Cardiopulmonary Resuscitation 1956 – Emergency Intervention to Restore Life

Cardiopulmonary resuscitation (CPR) is an emergency technique generally used to sustain the life of a person having a heart attack and/or breathing little or not at all. It is usually used until additional medical help reaches the scene. 

CPR may involve chest compressions to promote blood circulation  (repeatedly pressing on the chest),  mouth-to-mouth (MM) breathing or using a device to push air into the lungs. CPR may also involve the use of electric shocks to encourage a normal heartbeat.

In 1956, Austrian physician Peter Safar conducted a very unusual experiment. To keep his subjects alive, Dr Safar: 

• Began human experiments with 31 volunteers whose respiratory muscles he paralysed (using a poison called curare) to determine whether mouth-to-mouth breathing could provide sufficient oxygen.
• Monitored blood oxygen and carbon dioxide levels for several hours while inflating their lungs with exhaled air, demonstrating that mouth-to-mouth breathing was feasible (by showing that it provided enough oxygen). 

Alongside research by doctors such as James Elam, Safar persuaded a Norwegian rag-doll manufacturer to produce a mannequin for CPR training. The mannequin was named Resusci Anne. In his 1957 book  ABC of Resuscitation, Safar proposed a combined approach in which a rescuer checks a victim's airway, facilitates breathing and performs chest compressions. The book is a foundation for CPR training worldwide.

The medical research environment of the 1950s differed considerably from today's. At that time, ethical approval processes and participant informed consent for medical experiments were not defined as firmly and consistently as they are now. Safar's work may have met the ethical standards of the time, but these standards were less strict than today's. His work revolutionised emergency medical intervention. The techniques he developed contributed to saving countless lives and formed the basis of modern first-aid and emergency medicine training.

The Bible states that the prophet Elisha placed his mouth over a child's and restored the child to life (2 Kings 4:34). In 1767, guidelines published in the Netherlands recommended warming drowning victims, providing MM ventilation and  "blowing the smoke of burning tobacco into the rectum". 

Description of the article image: An illustration published in 1996 describing a mannequin for practising the breathing component of CPR. The device has an inflatable simulated human chest that rises and falls.

Historical figures mentioned in the article: James Otis Elam (1918–1995), Peter Safar (1924–2003)

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