Introduction to CPR
Ever wondered how the lifesaving procedure we call “CPR” came to be? Cardiopulmonary resuscitation (CPR) may seem like it’s been around forever, but the technique was not finalized until 1960. Even today, medical experts continually refine CPR to improve its effectiveness, with the most recent update occurring in 2015.
Table of Contents
Early Techniques in Resuscitation
Mouth-to-Mouth Ventilations
Throughout history, mouth-to-mouth ventilations were used separately from chest compressions. Doctors and midwives used these ventilations to help unresponsive newborns take their first breaths.
Chest Compressions
In Japan, jujitsu students learned how to revive an unconscious person using a form of chest compressions delivered from behind.
Historical Milestones in CPR
The Bellows Method
The first documented use of rescue ventilations involved blacksmith’s bellows. Paracelsus, a German-Swiss physician, used bellows to introduce air (and smoke) into a victim’s mouth. This method became standard for a few centuries. Unfortunately, it was not widely adopted due to the impracticality of carrying bellows and the lack of understanding of the importance of airway management.
Royal Humane Society Resuscitation apparatus. Credit: Wellcome Collection.
Mid-1700s Innovations
By the mid-1700s, medical practitioners in Scotland and France used mouth-to-mouth rescue breaths to revive victims of suffocation and drowning. In Amsterdam, the Society for the Recovery of Drowned Persons recommended mouth-to-mouth breathing and manual pressure on the abdomen. They also tried unconventional methods like tickling the victim’s throat and stimulating their orifices with tobacco smoke.
19th Century Discoveries
In the mid-1800s, London physicians Marshall Hall and Henry Silvester developed methods close to chest compressions. Hall’s method involved rotating a patient back and forth, while Silvester’s method incorporated chest-pressure and arm-lifting techniques. This method involved placing the victim faceup, elevating the shoulders, and using a sequence of chest compressions and arm movements repeated about 12 times per minute.
In the late 1800s, American doctor George Crile and German surgeon Dr. Friedrich Maass successfully used chest compressions to resuscitate patients, but their techniques were not widely adopted until much later.
Modern CPR: The 20th Century Breakthrough
The Landmark Presentation of 1960
In the mid-20th century, doctors James Elam, Archer Gordon, James Jude, Peter Safar, and Guy Knickerbocker conducted extensive research on resuscitation. In 1960, Knickerbocker, Jude, and Safar presented their findings to the Maryland Medical Society, proving the effectiveness of combining chest compressions with mouth-to-mouth breathing. This technique, though unnamed at the time, laid the foundation for modern CPR.
Global Training and Education
These pioneering doctors developed training mannequins like Resusci Anne and educational films such as “The Pulse of Life.” The film included the mnemonic “ABC” (airway, breathing, circulation) to help learners remember CPR steps. By the 1970s, global CPR training programs for laypeople began, with emergency dispatchers guiding callers through CPR steps over the phone.
CPR Today: Advances and Techniques
Hands-Only CPR
In 1992, the International Committee on Resuscitation (ILCOR) was founded to review and share scientific data on resuscitation. By the 2000s, ILCOR recommended hands-only CPR (chest compressions without mouth-to-mouth) for non-drowning victims, as research showed it to be nearly as effective when performed by laypersons.
Current Training Methods
Emergency First Response® (EFR) uses the latest research and instructional design for CPR training, ensuring students gain confidence and competence quickly and effectively. This approach caters to various learning styles, enhancing the overall effectiveness of CPR training.
Conclusion
The journey of CPR from ancient resuscitation techniques to a standardized lifesaving procedure is remarkable. Continuous improvements and widespread training ensure that CPR remains a critical skill for saving lives. By understanding and applying the latest CPR techniques, we can all be prepared to make a difference in emergency situations.
