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n the 16th of September 2020 we celebrated the 60th anniversary of the combined research of Kouwenhoven, Knickerbocker, Jude and Safar saved millions of lives through the creation of Cardiopulmonary Resuscitation (CPR). From flagellation to burying in snow, the science and techniques to save lives has evolved throughout time, many of these techniques using either chest compressions or ventilation. However, it was not until the late 1950s when two groups of researchers in the city of Baltimore, Maryland combined their findings that the foundations for modern CPR were made. Peter Safar was born in Vienna, Austria in 1924 to a family of physicians, his father an ophthalmologist and his mother a paediatrician. During the political turmoil of the 1930s and the eventual Nazi occupation, Safar because of his non “Aryan” heritage was sent to a labour camp in Bavaria and would’ve been drafted if it was not for his tenacity. Safar found that if he rubbed tuberculin cream into his eczema sores they would become inflamed and noticed by army physicians. Once he successfully avoided being drafted, he began medical school in Vienna and in 1949 was awarded a surgical fellowship at Yale University. Instead, Safar completed an Anaesthesiology residency at the University of Pennsylvania after the realisation that “surgery would not advance without better life support and you learn life support in anaesthesiology.”
60 YEARS OF CPR By Teghan Mear
New Zealand Resuscitation Council
Did you know a dog in cardiac arrest and an unreliable elevator helped discover how to “slow down the dying process” in the 1950s?
ABOVE: Resuscitation for life saving work, Auckland 1935
In 1956 Safar met James Elam who had determined in his research that expired air ventilation was capable of maintaining normal blood gases in patients. This meeting trigged a series of studies which informed Safar’s now famous paper on mouth-to-mouth resuscitation in the Journal of the American Medical Association in 1958. Safar’s experiment determined that mouthto-mouth ventilation was superior to the manual Holger-Nielson. During a presentation at the Scandinavian Society of Anaesthetists meeting in Norway, Safar met Bjorn Lind who knew Asmund Laerdal – a Norwegian toy-maker. A collaboration began after Lind told Laerdal about this new resuscitation technique which resulted in the development and production of “Resusci Anne” in 1960. During this same time period in the 1950s a team of electrical engineers at John Hopkins University in Maryland, were working under William Kouwenhoven. The engineers were trying to improve the external defibrillator, which Kouwenhoven had developed for both internal and external defibrillation in 1933. One day Guy Knickerbocker, a 29-year-old graduate was working in the lab and one of the animal model dogs went into cardiac arrest. Normally when this happened, they would use a defibrillator to shock the dog’s heart back into rhythm - but that day they were in the lab on the 12th floor and the equipment was on the fifth floor. The notoriously slow elevators in the building meant they would never get the defibrillator to the dog in time, the team began chest compressions. It was noted that adequate circulation could be
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