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December 21, 1984

The Physiology of Cardiopulmonary Resuscitation: An Update

Author Affiliations

From the Section of Emergency Medicine, Department of Surgery (Drs Sanders and Meislin), and the Section of Cardiology, Department of Internal Medicine (Dr Ewy), University of Arizona Health Sciences Center, Tucson.

JAMA. 1984;252(23):3283-3286. doi:10.1001/jama.1984.03350230043031

WHILE great strides have been made in the care of patients who suffer cardiac arrest, there is much room for improvement. The basic technique of cardiopulmonary resuscitation (CPR) has changed little since Kouwenhoven and colleagues1 introduced it in 1960. The present standard was set by a committee of experts at the National Conference on Cardiopulmonary Resuscitation and Emergency Cardiac Care in 19732 and updated in 1979.3 How successful has this technique been? Recent studies have shown that patients suffering in-hospital cardiac arrest have a 14% to 24% chance of being discharged alive.4,5 This past year, Bedell and associates4 reviewed 294 consecutive patients who underwent CPR in a university hospital in Boston. Only 41 patients were discharged alive; many who died, however, had serious underlying medical problems. DeBard5 reviewed 1,073 cases of patients undergoing CPR in a community hospital in Dayton, Ohio. Fifty-six percent of patients