Medicine: Pressed Back to Life

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The nearest kitchen or Scout knife has saved many a life when used in emergencies to open the chest for massage of a stopped heart. But the method is risky. This week Johns Hopkins University researchers reported success in 50 cases with a faster and safer technique, suitable for use by laymen after a little training. The principle: closed-chest massage.

Dr. William B. Kouwenhoven, 74, an electrical engineer (professor emeritus at Hopkins) who also lectures on surgery at the university, worked out the method with the help of three colleagues. The team experimented first with animals, then adapted the idea to human anatomy. It consists of putting one hand palm down on the unconscious subject's lower breastbone, placing the heel of the other hand on top, then pressing down sharply and releasing smartly, 60 to 80 times a minute. Even in old people, ribs are so flexible that danger of breaking them is negligible. One limitation: the method will not work on a patient who is partly conscious, because he will resist the imposed rhythm. If there is only one rescuer available, says the Kouwenhoven team, massage is more urgent than mouth-to-mouth breathing for resuscitation. If there are two rescuers they should combine the methods. All ambulance drivers in Baltimore's fire department have learned closed-chest massage, and it has become standard practice in the emergency room of Johns Hopkins Hospital.