THREE MINUTES DEAD.

Auckland Star, Volume XLIX, Issue 207, 30 August 1918, Page 2

THREE MINUTES DEAD.

THEN BROUGHT TO LIFE. HEART MASSAGE OPERATION IN AUCKLAND. The current issue of the "'New Zealand Medical Journal" includes an article by Dr. Carrick Robertson, of Auckland, illustrating the efficacy of heart massage in eaees of, apparent death under an anaesthetic. The account is of extraordinary interest, in that the man in the ease had been dead at least three, and probably five, minutes. This Jis what Dr. Robertson says:— "A sailor came to the Auckland Hospital with a ecptic thumb, lie wae seen in the casualty department, when it was decided that the thumb should be opened under a general anaesthetic The man was apparently in good health. The anaesthetic was proceeded with, and when the man was 'under,' the house eurgeon incised the abscess. Ag Boon ac lie had done this he noticed that no bleeding took place from the incision this was the first intimation he had that the man's heart had stopped. It was then discovered that there wae no radial pulse, and the respirations were dying away. Artificial respiration wae immediately started, and. ae I happened to be in the hospital at the time, I was sent for. On my arrival in the casualty room the man wee quite white and there were no heart sounds. Artificial respiration wae going on, but there wae no attempt at voluntary respiration. The man eccmed quite dead, co I quickly put iodine on the skin and made an incision in the upper right rectus region. Introducing my hand through this incision, I wae able to grasp the heart firmly in my hand, for the diaphragm was so flaccid that this wae quite easy. I then waited for a few seconds to ccc if there was any muscular movement in the heart, but could feel none, so I squeezed the heart between the hand and the ribs several times, whereupon it (rare a distinct but feeble kick, followed by Blow and feeble contractions, which soon became bounding and rapid. At this time the appearance of the man was quite alarming, for owing to the excessive pulsatione in all the arteries of the body, he almost seemed to lift off the couch with each beat. We were afraid that there muet be clots in the smaller veseele which required this excessive driving force to push them along. However, as events showed no embolism or thrombosis took place, the wound was eewn up and the man put to bed. On recovery he became maniacal and had to be put in a restraining-ehect. He remained in this excited state for twelve hours; after thir. he quietened down, but wae quite childish for another day. In two days' time he was quite normal, but could not remember coming to the hospital or anything that had happened for two days afterwards. "• T have had several cases of heart massage during the last year or two, but I have never seen so striking an example of its saving powers. The interest of this case lies particularly in the fact that at the lowest calculation this man must have been dead for three minutes, probably five. His mental symptoms I put down to an oedema of the brain supervening on the stasis of the circulation. I think it was only because he was a comparatively young man (34 years) that he did not buret a cerebral blood vessel during the lirst five minutes after the heart started to beat again, for I feel sure that no arteries nt all senile in type could have withstood such excessive heart action. " The firet case of heart massage which 1 tried was upon a man on whom T was operating for appendicitis. His heart stopped after I had made the appendix incision, and as I could not reach the heart from this incision another wan made below the costal margin as related in the above case. Thie man did well, but, of course, the result was not co striking for a very little time elapsed between his heart stopping and trie mas> sage which restarted it. In a third case in which this manoeuvre was tried I am 6orry to cay it was unsuccessful. " Although heart massage is fairly well known as a possible procedure, I have not heard any personal reports of such crises, bo T venture to think the record of these caws may be of interest to the profession in New Zealand. It will be seen that heart maesnge adds another efficient method of dealing with ensee of sudden collapse on the operating table. With the experiences recorded ahove I am firmly convinced that when the surgeon is mire that the heart has stopped ther should be no excuse for not applying this procedure: but T should like to emphasise the fact that this should only be done nfter failure to restore animation with the usual restoratives, and, judainff from the first case, it would seem that there is no great hnrry, for the heart will respond after a comparatively long latent period.'