How many articles have you read authored by skeptics highlighting studies that conclude that survival rates for CPR are dismally low - 24 hour survival rates of two to ten percent. Truth is it is extremely difficult to measure the success of an emergency rescue attempt outside of the hospital. For one thing, it is impossible to know all the factors in each individual case. For another, the rescue team is too occupied to make intelligent notes required for an accurate study.
Prior to 1960, the defibrillator was primarily used on the exposed heart by thoracic surgeons. For them it was almost 100 percent effective. An exposed heart would tell them about the distress of fibrillation – the vital muscle was not pulsating but was instead moving like “a bag of worms.” Looking at the exposed heart, they could tell. The use of a heart monitor was rare because they were not readily available.
CPR was popularized in the medical community after the publication of an article that appeared in the Journal of the American Medical Association July 9, 1960 by W.B.Kowenhoven and James R Jude, MD. They were studying Closed Chest Cardiac Massage as a means of prolonging life to enable the use of an external defibrillator. At that time the external defibrillator was an experimental device which had little practical application. There was no accepted way to keep blood circulating for the critical 4 minute period before the brain was damaged. Their study involved twenty patients with a seventy percent 24 hour survival rate.
Some of the variables that contribute to the success or failure of emergency cardiac resuscitation are:
1. Patient’s physiology
2. Cause of cardiac arrest
3. Timing from the onset
4. Coronary disease, if present
5. Effectiveness of CPR
CPR when properly applied will most often help to keep oxygen laden blood supplied to the brain, but by itself will not cure the mechanism that caused the heart to quit. Kouwenhoven’s lament was that accidental fibrillation will kill the healthy heart. Drowning, asphyxiation, electric shock, traumatic shock, apnea are some of the events that will cause the healthy heart to fibrillate. The defibrillator is the only known way to reverse this condition.
If the person lying on the ground, unconscious, with no perceptible heartbeat is in fibrillation, your effort to revive him should work well. If the cause of their heart stoppage is due to some form of heart disease, or nervous system disorder, the defibrillator will probably not restart their heart.
In excess of two hundred thousand Americans suffer sudden cardiac death each year outside of hospital care. The need to keep those of us willing to save a friend or relative, too young to die, is as great as it ever was. The need to keep up with the latest technique is imperative.
Time is the enemy. Survival results greatly improve when defibrillator shocks are delivered as soon as possible, whether CPR is used or not. If you value the lives of your friends and family, and are potentially able to help them survive a life shortening cardiac incident, take one of the many well qualified training courses in CPR. Get together with your neighbors Buy and learn how to use an AED. Calling 911 is a must, but you are there first and so you can and must provide help long before the Emergency Medical Technicians get there. (Average response time, 6 minutes. A long time when brain damage occurs after 4minutes without bloodflow.)
International experts in resuscitation have been meeting for over forty years in an attempt to standardize CPR. Their goal has never been met due to the illusive nature of sudden cardiac death. Far all the debate and divisiveness encountered in this process, no one who uses CPR on a regular basis has concluded that CPR doesn’t work. It just works differently for different people. The objective of this article is to get you to believe CPR can work for you if you are diligent and motivated.
When you are called on to save the life of a loved one, you need to make your success rate one hundred percent. There isn’t anything that will bring as much joy and satisfaction into your life.
Many studies have been done, however no study to my knowledge has been performed that includes a large (10,000) sample, nor well managed criteria. This ideal study seems improbable due to the exigencies of a cardiac emergency.
Click below to obtain a copy of Kouwenhoven's clinical study.
Click below to obtain a copy of Kouwenhoven's clinical study.
July 9, 1960 Vol173 pp 1064-1067 Closed Chest Cardiac Massage
W. B. Kouwenhoven, Dr. Ing, James R. Jude, M. D. G. Guy Knickerbocker, M.S.E., Baltimore
