When cardiac arrest occurs, either as standstill or as ventricular fibrillation, the circulation must be restored promptly; otherwise anoxia will result in irreversible damage. There are two techniques that may be used to meet the emergency: one is to open the chest and massage the heart directly and the other is to accomplish the same end by a new method of closed-chest cardiac massage. The latter method is described in this communication. The closed-chest alternating current defibrillator1 that was developed in our laboratories has proved to be an effective and reliable means of arresting ventricular fibrillation. Its counter-shock must be sent through the chest promptly, or else cardiac anoxia will have developed to such a degree that the heart will no longer be able to resume forceable contractions without assistance. Our experience has indicated that external defibrillation is not likely to be followed by the return of spontaneous heart
Kouwenhoven WB, Jude JR, Knickerbocker GG. Closed-Chest Cardiac Massage. JAMA. 1984;251(23):3133–3136. doi:10.1001/jama.1984.03340470059030
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