CPR, 2000 years ago

  According to statistics, about 540,000 people die of cardiac arrest in my country every year, which is equivalent to 1 death from cardiac arrest every minute, 80% of which occur outside the hospital. Within 4 minutes of cardiac arrest, about 50% of patients can be rescued if the correct CPR is administered. In modern cardiopulmonary resuscitation, the rescuer performs chest compressions on the patient with bare hands, squeezing the heart and lungs, forcing the heart and lungs to move rhythmically, helping the patient to carry out the circulation of cardiopulmonary function, and restoring spontaneous breathing and spontaneous circulation.
  The invention and perfection of cardiopulmonary resuscitation have gone through thousands of years of history. The ancients observed that dead patients resembled sleep, so they would use arousal and stimulation to terminate or reverse the process of death. The ancients of our country mostly used the methods of calling patients, acupuncture at “Renzhong” and “Yongquan” acupoints; ancient Western societies effectively called, smelled volatile substances (such as ether, etc.), bitten, whipped, and even scalded, bellows blowing Qi, handstand, barrel roll and other methods. From the point of view of modern medicine, these can only judge the patient’s state of mind, and can not play the role of cardiopulmonary resuscitation, and some methods will bring more harm to the patient.
  By the 1st century AD, Zhang Zhongjing and Hua Tuo both put forward the enlightenment theory of chest compression in historical books. Zhang Zhongjing’s “Essentials of the Golden Chamber” records the “Prescription for Rescue from Hanging Death”. The first aid process covers the basic techniques of modern cardiopulmonary resuscitation, especially its first aid concept of “equal attention to body and mind”, which is still an important guide in modern resuscitation. Principle: It is necessary to ensure both cardiopulmonary resuscitation and protection of brain function. Hua Tuo also has a similar description in the “Hua Tuo Notes”. Chao Yuanfang of the Sui Dynasty wrote “On the Origin and Symptoms of Diseases”, which pointed out that in cardiopulmonary resuscitation, it is equally important to restore breathing and circulation. By the Ming Dynasty, cardiopulmonary resuscitation technology was not only developed, but also popularized among the people. During the Qing Dynasty, many first aid monographs were published, and Chinese cardiopulmonary resuscitation techniques were also spread to neighboring countries such as Japan, and were widely accepted.
  Western modern cardiopulmonary resuscitation, originated from drowning first aid. The earliest dates back to 1767, Amsterdam, the Netherlands established the “Association to Save the Drowning”. The association claimed four years later that they had saved 150 drownings. The main methods are the following 7 steps: raise the body temperature of the drowning person; remove the residue and swallowed water from the drowning person’s mouth with a head-down position; forcefully press the drowning person’s abdomen; blow with a mouth-to-mouth or manual air bag The drowning person was given assisted breathing by means of breathing (the hygiene concept was established at that time, it was recommended to cover the drowning person’s mouth with a handkerchief or clothing before mouth-to-mouth artificial respiration); scratching the drowning person’s throat; stimulating the tide by smoking (injecting air from the mouth or anus); exsanguination. The first 4 methods, modern first aid measures are still used, and the latter 3 methods have been proved to be ineffective. But at the time, many European countries followed suit.
  The development of cardiopulmonary resuscitation had to mention chloroform as an anesthetic. It’s not a pungent anesthetic, but it can sometimes depress the heart muscle, causing hypotension, shock, and even death. In 1887, Dr. Langenbach, who encountered this problem at the Lazarus Hospital in Berlin, boldly applied the cardiac massage method in animal experiments to a patient whose heart stopped beating by inhaling chloroform during surgery. He cut open the patient’s chest cavity and performed “heart massage” directly inside his body with his hands. Although the patient’s life was not saved, his report attracted many surgeons in Europe to follow suit.
  At the same time, Sweden’s Dr. Krasko used the “cardiac massage without opening the chest” proposed by German physician Koenig to successfully rescue a 5-year-old boy who was in shock after inhaling chloroform during surgery. This case was quickly promoted in Germany, resulting in more success stories. In the middle of the 19th century, cardiopulmonary resuscitation developed many “chestless heart massage techniques”, such as alternate lateral abdominal recumbency, gymnastic breathing, and intermittent back compression.
  By 1958, Blalock, director of the Department of Surgery at Johns Hopkins Hospital in the United States, approved his two physicians to perform chest compressions in the operating room for patients in shock due to anesthesia, resulting in 20 consecutive patients. All patients were successfully rescued. Motivated by these successful experiences, the United States, under the promotion of the Red Cross, applied this first aid method to many patients who fainted outside the hospital.
  In 1960, it was an important node for CPR. William Covenhofen, an electrical engineer at the Johns Hopkins Hospital, first proposed the use of mouth-to-mouth artificial respiration, extracorporeal cardiac massage and extracardiac electric shock to help patients suffering from cardiac arrest, and started modern cardiopulmonary resuscitation. (CPR) era. At the same time, the American Heart Association has developed a standardized procedure for first aid, which is officially called “CPR”. Of course, it includes not only heart massage, but also mouth-to-mouth artificial respiration and other important first aid measures. In 1972, the United States began to promote CPR on a large scale, and in 1981, it began to provide on-site first aid by telephone and online, which greatly improved the survival rate of sudden cardiac death.
  Since 1990, the United States began to promote the automatic external defibrillator (AED), making AED+CPR into the public community, which can greatly solve the sudden cardiac death caused by ventricular fibrillation and improve the survival rate. Defibrillation is timely, and its survival rate will increase in minutes. In addition to the application of instruments, the rescue methods of CPR are also constantly updated. It is expected that more effective CPR techniques will be developed in the future to save more cardiac arrest patients.