A short history of cardiopulmonary resuscitation: from ancient myths to ourpresent days 1

Overview

Since the re-discovery of chest compressions and ventilation with expired air nearly 40 years ago, this essential and standard method of BCLS hasnot changed significantly. Reliable data from laboratory and clinical studies such on arterial pressure, coronary perfusion pressure, cardiac outputor neurologically intact survival is necessary for the evaluation of any new method and will determine if a „new“ technique or device can replaceS-CPR in the future. We must take into account that laboratory data are derived from „healthy“ animals with a relatively short duration of inducedcardiac arrest – this situation cannot be transferred to clinical practice. Obviously, the immediate start of CPR by lay bystanders seems to be sopredominant for the patient’s outcome that failures at the beginning of the „chain of survival“ cannot be compensated by sophisticated techniques ordevices or high-tech intensive care. We have to continue our efforts to intensify training programmes for wide parts of the population, otherwise, wecannot expect significant improvement of survival after out-of-hospital cardiac arrest. A promising concept may be the integration of „First Aid“ andBCLS in school teaching – not only in respect of to teaching the techniques, but also the mediation of BCLS as an essential part of social behaviourand responsibility.If these concepts and efforts should fail in the years to come, we have to accept these frustratingly low levels of successful resuscitation after suddencardiac arrest. Perhaps we subconsciously fear a scenario Johann Wolfgang von Goethe (1749– 1832) described 200 years ago in a famous letter toMrs. von Stein: „I believe it’s true that humanity will conquer in the end; but I also fear that the word will develop to a great hospital in which we areall our mutual nurses“.

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