Pathophysiologic Syndromes of Cardiopulmonary Resuscitation

Cardiopulmonary resuscitation or "CPR," as we know it today, was successfully applied before 1960.¹ National standards for external cardiac massage and mouth-to-mouth ventilation were set forth in 1966.² At that time it was recommended that CPR be performed only by medical personnel. Seven years later a second national conference³ acknowledged that the immediate availability of effective external support was essential to reduce out-of-hospital cardiac arrest mortality (estimated at 400,000 deaths per year) and that CPR could be rendered safely by nonmedical personnel. Since then, large numbers of laymen not only have been trained in CPR but also have been credited with the survival of many cardiac arrest victims. Many states have legislated requirements for training and certification of first responders (firemen, policemen, ambulance personnel, and the like). The demand for training and certification programs in many areas has evoked temptations to relax the rigid CPR "standards" established