Cardiopulmonary Resuscitation (CPR) is an emergency procedure performed when the heart stops beating, or beats ineffectively, to circulate blood. It helps preserve brain function and maintain circulation, significantly improving survival chances for individuals experiencing cardiac arrest. Immediate CPR can double or even triple a person’s chance of survival.
Ancient Roots of Revival
Attempts to revive unresponsive individuals date back to ancient civilizations. Early references to artificial respiration appear in ancient Egyptian literature and biblical accounts, suggesting an early understanding of the need to restore breath. For example, some interpretations suggest the prophet Elijah’s resuscitation of a child involved mouth-to-mouth techniques.
Across cultures, various unscientific methods were employed, often ineffective. Early European attempts included using bellows to force air into the lungs, or drastic measures like flagellation. In the 18th century, the Paris Academy of Sciences recommended mouth-to-mouth resuscitation for drowning victims. These primitive efforts highlight a persistent human endeavor to reverse apparent death, setting the stage for more systematic approaches.
The Emergence of Modern CPR Techniques
The scientific foundation of modern CPR solidified in the mid-20th century with breakthroughs in artificial respiration and external chest compressions. Anesthesiologists James Elam and Peter Safar conclusively demonstrated mouth-to-mouth resuscitation’s effectiveness in the mid-1950s. Elam’s research, using pharmacologically paralyzed human volunteers, proved expired air could adequately maintain oxygen and carbon dioxide levels in the blood.
Simultaneously, groundbreaking work on external chest compressions emerged from Johns Hopkins University. In 1958, electrical engineer William Kouwenhoven, along with colleagues Guy Knickerbocker and James Jude, discovered forceful chest pressure could effectively circulate blood. This accidental finding, made while studying cardiac defibrillation in dogs, showed external cardiac massage could restore significant circulation. The combination of mouth-to-mouth ventilation and external chest compressions was formally presented in September 1960, marking modern CPR’s birth.
Formalization and Global Acceptance
With the scientific basis established, the focus shifted to standardizing and disseminating CPR knowledge. In the early 1960s, the first formal CPR guidelines were developed, transitioning the technique from experimental practice to a recognized medical procedure. Important organizations played a role in this formalization.
The American Heart Association (AHA) and American Medical Association (AMA) were important in endorsing and promoting CPR. The AHA formed its CPR Committee and formally endorsed the technique in 1963. This endorsement led to widespread public training programs, making CPR accessible to non-medical personnel. The American Red Cross and other agencies also contributed to establishing standardized training and performance guidelines. By the early 1970s, CPR training spread globally, with significant efforts to increase public awareness and training accessibility.