History of CPR ⋆ Saint-Bernard Academy

The Evolution of CPR

In 1740, the Académie des sciences de Paris recommends mouth-to-mouth and chest massage in order to rescue drowned victims of the Seine River. A decade later, organisations throughout Europe made similar recommendations, starting with England and the Dutch Republic (the Netherlands at the time). However, CPR standards only appeared 200 years later, in the 1950s.

Johns-Hopkins University

In 1958, researchers at Johns-Hopkins University discovered by chance that by performing chest massages on an animal suffering from ventricular fibrillation, they could obtain a femoral pulse, which directly led to CPR as we know it today. While open chest cardiopulmonary resuscitation was already well in use in hospitals, the closed-chest cardiac massage method was now born. A few years later, Dr. William B. Kouwenhoven, from the same institution, engineered and created the first closed-chest defibrillator, developing a device capable of sending electric shocks in order to resuscitate an adult heart spontaneously. In other words, the 1950s were crucial in the history of modern emergency cardiac care.

Dr. Fred Wilson

In 1964, Canadian Dr. Fred Wilson was the leader in creating a resuscitation team in his hospital. While helping a patient suffering from a cardiopulmonary arrest with CPR, one of the nurses had to get a defibrillator from an operating room. While the story ends well, with a full recovery from the patient, Dr. Fred Wilson saw the need for a faster response and tool availability, which led to a dedicated resuscitation team, as well as creating his own “emergency cart,” where a defibrillator would always be ready on hand.

The International Liaison Committee On Resuscitation (ILCOR)

Since cardio-vascular resuscitation offers the best chance of survival for RCA victims, medical experts thought it was necessary to teach this procedure to everyone. However, medical and legal aspects made these teachings a difficult task. Canadian Dr. Anthony Graham, a cardiologist, accepted this colossal challenge alongside colleagues from the American Heart Association. Thanks to his teaching methods, nearly 500,00 Canadians now learn CPR every year.

The ILCOR (International Liaison Committee On Resuscitation) meets every five years to review and create new recommendations to improve the teachings of resuscitation and first aid, ensuring continuous improvements of CPR by examining the latest scientific breakthroughs and working tirelessly to improve the technique and practice of cardiopulmonary resuscitation.

An innovative teaching method

Since more people are now trained in CPR, many public spaces have acquired Automatic External Defibrillators (AED). This device significantly increases the chances to resuscitate a person who has suffered a cardiac arrest. It is therefore in everyone’s interest to be able to benefit from it. Many companies subsidise the purchase of an AED for their community, while some municipalities make them available in some of their public spaces, such as arenas and recreation centers.

The St-Bernard Academy proudly stands out by offering CPR and first aid online training. Now more than ever, people can benefit from knowledge allowing resuscitation thanks to our innovative teaching method

1732

Alloa, Scotland. Local surgeon Willian Tossach uses mouth-to-mouth to resuscitate a coal-pit miner. It seems that this is the first successful use of the mouth-to-mouth technique in the medical literature.

1740

The Académie des sciences de Paris officially recommends mouth-to-mouth resuscitation for drowning victims.

1774

London physicians Dr. William Hawes and Dr. Thomas Cogan found the Society for the Recovery of Persons Apparently Drowned (later known as the Royal Humane Society) to assist victims of sudden and unexpected death.

1775

Experimenting on animals, Danish veterinarian Peter Abildgaard discovers that chickens suffering from electrical shocks, counter shocks to the chest could restore a heartbeat.

1782

The Royal Humane Society states its preference for using bellows ventilation rather than mouth-to-mouth to artificially inflate the lungs.

1856

English physician Marshall Hall exhibits his simple resuscitation technique: alternate a patient from one side to the other. He later updates his technique by adding pressure to the chest.

1858

English physician Henry Silvester develops the arm-lift, chest-pressure method: lifting the arm to widen the chest area, then cross the arm along the chest area to create pressure, allowing the victim to exhale.

1874

German physiologist Moritz Schiff notes that massaging the heart on animals during surgery can restore blood circulation.

1878

In Germany, Rudolph Boehm notes that external cardiac massage provides adequate blood circulation in cats.

1891

After using external compression to restart the heart of 2 young human patients, German surgeon Dr. Friedrich Maass becomes the first to advocate for closed-chest cardiac massage to help with blood circulation, rather than ventilation alone. However, this method won't become standard practice for another half of a century.

1903

In Cleveland, Ohio, Dr. George Crile's research shows that external closed-chest massage restores blood circulation in dogs.

1904

Dr. Crile reports successful closed-chest cardiac massage in one human case. Once again, the non-invasive technique doesn't gain much traction, and patients continue to receive open-heart surgery.

1933

Researchers at Johns-Hopkins University, led by electrical engineer Dr. William Kouwenhoven accidentally (re)discover external compression when they find that pressure on a dog's sternum provides adequate blood circulation to the brain, keeping the animal alive until defibrillation can restart its heart. Their results are confirmed in more than 100 dogs.

1947

American surgeon Dr. Claude Beck performs the first successful use of an electric defibrillator on an exposed human heart.

1950

The American Heart Association begins the publication of Circulation, a scientific journal that informs physicians, researchers, as well as the general public about heart-related research breakthroughs.

1954

American physician and respiratory researcher Dr. James Elam becomes the first person to prove that exhaled air is sufficient to maintain adequate oxygenation.

1956

Dr. Elam and Dr. Safar prove that mouth-mouth resuscitation is an effective lifesaving method. Drs Elam, Safar, and Gordon play leading roles in promoting rescue breathing techniques to both healthcare providers and the general public. For the first time in human medicine, an external defibrillator successfully restores a steady rhythm to a quivering heart. Harvard cardiologist Dr. Zoll leads the study with funding from the American Heart Society.

1957

The United States military adopts mouth-to-mouth resuscitation to revive unresponsive victims. Later that year, Johns-Hopkins University unveils the first portable external defibrillator. After several years of research on closed-chest defibrillation, Dr. Kouwenhoven's team, which includes James Jude, MD, and Guy Knickerbocker, Ph.D., unveils its first prototype: the 200 lbs Hopkins Closed Chest Defibrillator.

1960

Resuscitation pioneers Drs Kouwenhoven, Safar, and Jude combine the mouth-to-mouth method with closed-chest cardiac massage to create cardiopulmonary resuscitation, the lifesaving technique we now call CPR. The AHA starts a program to introduce physicians to closed-chest cardiac resuscitation, which will become the forerunner of CPR training for the general public. The life-size mannequin is developed by Drs Safar, Elam, and Gordon, alongside Norwegian toymaker Åsmund Lærdal. This mannequin will soon teach CPR skills to more than 400 million people (and counting!) worldwide.

1963

Cardiologist Dr. Leonard Scherlis founded the AHA's CPR committee. The AHA later formally endorses CPR.

1966

The National Research Council of the National Academy of Sciences holds an ad hoc conference on cardiopulmonary resuscitation. This conference is the direct result of many requests from the American National Red Cross and other agencies to establish standardized training and performance standards for CPR.

1972

University of Washing cardiologist Dr. Leonard Cobb launches Medic II, the world's first mass training in CPR for the general public. During its first 2 years, the program helps train more than 100 000 people.

1973

Second National Conference on CPR and ECC.

1975

The AHA publishes the first Advanced Cardiovascular Life Support (ACLS) textbook.

1981

A program to provide phone instructions to perform CPR beings in King County, Washington. This program trains emergency dispatchers to give callers CPR instructions while EMT personnel are on route. This is now common practice across the United States.

1983

The AHA holds a national conference on pediatric resuscitation to develop CPR and ECC guidelines for pediatric and neonatal patients.

1985

Fourth National Conference on CPR and ECC.

1988

In collaboration with the American Academy of Pediatrics, the AHA introduces its first pediatric courses: Pediatric BLS, Pediatric Advanced Life Support (PALS), and neonatal resuscitation.

1990

Fifth National Conference on CPR and ECC. Public access defibrillation programs provide training and resources, including AEDs, to the public in order to assist them resuscitate victims of cardiac arrest.

1992

The International Committee on Resuscitation is founded.

1999

The first task force on first aid is appointed. The first International Conference on Guidelines for CPR and ECC is held.

2004

The AHA and ILCOR release a statement about AED usage on children, stating that for children aged 1 to 8 years old who show no sign of blood circulation, it is safe to use an AED.

2005

The AHA develops the Family & Friends CPR Anytime® kit, an innovative product that allows anyone to learn the core skills of CPR in just 20 minutes. The kit provides everything to learn basic CPR, AED skills, as well as choking relief, from a family room setting to a populated area. The 2005 International Consensus on CPR and ECC Science With Treatment Recommendations (CoSTR) conference leads to the AHA publishing the "2005 AHA Guidelines for CPR and ECC." These Guidelines recommend a new compression-to-ventilation ratio of 30:2 as well as changes to AED usage.

2008

The AHA releases new recommendations for bystanders, skipping mouth-to-mouth resuscitation and use Hands-Only CPR to help an adult who suddenly collapses. In Hands-Only CPR, bystanders dial 9-1-1 and provide high-quality chest compressions by pushing hard and fast in the middle of the victim’s chest.

2010

Following oh the 2010 International CoSTR Conference, the AHA publishes the 2010 AHA Guidelines for CPR and ECC. 2010 also marks the 50th anniversary of CPR.

2012

The AHA’s Hands-Only Mobile Tour hits the road to teach Hands-Only CPR across the United States.

2013

The AHA provides an interactive CPR kiosk at Dallas-Ft. Worth airport. This kiosk features a practice mannequin, video, and touch screen that give performance feedback as passengers between flights learn to perform hands-only CPR. Within 5 years, there will be more than 30 CPR kiosks in cities across the United States.

2015

The Institute of Medicine releases its strategies to improve cardiac arrest survival: "A Time to Act (2015)". Following the 2015 International CoSTR Conference, the AHA publishes the 2015 AHA Guidelines Update for CPR and ECC.

2017

The AHA begins its continuous evidence evaluation process for the Guidelines for CPR and ECC, then releases the 2017 Focused Update.

2018

The AHA publishes “Resuscitation Education Science: Educational Strategies to Improve Outcomes From Cardiac Arrest” in the journal "Circulation." This publication, which is applicable to all resuscitation training programs (not exclusive to AHA), examines best practices in education and applies them to resuscitation. By implementing the statement’s guidance, training programs and resuscitation instructors will help raise the standard of care and increase survival from cardiac arrest.