DEAD THREE MINUTES

Rangitikei Advocate and Manawatu Argus, Volume XLII, Issue 11632, 6 September 1918, Page 2

DEAD THREE MINUTES

THEN ' BROUGHT TO LIFE. HEART MASSAGE OPERATION IN AUCKLAND. The currrent issne of the New Zealand Medical Journal includes an article by Dr Garrick Robertson, of Auckland, ■ illustrating the efficacy of heart massage in cases of apparent death under an anaesthetic. The account is of extraordinary interest, in that the man in the case bad been dead at least three, and probably fixe, minutes. This is what Dr Kobertson says, : “A sailor came to the Auckland Hospital with a septic thumb. He was seen in the casualty department when it was decided that tne thumb should be opened under a general anaesthetic. The man was ap patently in good health. The anaesthetic was proceeded with, and when tne man was ‘under’ the house surgeon incised the abscess. As soon as he 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 was no radial pulse, and the respirations were dying away. Artitical respiration was immediately started, and, as I happened not to be in the hospital at the time, I was sent for. On my arrival in the casualty room the man was quite white and there was no heart sounds Arti fi cial respiration was going on, but there was no attempt at voluntary {.respiration. The man seemed quite dead, so I quickly put iodine on the skin ana made an .incision in the upper right rectus region. Introducing “mv baud through this incision, I was able to grasp the heart firmly in my hand, for the diaphragm was so flaccid that this was quite easy. I then waited for a few seconds to see 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 gave a distinct but feeble kick, followed by slow and feeble contractions, which soon became bounding and rapid. At this time the appearane of the man was quite alarming, for owing to the excessive pulsations in all the arteries of the body, he almost seemed to lift off the couch with each beat. We were afraid that there must be clots in the smaller vessels which required this excessive driving force to them along. However, as events showed no embolism or thrombosis took place, the wound was sown up and the man put to bed. On recovery he became maniacal and hid to be put in a restraining sheet. Ho remained in this excited state for 12 hours ;after this he quietened down, hut was quite childish for another day. In two days’ time he was quite normal, but could not remember coming to the hospital or anything that happened for two days afterwards. “I have had several casses of heart massage during the last year or two hut I have never seen so striking an example of its saving powers.. Tha interest of this casa lies particularly in the fact that at the lowest csicu lation this man must have been dead for three minutes, probably five. His mental symptonism I put down tojan 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 burst a cerebral blood vessel during the first five minutes after the heart started to heat again, for I feel sure tnat no arteries at all senilet in type could have withstood such excessive heart action.

‘ ‘The first case of heart massage which 1 tried was upon a man on whom I 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 was made below the'costal margin, as related in the above case. This man aid well, but, of course, the result was not so striking, for a very little time elapsed between the heart stopping and the massage which restored it. In a third case in which this manoeuvre was tried, I am sorry to say it was unsuccessful. “Although heart massage is fairly well known as a possible procedure I have not heard any personal reports on such cases, so I venture to chink the record of these cases may be of interest to the profession in New Zealand. It will be seen that heart massage adds another efficient metnod of dealing with cases of sudden collapse on the operating table. With the experiences recorded above, I am firmly convinced that when the surgeon is sure that the heart has stopped, there should be no excuse for not applyying this procedure; but I should like to emphasise the fact that this should only be done after failure to restcre animation with the usual

restoratives, and, judging from the firat case, it would seem that there is no great hurry, for the heart will respond after a comparatively long latent period ’