CPR Can Be A True Life Saver In Many Cases

February 5, 2023 at 8:30 p.m.


The recent report about Damar Hamlin, the Buffalo Bills player whose heart stopped during a game in Cincinnati on Jan. 2, became prominent in all the news media and sports reporting.

According to one of the physicians,  Hamlin died that day.  He fortunately came back to life due to heroic and rapid medical attention performed on the field of play.  Such an event would not have been possible prior to 1958.  Before then, there was no such thing as cardiopulmonary resuscitation (CPR).  If someone’s heart had stopped because of cardiac arrest, that person fell to the ground, with no pulse and no breathing.  They were simply declared dead.  

History

In 1957, with a flash of inspiration that envisioned the life-saving potential of forcefully applying one hand pressed palm down on another in the middle of a patient’s chest, cardiac surgeon James Jude became one of three men credited with making Johns Hopkins Hospital the birthplace of CPR.

Tens of thousands of people today who suffer cardiac arrest beyond the reach of an electronic defibrillator owe their lives to him.  A surgery intern, resident and fellow before joining the faculty, Jude had been observing the work of his fellow CPR pioneers, electrical engineers William Kouwenhoven and Guy Knickerbocker, as they perfected the development of a closed chest heart defibrillator and first applied it to a patient in 1957. In earlier experiments in dogs, Knickerbocker noticed that even before the defibrillator’s electric shock was applied to an animal’s arrested or irregularly beating heart, a slight rise in blood pressure occurred when the electrodes were pressed on the dog’s chest.  

Jude called this wonderfully “chance observation to a fertile young mind.” He immediately recognized that the discovery could be developed into a method for external cardiac massage – a means not only of restarting a stopped heart but keeping it beating long enough to sustain a patient’s survival until additional treatment could be provided.  

In 1958, both Jude and another Johns Hopkins surgeon, Henry Bahnson, were the first to successfully resuscitate patients with external cardiac massage.  Their work effectively ending a previously drastic measure used at Johns Hopkins of quickly cutting open a dying patient’s chest and cracking the sternum to rhythmically squeeze a faltering heart by hand.

What Is CPR

CPR is comprised of chest compressions, airway management and rescue breathing. To deliver high-quality CPR, you must begin high-quality chest compressions quickly, as these are considered the most important factor in giving the person a chance to recover. Compressing the chest circulates blood to the brain and the heart. High-quality chest compressions are delivered at a rate between 100 to 120 beats per minute and at a depth between 2 to 2.4 inches (5 to 6 cm).  

Because Hamlin was not responding, breathing or only gasping, CPR was administered. The medical team administered  30 compressions at a rate of 100 to 120 beats per minute and at a depth between 2 to 2.4 inches (5 to 6 cm).

Giving breaths during CPR can help maintain a supply of oxygen in the lungs. Oxygen, in turn, is circulated to the brain and to the vital organs by chest compressions and subsequent application of the automated external defibrillator  (AED).  Research studies have suggested that survival does not require mouth-to-mouth resuscitation, a technique first recommended for drowning victims by the Paris Academy of Science in 1740. Most patients whose hearts stop have enough oxygen in their blood to survive if blood can be pumped through their bodies and, especially, to their brain.  Now CPR is hands only.

How Important Is CPR

It is critically important to learn CPR. If a person is unresponsive and there is no breathing or pulse beat, they are going to die without it.  More important, it is highly unlikely you will make the situation worse.  

There are good Samaritan laws in all 50 states that protect bystanders. And the federal Cardiac Arrest Survival Act, signed into law in 2000, provided civil immunity for users of AEDs.  When someone is unresponsive, consent to CPR is implied.

Final Thoughts

Cardiac arrest is not the same as a heart attack that occurs when blood flow in an artery feeding the heart is blocked.  Outside of a hospital, more than 300,000 people a year have a cardiac arrest, also known as sudden cardiac death. The survival rate for those who have cardiac arrests outside of hospitals and like Damar Hamlin, have bystander CPR, the rate is just 11.2%.

For the few like Hamlin who receive immediate defibrillation, survival rises to 41%. In addition, brain damage is likely if the person in cardiac arrest goes 4 to 6 minutes without CPR, and brain death occurs after just 10 minutes. Only 8% of cardiac arrest survivors emerge with a good neurological outcome. Hamlin appears to be one of the fortunate ones.

Max Sherman is a medical writer and pharmacist retired from the medical device industry.  His new book “Science Snippets” is available from Amazon and other book sellers. It contains a number of previously published columns.  He can be reached by email at  [email protected]

The recent report about Damar Hamlin, the Buffalo Bills player whose heart stopped during a game in Cincinnati on Jan. 2, became prominent in all the news media and sports reporting.

According to one of the physicians,  Hamlin died that day.  He fortunately came back to life due to heroic and rapid medical attention performed on the field of play.  Such an event would not have been possible prior to 1958.  Before then, there was no such thing as cardiopulmonary resuscitation (CPR).  If someone’s heart had stopped because of cardiac arrest, that person fell to the ground, with no pulse and no breathing.  They were simply declared dead.  

History

In 1957, with a flash of inspiration that envisioned the life-saving potential of forcefully applying one hand pressed palm down on another in the middle of a patient’s chest, cardiac surgeon James Jude became one of three men credited with making Johns Hopkins Hospital the birthplace of CPR.

Tens of thousands of people today who suffer cardiac arrest beyond the reach of an electronic defibrillator owe their lives to him.  A surgery intern, resident and fellow before joining the faculty, Jude had been observing the work of his fellow CPR pioneers, electrical engineers William Kouwenhoven and Guy Knickerbocker, as they perfected the development of a closed chest heart defibrillator and first applied it to a patient in 1957. In earlier experiments in dogs, Knickerbocker noticed that even before the defibrillator’s electric shock was applied to an animal’s arrested or irregularly beating heart, a slight rise in blood pressure occurred when the electrodes were pressed on the dog’s chest.  

Jude called this wonderfully “chance observation to a fertile young mind.” He immediately recognized that the discovery could be developed into a method for external cardiac massage – a means not only of restarting a stopped heart but keeping it beating long enough to sustain a patient’s survival until additional treatment could be provided.  

In 1958, both Jude and another Johns Hopkins surgeon, Henry Bahnson, were the first to successfully resuscitate patients with external cardiac massage.  Their work effectively ending a previously drastic measure used at Johns Hopkins of quickly cutting open a dying patient’s chest and cracking the sternum to rhythmically squeeze a faltering heart by hand.

What Is CPR

CPR is comprised of chest compressions, airway management and rescue breathing. To deliver high-quality CPR, you must begin high-quality chest compressions quickly, as these are considered the most important factor in giving the person a chance to recover. Compressing the chest circulates blood to the brain and the heart. High-quality chest compressions are delivered at a rate between 100 to 120 beats per minute and at a depth between 2 to 2.4 inches (5 to 6 cm).  

Because Hamlin was not responding, breathing or only gasping, CPR was administered. The medical team administered  30 compressions at a rate of 100 to 120 beats per minute and at a depth between 2 to 2.4 inches (5 to 6 cm).

Giving breaths during CPR can help maintain a supply of oxygen in the lungs. Oxygen, in turn, is circulated to the brain and to the vital organs by chest compressions and subsequent application of the automated external defibrillator  (AED).  Research studies have suggested that survival does not require mouth-to-mouth resuscitation, a technique first recommended for drowning victims by the Paris Academy of Science in 1740. Most patients whose hearts stop have enough oxygen in their blood to survive if blood can be pumped through their bodies and, especially, to their brain.  Now CPR is hands only.

How Important Is CPR

It is critically important to learn CPR. If a person is unresponsive and there is no breathing or pulse beat, they are going to die without it.  More important, it is highly unlikely you will make the situation worse.  

There are good Samaritan laws in all 50 states that protect bystanders. And the federal Cardiac Arrest Survival Act, signed into law in 2000, provided civil immunity for users of AEDs.  When someone is unresponsive, consent to CPR is implied.

Final Thoughts

Cardiac arrest is not the same as a heart attack that occurs when blood flow in an artery feeding the heart is blocked.  Outside of a hospital, more than 300,000 people a year have a cardiac arrest, also known as sudden cardiac death. The survival rate for those who have cardiac arrests outside of hospitals and like Damar Hamlin, have bystander CPR, the rate is just 11.2%.

For the few like Hamlin who receive immediate defibrillation, survival rises to 41%. In addition, brain damage is likely if the person in cardiac arrest goes 4 to 6 minutes without CPR, and brain death occurs after just 10 minutes. Only 8% of cardiac arrest survivors emerge with a good neurological outcome. Hamlin appears to be one of the fortunate ones.

Max Sherman is a medical writer and pharmacist retired from the medical device industry.  His new book “Science Snippets” is available from Amazon and other book sellers. It contains a number of previously published columns.  He can be reached by email at  [email protected]

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