According to the Canadian Heart and Stroke Foundation (2019), it is estimated that around 35,000 cases of cardiac arrest—a condition where an individual’s heart stops beating—occur in Canada every single year (2). Without immediate treatment, cardiac arrest can quickly lead to death, with out-of-hospital survival rates being less than 10% for most communities (Canadian Heart and Stroke Foundation 2019, 2). Yet, when administered immediately, cardiopulmonary resuscitation, an emergency procedure also known under the acronym of CPR, can double or triple chances of survival (American Heart Association, n.d.b). CPR is therefore an essential life-saving treatment, one that plays an especially important role within the field of emergency medical research and care.
Throughout history, there have been many attempts at different methods for emergency resuscitation. Many of them have relied on the same general principles of modern CPR as we know it today: breath and compressions. For instance, a very early account of emergency resuscitation, established around the year 1530, was the Bellows Method, a practice created by Swiss physician Paracelsus that used a fireplace bellows to blow air into the patient’s lungs (American Heart Association News 2018). Another early example includes open-heart massage, an 1874 revelation of German physiologist Moritz Schiff whose research demonstrated that massaging a heart during surgery can restore circulation. In fact, following this discovery, open-heart massage remained the standard form of treatment for the next half century (American Heart Association, n.d.a). While these methods may seem absurd to us today, they both exist on the long timeline of trial and experimentation that allowed us to finally arrive at the modern form of CPR, officially established in the 1960s.
However, there were three major events in the mid 1900s that directly led to the formal establishment of CPR as the method we know it as today. The first of these events occurred in 1956, with James Elam and Peter Safar, two doctors, proving the efficacy of mouth-to-mouth resuscitation as a lifesaving method. The second event, which took place just one year later, in 1957, was the creation of the first portable external defibrillator by a team of John Hopkins doctors (American Heart Association, n.d.a). Finally, this same team, composed of William Kouwenhoven, James Jude, and Guy Knickerbocker, pioneered what became the third event—the acceptance and use of closed-chest cardiac massage (Peck 2011). Thus, it was these three pivotal moments in history, the advocacy for mouth-to-mouth resuscitation, the construction of the external defibrillator, and the acceptance of external chest compressions that, when combined together in the 60s, led to the formation of cardiopulmonary resuscitation. In fact, in their landmark paper from July of 1960, Kouwenhoven, Jude, and Knickerbocker declare that, with this new technique, “[a]nyone, anywhere, can now initiate cardiac resuscitative procedures. All that is needed are two hands” (Kouwenhoven, Jude, and Knickerbocker 1960, 1064). This declaration still rings true today, with CPR still serving as a crucial lifesaving treatment for those suffering from cardiac arrest, both in and out of the hospital, for which we have emergency medical practice and research to thank.
References
American Heart Association. n.d.a. “History of CPR” CPR and First Aid: Emergency Cardiovascular Care. Resources. Accessed September 2nd, 2022. https://cpr.heart.org/en/resources/history-of-cpr.
———. n.d.b. “What is CPR?” CPR and First Aid: Emergency Cardiovascular Care. Resources. Accessed September 3rd, 2022. https://cpr.heart.org/en/resources/what-is-cpr.
American Heart Association News. 2018. “CPR through history.” American Heart Association. Published June 1, 2018. https://www.heart.org/en/news/2018/05/01/cpr-through-history.
Heart and Stroke Foundation of Canada. 2019. “Addressing Cardiac Arrest in Canada.” Policy Statement (November): 1-12. https://www.heartandstroke.ca/-/media/pdf-files/canada/2017-position-statements/final-en-addressingcardiacarreststatement-nov-2019.Ashx?Rev=388eeef4069747dcb4ab6353d36b3f7b%26hash=9e27a3232e8f908e45e115b0b9dcc9d5.
Kouwenhoven, W.B., James R. Jude, and G. Guy Knickerbocker. 1960. “Closed-Chest Cardiac Massage.” Journal of the American Medical Association 173, no. 10 (July): 1064-1067. doi:10.1001/jama.1960.03020280004002.
Peck, Mark. 2011. “John Hopkins Celebrates 50 Years of CPR: The Story of Drs. Kouwenhoven, Jude & Knickerbocker.” The National EMS Museum. Submitted August, 2011. https://emsmuseum.org/collections/archives/defibrillators/1957-first-defibrillator/.
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