situation. He said he could be shaken by the frightening experience if he dwelt on it, but he chooses not to.

"You do what you can and you don't worry about what you can't," he said.

His wife has not had a chance to talk to Johnson since the ordeal, but she thanked him at the emergency room.

"I'm just grateful for all (the community's) good thoughts and again I'm very grateful to the people that helped (Monday) night, particularly Royce Johnson," she said.

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