Manual Artificial Respiration Research Articles

Edward Schafer (1850–1935) and artificial respiration

In 1861 the Royal Medical and Chirurgical Society of London set up a series of committees to examine different methods of manual artificial respiration for use in apparent drowning. In 1903 Edward Schafer, then Professor of Physiology at Edinburgh and chairman of the fourth committee, described his own prone-pressure method which, on the basis of recorded respiratory minute-volumes, was superior to other methods and subsequently was employed worldwide for nearly 50 years.

Artificial respiration; theory and applications.

<i>Artificial Respiration, Theory and Applications</i>, as edited by James L. Whittenberger, MD, from the works of 15 authors, is well written and makes for fast, clear, and easy reading and understanding. The theories and mechanics of respiration are described well and the different phases are fully covered. There are many illustrations to clarify any questions the reader may have about theory or mechanics. Part One deals with the physiology of respiration, in which the exchange of gases is explained definitely and briefly. The pulmonary and systemic circulations and their functions in respiration are well presented. Part Two deals with the different techniques of artificial respiration and discusses their good and bad features. Methods of manual artificial respiration are explained by word and picture, the mouth-to-mouth or mouth-to-nose seemingly preferred. The open airway is stressed as being absolutely essential, in this as in all other techniques. The different mechanical methods are

Pulmonary ventilation and respiratory gas exchange during manual artificial respiration and expired-air resuscitation on apnoeic normal adults. A comparison of the Holger Nielsen method and the mouth-to-mouth method.

SUMMARY Comparative experimental studies on resuscitation by the mouth‐to‐mouth and Holger Nielsen (back‐pressure arm‐lift) methods are reported. The experiments were performed on five normal unconscious apnoeic adults and extended over periods of from 20 to 40 minutes. Tidal air, minute volume and alveolar ventilation/min. were determined pneumographically and/or spirometrically and/or volumetrically. The oxygen saturation and carbon dioxide tension of the arterial blood were determined during the experiments. Sufficient alveolar ventilation with normal arterial oxygen saturation and PCO2 was obtained by the mouth‐to‐mouth method in four out of five cases. In one case, hypoventilation occurred during the performance of the mouth‐to‐mouth method. Sufficient alveolar ventilation with normal arterial oxygen saturation and constant PCO2 was obtained by the Holger Nielsen method in one out of five cases. In four cases, variable degrees of hypoventilation occurred during the performance of the manual manoeuvres with an increase in the PCO2 of the arterial blood. However, an arterial oxygen saturation of more than 80% was maintained throughout the experimental period (30–40 minutes), although resuscitation with atmospheric air was given during the greater part of the period. The advantages and disadvantages of the two methods are discussed. Maintenance of a patent airway during artificial respiration must be considered to constitute a conditio sine qua non. If the Holger Nielsen method is to produce sufficient alveolar ventilation in the field, the respiratory frequency must be 15–16 breaths per minute, and the victim's head should be bent backwards (extension in the atlanto‐occipital joint). The authors are unable to recommend one of the two methods as being superior to the other in adults, but agree with the American investigators in their recommendation of the mouth‐to‐mouth method in infants and small children. The view is expressed that it would be desirable to train the general population as “two‐method” resuscitation operators.

A comparison of mouth-to-mouth and manual artificial respiration techniques

Chemical, industrial, and mechanical progress have increased the incidence of cases requiring artificial respiration in industrial, military, and civilian spheres. The danger from electricity is a potent factor in all of these situations.

Mouth-to-mouth versus manual artificial respiration for children and adults.

In the field of manual artificial respiration, a general crystallization of ideas occurred several years ago as a result of extensive research on adult human subjects.¹This led to acceptance of "push-pull" manual resuscitation methods on a national basis. The results of these investigations were also applied to infants and small children although comparable specific data were not available for these age groups. Many manual methods have been proposed for children, but there has never been a controlled, comparative study of their efficiency. In October, 1955, a technique for resuscitation of infants and small children by means of manual tilting on the forearm of the rescuer was recommended by Rickard.²In essence, he utilized the principle of the Eve rocking method.³An important addition was use of the rescuer's finger in the victim's mouth to provide a "continuous digital airway." This interesting suggestion was not supported by

MANUAL ARTIFICIAL RESPIRATION IN THE SITTING POSTURE

MANUAL ARTIFICIAL RESPIRATION IN THE SITTING POSTURE

Evaluation of methods of resuscitation

The anaesthetist is well qualified as a specialist to train other doctors and lay personnel in methods of resuscitation. A plea is set forth for a widespread training programme. The prevention and treatment of respiratory obstruction can be a life-saving procedure in itself, and simple methods for maintaining a clear airway are described. Cases of severe respiratory obstruction in imminent danger of death can be saved by the introduction of a number fourteen trocar through the crico-thyroid membrane, thus providing more ideal conditions for a low tracheotomy. The time factor is insisted upon in starting manual artificial resuscitation in drowning victims. Should apparent cardiac arrest accompany cessation of respiration, simple methods of heart stimulation are recommended to be applied simultaneously with artificial respiration. In an emergency, artificial respiration should be started with immediately available methods such as manual artificial respiration or mouth to mouth breathing. It is explained that mechanical methods of artificial respiration are intended to replace the operator who has initiated resuscitation by manual methods. Different types of mechanical devices are described and the advantages of self-contained units not requiring a source of compressed air or oxygen to become operative, are made evident. It is suggested that a bag and mask device be incorporated in all types of automatic resuscitators to meet individual exigencies of lung compliance. The use of a Nomogram for patients undergoing long-term maintenance of artificial respiration in a tank respirator is a simple practical means of avoiding consequences of overventilation or hypoventilation. Cuirass type respirators and the rocking bed are considered as weaning devices and are not recommended for use in apneic patients with low lung or thoracic compliance. A new type of infant resuscitator incorporating the Fink modification of the Stephen-Slater valve is presented and described. The resuscitator is a selfcontained easily transportable unit which is simple in design and operation. It is intended for routine use and is operated at controlled pressures. It is not to be confused with the G.B.L. hand resuscitator which operates at high mask pressures and time limited impulses.

Critical survey of manual artificial respiration.

In recent years numerous studies have punctuated the growing belief that newer methods of manual artificial respiration are superior to the commonly used Schafer prone pressure method. Experimental data emanating from a broad spectrum of laboratories 1 have indicated a general agreement regarding the low ventilatory efficiency of prone pressure in comparative studies. The observations of Comroe and Dripps 2 on apneic hospital patients confirmed this finding and reawakened interest in manual artificial respiration. The extensive tests of Gordon and associates on warm corpses 3 and on curarized-anesthetized normal human adults 4 have further aided in crystallizing the issue. The interest of the American National Red Cross, American Medical Association, public utilities and various other national groups has stimulated an attempt to resolve this dilemma. The Department of Defense has assumed the sponsorship of an integrated research program for the critical evaluation of several candidate methods under a variety of

Manual artificial respiration, pedagogical and fatigue factors involved in its use.

ARTICLESManual Artificial Respiration. Pedagogical and Fatigue Factors Involved in Its UsePeter V. Karpovich, and Creighton J. HalePeter V. Karpovich, and Creighton J. HalePublished Online:01 Dec 1951https://doi.org/10.1152/jappl.1951.4.6.472MoreSectionsPDF (557 KB)Download PDF ToolsExport citationAdd to favoritesGet permissionsTrack citations ShareShare onFacebookTwitterLinkedInWeChat Previous Back to Top Next Download PDF FiguresReferencesRelatedInformation More from this issue > Volume 4Issue 6December 1951Pages 472-475 https://doi.org/10.1152/jappl.1951.4.6.472PubMed14907564History Published online 1 December 1951 Published in print 1 December 1951 Metrics

Air-flow patterns and pulmonary ventilation during manual artificial respiration on apneic normal adults. II.

Air-flow patterns and pulmonary ventilation during manual artificial respiration on apneic normal adults. II.

Energy expenditure of operators during manual artificial respiration. IV.

Energy expenditure of operators during manual artificial respiration. IV.

Comparison of methods for performing manual artificial respiration on apneic patients.

ARTICLESComparison of Methods for Performing Manual Artificial Respiration on Apneic PatientsRobert G. Nims, Eugene H. Conner, Stella Y. Botelho, and Julius H. Comroe JR.Robert G. Nims, Eugene H. Conner, Stella Y. Botelho, and Julius H. Comroe JR.Published Online:01 Dec 1951https://doi.org/10.1152/jappl.1951.4.6.486MoreSectionsPDF (1 MB)Download PDF ToolsExport citationAdd to favoritesGet permissionsTrack citations ShareShare onFacebookTwitterLinkedInWeChat Previous Back to Top Download PDF FiguresReferencesRelatedInformation Cited ByVentilation caused by external chest compression is unable to sustain effective gas exchange during CPR: a comparison with mechanical ventilationResuscitation, Vol. 28, No. 2“Re-evaluation” of CPRResuscitation, Vol. 20, No. 1The experimental development of modern resuscitationResuscitation, Vol. 1, No. 1RESCUE BREATHINGThe Lancet, Vol. 274, No. 7092ARTIFICIAL RESPIRATIONThe Lancet, Vol. 272, No. 7040OOPHORECTOMY AND BREAST CANCERThe Lancet, Vol. 272, No. 7040 More from this issue > Volume 4Issue 6December 1951Pages 486-495 https://doi.org/10.1152/jappl.1951.4.6.486PubMed14907566History Published online 1 December 1951 Published in print 1 December 1951 Metrics

Pedagogical and performance factors of manual artificial respiration with naval personnel. V.

Pedagogical and performance factors of manual artificial respiration with naval personnel. V.

Phenomenon of Asphyxial Resuscitation. Resuscitation with Inert (Asphyxiating) Gases

In a study of the various resuscitation procedures in advanced asphyxia, over a hundred experiments were carried out in 43 dogs. During this work, it was observed that in the third phase of asphyxia (cessation of respiration and rapidly falling blood pressure), complete resuscitation of the heart and respiration can be quite regularly produced by rhythmic alternating insufflation and suction with an inert gas (nitrogen, helium), which had just been used to produce the asphyxia. Asphyxial resuscitation was administered at a rate of 15-20 complete strokes per minute, using a positive phase of + 14 mm Hg and a negative phase of −9 mm Hg. This resuscitation was continued until the first spontaneous respiration occurred and was then immediately discontinued and the animal allowed to breathe atmospheric air. (Fig. 1.) The animals were anesthetized by intraperitoneal injection of nembutal (1 cc per 5 pounds). They were then asphyxiated by (1) obstructive (strangulation) asphyxia, or (2) nitrogen, helium, or nitrous oxide inhalation. Either a specially-fitting face mask and pharyngeal airway were used or else a special intratracheal catheter with inflation cuff to prevent leakage. If asphyxia be allowed to reach the third phase (cessation of respiration, rapidly falling blood pressure), the animal ordinarily dies; but if asphyxial resuscitation be applied in this third phase at periods from one-half to 2 3/4 minutes after cessation of respiration, permanent resuscitation of the heart and respiration can be accomplished quite regularly. Asphyxial resuscitation, using inert gas, was produced by manual artificial respiration in 15% of the animals, produced by rhythmic positive insufflation in 17%, and produced by rhythmic suction in 20% of the animals. This phenomenon, however, was produced in 85% of the experiments where the combination of rhythmic insufflation and suction was used. (Table I.)

The Best Method of Manual Artificial Respiration

(1941). The Best Method of Manual Artificial Respiration. Research Quarterly. American Association for Health, Physical Education and Recreation: Vol. 12, No. 1, pp. 50-60.

Some comments on manual artificial respiration and a proposed new method

Acta Medica ScandinavicaVolume 103, Issue 6 p. 539-546 Some comments on manual artificial respiration and a proposed new method PALM PRæST, PALM PRæST St. Joseph's Hosp. med. dept. Copenhagen. Chief: Senior Physician, Dr. med. H. HansborgSearch for more papers by this author PALM PRæST, PALM PRæST St. Joseph's Hosp. med. dept. Copenhagen. Chief: Senior Physician, Dr. med. H. HansborgSearch for more papers by this author First published: January/December 1940 https://doi.org/10.1111/j.0954-6820.1940.tb09054.xAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Volume103, Issue6January/December 1940Pages 539-546 RelatedInformation