LIFE-SAVING AFFAIRS

Wanganui Chronicle, Volume 79, Issue 59, 10 March 1936, Page 6

LIFE-SAVING AFFAIRS

RESUSCITATION METHODS HOLGER-NTELSON AND SCHAFER. Some months a o o m.l.a , rculated in New Zealand regarding the Holger Nielson method of resuscitation of "the apparently drowned, but further advice from tne headquarters the Koval Life-Saving Society- in lu Hand indicates that the method nas 1,,-eii thoroughly investigated and is not , recommended as compared with tne adopted Schafer method. The following letter to the bon. secretary of the New Zealand Council from Mr. A. U. I’Handover, vice-president of the Royal l.'fe saving Society, speaks for itself:With reference to the Holger-Nielson Method and your question thereon. \ t>«Jr article was an almost verbatim , npv of that published in this country in Julv. I have already told you a >ub committee of four was set up to consider it; and tne vice-chairman of r r Central' Executive spent a week in Copenhagen in early November to study ;t and came back deeply impressed. The sub-committee met last Wednesday to discuss the Holger Nielson Method in full detail, both for and against. Steadily ccrta.ii features ♦•in€r' , ed and led us to recommend that l ie Holger Nielson Method be not accepted tor tuition by the society. Only one reason will be stated can ially for its non-acceptance and that i the briefest wording which I will expand s.nce 'ou are so interested. In case? of drowning the small Lrcn- ■ doles and especially the air ?o s arc j blocked by a churned froth of w»hri and mucus. As the air-sac is the only | area of the Jung capable of pr.j.iding of or O and UO2 exchange, these must ' be cleared to allow of recuveiy. Sticii . a r-?acs as remain sealed Yorn iuci..= i for •*secondary pneumonia* 7 a common J complication after drowning. A consideration of the Holger-Niebu i Method and I am assuming you are cognisant of its details i shows that its ! chief emphasis is on * * inspiri. 10.1. This intake of fresh air is iue to snchest rapacity but the air is • hipfly taken into the upper air passages from which diffusion is made d’fn uk by the sticky froth blocking the finer branches. The following shoe! b r pressure expels this extra air just taken in. leaving rhe air sacs little or no better off. Thus we feel that there is but slight chance of the vitiated air i . the ah eoli being quickly purified or thp tubes cleared. Especiallv is this .- » ’• r tnose alvcoi in distance parts of the lungs as at the border of the diaThe stronger inspiration with the weaker expiration would tend to slow up drainage of the bronchial lubes. Tn Schafer the emphasis is mi or sure causing expiation so that the contents of the lungs are forced out and later air flows in. This diaphragm pressure is exerted on the pliable substance of the lung (i.c.. the material forming the air sacs * and hence directly helps to clear the air-sacs. The figures quoted in the article you sent are likely to cause some concern until their corrected values are known. Perhaps the following three points will show the value of the figures in the 1. The prone pressure method used: - Fro.n Danish articles on the Holger Nielson Method it became evident to me that the Sehafer Method used in Denmark varied from our own. Hence 1 asked our representative to ask to see it done and report on it. This report showed that the hands ere placed on the back of the chest nigh up towards the shoulder blades, higher up even than in our old handbook: This materially lessens the efficiency of the method in air-ex-change. Even then the ventilation per respiration quoted for Schafer in Danish medica reports is given as “aOc.r. whereas tidal air requirements average oOOe.c. see present hand nook . For the Holger-Nielson Method the figure quoted is 1,100c.c. a*, erage. 2. Speed of working: From Schafer’s original work it became established that the ventilation per minute was a ’ cry important factor. Thus tho speed of working must be considered. The article you sent gave the speed for Schafer used at 9.4 per minute and the results were calculated upon that. But the older