Cardiopulmonary resuscitation, CPR, was developed in a three-part process which began with mouth-to-mouth resuscitation. Otherwise known as expired air resuscitation (EAR), expired air ventilation (EAV), and more colloquially as rescue breathing or the kiss of death, mouth-to-mouth resuscitation with the addition of chest compressions was first developed in 1956 by Dr. Peter Safar and Dr. James Elam.


   The American Heart Association’s website lists, in chronological order, the major achievements in the history of the development of cardiopulmonary resuscitation. The website states that, in 1954,  “James Elam is the first to prove that expired air was sufficient to maintain adequate oxygenation” ( Elam’s discovery was prompted by his work with paralyzed polio patients and was the first step in the development of the technique of CPR as it is known today.


   The second step in the process occurred in 1956, when “Peter Safar and James Elam invented mouth-to-mouth resuscitation” ( This advancement was the result of a collaboration between Safar and Elam on a volunteer study which took place in Baltimore, Maryland. During this volunteer study, the technique of tilting a person’s head backwards to allow a more direct passageway for air to enter into the lungs was perfected. Chest compressions were also introduced in an effort to maintain blood flow to the brain. The combination of these two techniques, mouth-to-mouth resuscitation and chest compressions, created a more complete form of cardiopulmonary resuscitation. Not only could administers get air to the lungs; they had also found a way to keep blood flowing to the brain.


   The American Heart Association recognized this form of CPR in 1960. With national recognition from a major organization having been thus achieved, Safar and Elam could now effectively promote the lifesaving technique they had been able to perfect. Theory quickly transformed into practice, and both Safar and Elam dedicated their time to teaching other physicians how to, literally, save a life.


   Through the American Heart Association, a major education campaign to raise national awareness and to encourage all types of medical personnel to learn cardiopulmonary resuscitation began. The United States military showed its support for CPR by implementing the practice almost immediately. Various other institutions and organizations followed suit, and cardiopulmonary resuscitation soon became standard protocol for quickly assessing victims in emergency field situations.


   Today, CPR is not only relegated for use by medical or military personnel. Some institutions of higher learning, like Safety Training Seminars of Marin, also offer a course or series of courses on CPR and first-aid. It is also not uncommon for those who are affiliated with recreational sports to have received some kind of CPR certification course. Lifeguards, for example, are highly encouraged, and sometimes even required, to have completed CPR certification as a condition of employment and STS of Marin offers all the CPR and First-Aid classes Lifeguards need.


   Through the consistent efforts of two doctors, and with the support of nationally recognized organizations such as the American Heart Association, cardiopulmonary resuscitation has evolved from a mere theory into a three-part process of transition which finally culminated in the accepted and widely used practice for sustaining life in emergency situations.

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