Measured Progress in Cardiopulmonary Resuscitation.

Abstract

> “…inspiration is easy. Implementation is the hard part.” > > –Bob Taylor, Taylor Guitars Eight months after Kouwenhoven et al1 published their 1960 landmark report of successful closed chest cardiac compressions for 2 children and 2 adults who developed perioperative cardiac arrest,1 a cardiologist provided that same closed chest cardiopulmonary resuscitation (CPR) in the operating suite after my 4-year-old brother experienced cardiac arrest during induction of anesthesia. My brother is alive today because of published resuscitation science applied to practice. In 1961, Peter Safar proposed combining mouth-to-mouth ventilation with closed chest compressions in a poster for the Pennsylvania chapter of the American Heart Association (AHA), and the ABCs of CPR were born. In 1966, the National Academy of Sciences–National Research Council conference on CPR charged the AHA with teaching CPR to healthcare providers. In 1973, the second conference on CPR and Emergency Cardiovascular Care recommended expanding teaching of CPR to the lay public. This conference also recommended that the AHA establish resuscitation guidelines based on scientific data and develop standards for basic and advanced life support training. The American Red Cross and other organizations, such as the Citizen CPR Foundation, soon supported the lay rescuer CPR training effort. Great enthusiasm existed for the potential of CPR, but little scientific data on which to base recommendations, with more emphasis on teaching CPR skills than on measuring CPR outcomes. By 1991, the chain of survival provided a metaphor for the priorities of resuscitation and training, emphasizing early bystander recognition of cardiac arrest and access to the emergency medical …