Evolution of CPR -

Evolution of CPR

Did you know that more than 90% of cardiac arrest victims actually die before they are able to get to a hospital for advanced care? How can we improve the survival rate in our community? CPR has been proven to double or even triple the victims chance to survive. What is CPR and how was this life saving technique discovered?

The first part of CPR to appear in our history is “Resuscitation” or the delivery of breathes into the victim airway. There are references to some form of resuscitation that dates as far back as the mid 1500’s when Vesalius was able to give breath to a dying animal through a reed that he placed in his trachea so that he could study the anatomy of the animal. Then in the early 1700’s Tossach was gave the first documented resuscitation via mouth-to-mouth to a coal miner who could breathe due to inhalation of toxic fumes.  After this the Paris Academy of Sciences started recommending mouth-to-mouth breathing for victims that have drowned. The Society of Recovery of Drowned Persons was created in Amsterdam August 1767 and some of the technique they used to save around 150 people in their first 4 years are warming the victim; tickling of the victim’s throat; placing the victims head lower than the rest of their body to allow easy removal of excess water; putting pressure on their abdomen; bloodletting; using the Bellows or mouth-to-mouth method to deliver air into their lungs; or using tobacco smoke as an oral fumigation but it was also used as a way to stimulate the intestines via the anus to provoke a response in the unresponsive person. Other societies followed soon after throughout Europe and the Royal Humane Society in London was the example we used when forming societies in New York, Philadelphia, and Boston. Mouth-to-mouth breathing technique is the most widely used method for resuscitation still today.

Even though the first chest compressions were performed by Dr. Friedrich Maass in 1891, the first successful chest compression came in 1903 by Dr. George Crile. He also performed chest compressions on the first American in 1904. However, closed chest massage, or chest compressions, were not an excepted practice by physicians until 1958 when Dr. William Kouwenhoven, Dr. Guy Knickerbocker, and Dr. James Jude accidentally discover their benefits while studying defibrillation for dogs. The first human to survive using this technique was an obese woman who went into cardiac arrest. Dr. Jude stated that since they were not in the operating room they chose the closed chest technique and she her pulse and blood pressure came back so quickly that there was no need to open her chest. These 3 prestigious doctors discussed their discovery at the Maryland Medical Society annual meeting in 1960 and felt that mouth-to-mouth and closed chest compressions could no longer be two separate procedures for resuscitation. In 1962, AS Gordon and David Adams produced a 27 minute film called “The Pulse of Life” that was used to train millions of students how to use CPR. In this film Gordon and Adams came up with a way to remember the sequence for CPR. This was the A B C’s of CPR (Airway, Breathing, and Circulation).

The American Heart Association was created by Dr. Leonard Scherlis in 1963 and along with the American National Red Cross and 30 other organizations wanted to standardize this procedure. So they convened an ad hoc conference on cardiopulmonary resuscitation for the first time in 1966. Every 6-7 years the AHA sponsored these meetings in order to review the standards for CPR and ECC (Emergency Cardiovascular Care). In an effort to ascertain if resuscitation practices were in place in other countries, so AHA invited experts from other countries to sit in on the 1985 meeting. Seeing the need to expand their group efforts to these countries, in 1993 serval panel members formed the International Liaison Committee on Resuscitation (ILCOR).  Some of the organizations that attended these meetings were the American Heart Association, the European Resuscitation Council, the New Zealand Resuscitation Council, the Heart & Stroke Foundation of Canada, the Australian Resuscitation Council, the Consejo Latino-Americano de Resuscitatión, and the Resuscitation Council of Southern Africa. Twice a year the ILCOR hold meetings to coordinate an evidence based review that organizations around the world will use to standardize CPR training. The newest of these standards are scheduled to be published and implemented by the end of 2015.

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