History of cardiopulmonary resuscitation
[7] The modern elements of resuscitation for sudden cardiac arrest include CPR (consisting of ventilation of the lungs and chest compressions), defibrillation and emergency medical services (the means to bring these techniques to the patient quickly).
The earliest references to CPR can be found in ancient Egyptian literature of the Old Kingdom of Egypt, in which Isis resurrected Osiris (her slain brother and husband) with the breath of life.
In the second Book of Kings, Elisha successfully performed mouth-to-mouth resuscitation on another apparently dead child, this time in the village of Shunem.
[10] Burhan-ud-din Kermani, a physician in 15th century Persia, described his approach to the treatment of ghashy (cardiac and respiratory insufficiency), which involved moving the victim's arms and expanding and compressing the left side of the chest.
[11] In 1667, Robert Hooke performed an experiment that refuted Galen’s hypothesis that death would ensue if the lungs ceased to expand and contract.
[13] The first organized effort to respond to sudden death was in 1767, when a group of citizens in Amsterdam formed the Society for the Recovery of Drowned Persons (SRDP).
[14] In Hamburg, an ordinance was passed in 1769 which allowed notices to be read in churches describing how to use these methods to rescue people who were drowned, strangled, frozen, or overcome by noxious gases.
[15] English physician Thomas Cogan (1736 – 1818) was living and practicing in the Dutch Republic at that time, having just earned his medical degree from Leiden University in 1767.
[18] Curry performed experimental work on external defibrillation in small animals, and even described two successful cases of human resuscitation by this means.
Chief among these were 1) that the resulting inspiratory and expiratory volumes were quite small, 2) that repeatedly rolling a lifeless body from prone to lateral was likely to cause significant injury to the cervical spine and face, and finally 3) that the risk of pulmonary aspiration of gastric contents was unacceptably high using Hall's method.
[4][22] Silvester's method received a great deal of attention, and was advocated by many prominent physicians of that era, including Friedrich von Esmarch.
[5][30] The mostly forgotten technique of mouth-to-mouth ventilation finally came back into favor in the mid-20th century, beginning with its "accidental rediscovery" by James Elam (1918 - 1995).
[32] In 1956, Elam met Peter Safar (1924 – 2003) — also an anesthesiologist — and persuaded him to join the effort to convince the world that ventilating the lungs with expired air was effective as part of a resuscitative technique.
[36] Based on this recommendation, the mouth-to-mouth ventilation technique was endorsed that year by the National Research Council, United States Armed Forces, and the American Red Cross.
[38] That year, Elam served as a medical adviser on the instructional film Rescue Breathing, which demonstrated and publicized this new life-saving technique.
[39] In 1959, Elam (together with Danish anaesthetist Henning Ruben, the co-inventor of the Ambu bag) wrote an instructional booklet entitled Rescue Breathing, which was distributed throughout the United States.
[40] Organizations such as the American Red Cross began to provide training at local chapters in the proper administration of artificial respiration.
[27] In 1958, a team of researchers at Johns Hopkins University (who were unaware of Maass' experience and publication)[27] made an accidental discovery while studying cardiac defibrillation in dogs.
The team — which included William Kouwenhoven, Guy Knickerbocker, and James Jude — noticed that by forcefully applying the paddles to the chest of the canine test subject, they could achieve a pulse in the femoral artery.
[42] The first person successfully resuscitated using this technique was recalled by Jude: "She was rather an obese female who … went into cardiac arrest as a result of flurothane [sic] anesthetic.
"[43] In a 1960 landmark article in The Journal of the American Medical Association, the Johns Hopkins team reported their findings on 20 cases of in-hospital cardiac arrest.
They produced an 11-minute training film called Life in Your Hands in 1961, in which they demonstrated the new technique of CPR in various settings and stressed the importance of "Air and Circulation".
[51] For the film, Gordon and Adams devised the easy-to-remember mnemonic of A, B & C, which represented the sequence of steps in CPR: Airway, Breathing, and Circulation.
Zoll published a report of his experience in The New England Journal of Medicine in 1956, in which his external defibrillator was employed to successfully stop ventricular fibrillation eleven times in four different patients.
The availability of new, small capacitors considerably reduced the size and weight of external defibrillators, which could now be easily brought to victims in a wide range of environments.
He believed the problem of death from acute myocardial infarction had to be solved outside the hospital, not in the emergency room or the coronary care unit.
[citation needed] The team reported the initial results of their program in the August 5, 1967 issue of The Lancet; their findings on 312 patients covered a 15-month period.
[citation needed] The article has historical importance because it served to stimulate pre-hospital emergency cardiac care programs throughout the world.
[citation needed] In 1984 the first program with fire fighter EMTs using automated external defibrillators (AEDs) also began in King County, Washington.
Dispatcher-assisted CPR is now standard care for dispatcher centers throughout the United States and in other countries such as Israel, Great Britain, Sweden, and Norway.
