New Resuscitation Method Described

Press, Volume C, Issue 29626, 23 September 1961, Page 13

New Resuscitation Method Described

Closed-chest heart massage could offer a change of sur-I viva! where other resuscitation methods had proved of no avail, but the method was likely to be successful onlyin a few cases, said. Dr. S. C. Peddie, yesterday. Dr. peddie returned recently from a tour which included Zurich, Copenhagen, and several cities in Britain and the United States. His main puft pose was to see what new resuscitation methods were being developed overseas, and he will report on these next week to the standing committee on resuscitation of the Internal Affairs Department. Closed-chest heart massage had already been adopted in several hospitals in preference to open-chest massage, said Dr. Peddie. Tn the Broropton Chest Hospital. London, for example, openchest massage was now restricted to cases where the chest was already open on the operating table. Hie new method could be used by trained rescue personnel as well as doctors, he added, whereas open-chest methods had to be restricted except in mass disaster, to surgeons working in oper-ating-theatre conditions. When the heart was restarted by closed-chest massage, it almost invariably began with an erratic beet, and regularity had to be restored by an electric shock technique. This was unsuitable for use except by trained persons. Successful Use. In the United States, Dr. P. Safar told Dr. Peddie of the successful use of cloaedchest cardiac massage at the Baltimore City Hospital. In a series of more than 100 cases. Dr. Safar said, this type of massage gave a “Survival”

> rate (for three hours or i longer) of 62 per cent com- ■ pared with a rate of 24 per cent, in a similar series of cases where open-chest massage was used. Near-normal blood pressures were achieved on "frankly dead" patients. Dr. Safar’s rules for the application of cloeed-chest massage were: (1) Ventilate the lungs first and always. (2) Use a hard resistant surface such as a floor —not a bed. (3) Start within two minutes of death. (4) Use no drugs. (5) The rate of compressions should be about 60 a minute.

Closed-chest massage had to be applied almost to the limit of physical capacity of the person applying it. if it was to be successful, said Dr. Peddie. He had been convinced of this by bloodpressure experiments in Copenhagen and in the United States. In Copenhagen, Dr. H. Ruben, one of the originators of the Ambu Mannikin, had demonstrated on a recently-modified version of the mannikin his physical ability to maintain adequate blood-pressure by closed-chest massage. Disaster Equipment

Using as a basis for his researches the 1956 Hungarian revolt. Dr. Ruben had developed equipment to provide emergency field anaesthesia and resuscitation on a large scale to meet any mass disaster The equipment was minimal in size and complexity and independent of power supply. Laymen could be trained readily in its use. Dr. Peddie discussed the mouto-to-nose resuscitation technique with several eminent research doctors, including Dr. Hossli, of Zurich. Dr. Hossli preferred this technique in general because it was much better than, the mouth-to-mouth method for persons without natural teeth, and because it emphasised to the person applying it the need for the largest possible amount of head tilt for an air-tight seal. Dr. Hossli had found nasal obstruction was very rare, and in almost all cases at least one nostril was open. During his tour, Dr. Peddie saw much anaesthetic and analgesic work. The standard of anaesthetics in Christchurch. thanks to Dr. E. H. H Taylor and his team at Christchurch Hospital, was as high as any he had observed abroad, and better than many. The standard in Christchurch of analgesic services available . for pain relief in labour compared more than favourably with overseas facilities he had seen.