Resuscitation Timeline

The History of Resuscitation Timeline

3000 BC – Mayan hieroglyphics and cave drawings indicate that they and the Peruvian Incas in South and Central America performed rectal fumigation to attempt resuscitation.  This involves blowing hot air or smoke into the rectum of the casualty.

896 BC – “Then he got on the bed and lay upon the boy, mouth to mouth, eyes to eyes, hands to hands. As he stretched himself out upon him, the boy’s body grew warm.” (2 Kings 4:34)

1000 AD – A Muslim philosopher and physician known as Avicenna performed the first known experimental intubation of the trachea.  Gold, silver, or other metals were used in an effort to support inspiration.

1500 AD – The Heat Method and flagellation were invented and tried.  The heat method consisted of placing coals and hot ash onto the victim to counteract the cooling that death brings to the body.  Flagellation involved whipping the patient to stimulate a response.  These methods were both highly successful in awaking a deep sleeper, but futile resuscitative efforts.

1530 – The Bellows Method became very popular.  This involved using a fireplace bellow to ventilate the patient.  Unfortunately, airway anatomy was not very well known back then, and without hyperextension of the neck, the procedure didn’t work very well.  However, modern day bag-valve masks were inspired by this archaic procedure.

1543 – Vesalius et al. published “De humani corporis fabrica”.  This publication included descriptions of reviving animals by blowing into a tube.

1711 – For some reason, North American Indians and American colonists sought fit to bring back the rectal fumigation method.  Lets hope, this was the final comeback tour for this procedure—for the patients, their families, and most of all, our sake.

1740 – The Paris Academy of Sciences made an official recommendation for mouth-to-mouth for the resuscitation of drowning victims.  Of course it was the French who found benefit in placing their mouth on another’s.

1750 – Goodwin and Kite hypothesized that asphyxia caused the heart to stop; which was the ultimate cause of death.  They theorized that electrical shock (defibrillation) should be used to restart the heart.  Unfortunately this method was not appreciated because it required the victim be lain supine which caused the tongue to obstruct the airway.

1767 – The Society for the Recovery of Drowned Persons was founded and became the first organized group to take on sudden unexplained death.  This was also the year that The Dutch Humane Society published their instructions for resuscitating drowning victims.  They suggested keeping the victim warm, providing mouth-to-mouth, and once again, the dreaded rectal insufflations.

1770 – In Europe the leading cause of death at the time was drowning.  The Inversion Method became widely used to treat cardiac arrests from drowning.  This involved hanging the victim by his feet, often from a lifeguard tower.  The pressure on the chest would force expiration while it was though the release of that pressure would stimulate inhalation.  Lifeguards typically had to be pretty strong to lift the patients up and down repeatedly.

1773 – In an effort to provide artificial ventilation, the Barrel Method was invented.  The rescuer would lay the victim prone over the length of a large barrel.  He or she would then hold onto the patient by their feet and roll them back and forth.

1803 – The Russian Method was used, which may sound a lot like modern-day induced hypothermia.  This entailed placing the victim’s body under a bed of snow or ice in an attempt to slow metabolism.  Unfortunately, the brain was often left un-cooled, defeating the purpose.

1812 – Lifeguards became equipped with horses; which they kept tied to their lookout towers.  The Trotting Horse Method utilized these horses when a drowning victim presented.  The lifeguard would place the victim face down, draped over the horses back.  The horse would then be led to a trot, up and down the beach.  The bouncing of the victim’s chest on the horses back was thought to provide compression and relaxation.  This was banned in 1815 when citizens complained that their beaches weren’t clean enough.

1849 – A student, M. Hoffa, was the first to witness and document the onset of ventricular fibrillation after inducing it with an electrical stimulus.

1856 – Dr. Marshall Hall challenged conventional wisdom at the time.  He invented The Ready Method; which was aimed at providing artificial ventilation.  The rescuer would roll the patient from a lateral position to the prone position about sixteen times a minute, with pauses to provide pressure while in the prone position to facilitate exhalation.  This method was surprisingly successful for the time.  An article from September of 1859 in the Editor’s Box of the British Medical Journal describes a physician’s use of the method to resuscitate a baby, after he had thought he delivered a stillborn.

1858- The Silvester Method was introduced in an effort to resuscitate stillborn children.  The neonate would be laid supine and their arms would be lifted and then pressed against their chest.  A rate of about sixteen arm lifts per minute was advocated.

1881 – Clara Barton founded the American Red Cross.

1891 – Dr. Friedrich Maass performed the first equivocally documented chest compression on a human being after John Howard wrote about the procedure.

1892 – French authors wrote about the Tongue Method.  The victim’s mouth was held wide open while their tongue was rhythmically pulled back and forth.

1903 – It is reported that Dr. George Crile performed the first successful external chest compression to resuscitate a human.  A year later he performed the first closed-chest cardiac massage in America.

1911 – The first edition of the Boy Scout handbook in the United States contained the Holger Nielsen Technique.  The victim would be laid prone and their arms would be pulled on while pressure would be applied to their back.

1924 – Six cardiologists, representing several groups, founded the American Heart Association.

1932 – Dr. Frank C. Eve created his rocking method.  This entailed using a stretcher with a patient laid on it, almost like a seesaw.  It would be pivoted about its center in an effort to push the diaphragm alternately up then down.  The Royal Navy adopted it during WWII for resuscitation of near-drowning victims.

1947 – Dr. Claude S. Beck, a thoracic surgeon for the University Hospitals in Cleveland, performed the first electrical defibrillation to save a human life.

1952 – Dr. Paul Zoll resuscitated two cardiac arrest patients in Boston by utilizing external defibrillation.

1956 – Peter Safer and James Elam invented mouth-to-mouth resuscitation; after identifying that expired air alone was sufficient enough to provide adequate oxygenation.

1957 – The United States Military adopted mouth-to-mouth resuscitation to revive unresponsive victims.

1960 – W.B. Kouwenhoven, J.R. Jude and G.G. Knickerbocker began to use what was termed Cardiopulmonary Resuscitation or CPR.

1966 – The National Academy of Sciences published a report entitled Accidental Death and Disability: The Neglected Disease of Modern Society, or “the white paper”.  This placed pressure on the government to provide better ambulance services.  This was the year the DOT took over prehospital education standards.

1973 – The American Heart Association and the American Red Cross began an aggressive campaign to teach and instill CPR methods.  The rates and ratios have changed multiple times, but the fundamentals remained the same—ventilations and chest compressions.

1990 – The Chain of Survival became widely advertised by the AHA.

1996 – Emphasis was placed on early defibrillation.

2005 – AHA revisits basic life support, and places much more emphasis on chest compressions.  Therapeutic hypothermia is listed in the AHA guidelines as a potentially beneficial treatment for revived cardiac arrest victims.

Now – Cardiocerbral Resuscitation, or CCR de-emphasizes airway management, and reinforces AHA’s recommendations for better chest compressions.  The impedance threshold device has shown to improve cardiac and cerebral perfusion during CPR.  Evidence supports the transportation of revived cardiac arrest patients to a PCI-capable facility.