MAY, 1943

 

The Schafer Prone Pressure Method of Resuscitation.

RESUSCITATION AND FIRST AID

By Dr. Thomas Kirk Cureton

This article is condensed from the chapter
on Resuscitation and Water First Aid in Dr.
Thomas Kirk Cureton’s new book, ‘Warfare
‘Aquatics,’ and is reprinted with permission
of the Stipes Publishing Co. A review of the
book may be found on page 30.

T THIS time there are four
A methods of resuscitation in
common use:

1. The Silvester method which is
widely used by the United States
Coast Guard operators and is in use
by doctors and first aid workers
when it is desirable to put the pa-
tient on the back.

2. The Schafer method which is
preferred by the American Red
Cross in its first aid work.

3. The Nielsen method which has
increased greatly in popularity.*

4. Mechanical resuscitation with
the E & J or McKesson equipment.

Modern workers in resuscitation
should be trained in all of these
methods because they will all be
‘found in use and each one of them
has advantages under certain condi-
tions.

N iahen Method

This method was devised by Colo-
nel Nielsen in charge of the Danish
Life Saving work where it is gen-
erally considered superior to the
Schafer method. The physiological
evidence has been interpreted by
Colonel Nielsen and others in favor

*Lt. Col. Holger Nielsen and the Danish
Resuscitation Commission: Dr. H. Bendlsen
(Chairman), Dr. Svend Hansen, Dr. Paul
Guildal, C. Holstein-Rathlou, Prof. August

reel ‘Dr. J; imdhard, & B. Pederson, Dr.
. Svendsen. -; ' we eT he)

 

of this method because it more near-
ly corresponds to natural deep
breathing and offers greater stimu-
lation to circulation. It also decreases
the potential danger of causing in-
ternal injuries by great pressure on
the abdominal organs. It affords an
easier position from which to op-
erate than the Schafer method. It
also leaves the greater part of the
body free to be worked upon with
massage. The operational instruc-
tions are as follows:

1. The side of the face is placed on
the back of one or both hands which
are bent at the elbows and crossed
under the face. The body is freed
as quickly as possible of tight gar-
ments and the nose and mouth are
checked to see that they are perfect-
ly free to breath. A slap on the back
is given to help open the mouth and
make the tongue fall forward.

2. The operator kneels on one
knee at the head of the victim and
presses downward on the shoulder
blades with the palms of the hands
and with fingers widely separated.
Pressure is exerted evenly and
smoothly in the downward direction
for about 2% seconds.

3. The operator relaxes the pres-

sure and seizes the upper arms just
above the elbows and lifts them vig-
orously upward for 4 or 5 inches to
assist the expiration of the chest and
the inspiration of the air. This is
a unique feature of the Nielsen
method. The arms are lowered and
the cycle is repeated at a rate of ap-
proximately 2% to 3 seconds relaxa-
tion and stretching on the chest.

 

The Silvester Method of Resuscitation (victim supine).

4. During the application of the
movements supplemental treatment
is applied in the way of hot pads or
stones, vigorous rubbing of parts of
the body toward the heart, slapping
the bottoms of the feet and other
methods of reflex stimulation.

5. A change of operators is made
whenever needed without interfer-
ing with the respiratory movements.

Silvester Method

A brief description of the Silvester
method of resuscitation is given as
follows:

1. The subject is placed upon the
back and the mouth is cleaned and
the tongue pulled forward.

2. The operator works from the
head end and places his hands over
those of the subject. The subject’s
arms are raised sideward and up-
ward to an overhead position for 2

‘seconds. This movement assists the

inspiration.

3. The hands are placed back on
the chest over the lower ribs and
pressure is exerted downward for
about 3 seconds until as much air has
been forced out of the chest as pos-
sible.

4. The movements are continued
at a rate of about 12 to 15 per
minute.

5. Supplemental treatment is ap-
plied by an assistant. It may be nec-
essary to tie the tongue forward or
to hold it. It can easily be deter-
mined from this position whether
the subject is breathing or not. If the
cheek is lowered to a position direct-