An Old CPR Kit

This entry is part 1 of 1 in the series Medical Artifacts
  • An Old CPR Kit

An Old CPR Kit

An Old CPR kit that I encountered while decluttering the house brought back a lot of memories. Cardiopulmonary resuscitation that consists of both chest compressions and artificial respiration is still the gold standard. However, around 2010, laypersons began receiving training in compression-only (hands-only or cardiocerebral resuscitation) CPR. This change came for several reasons. Studies showed that bystanders were more likely to assist if they did not have to do the artificial respiration part of CPR. Studies also showed that laypersons could achieve equal or better results with this than when both compressions and artificial respirations were attempted.

As a practicing physician I maintained certification in CPR as well as Advanced Cardiac Life Support. Since retiring, however, I had not given this a lot of thought. This week I came across a couple of these old CPR kits, which I kept on a key chain and in the dashboard of my car. These kits came into being after the beginning recognition of the AIDS epidemic. The purpose is to give some protection against exchange of body fluids in an outpatient setting.

old CPR kit
Small Kit to Carry on Keychain or Keep in Dashboard of Car

When opened, the kit contains instructions for use of the covering for the mouth and how to place it; the mask itself with the short tube for artificial breathing; two alcohol wipes; and two pairs of gloves, large and medium.

old CPR kit
“Rescue Key Accessory Pack”for Artificial Respiration
old CPR kit
“Rescue Key Accessory Pack”for Artificial Respiration
Old CPR Kit
“Rescue Key Accessory Pack”for Artificial Respiration
old CPR kit
“Rescue Key Accessory Pack” for Artificial Respiration

CPR Without a Kit

I did not have one of these kits the first time I had to perform CPR “for real.” I was a resident with a one week vacation. My family and I went to the Grand Canyon. I had worked as a Ranger-Naturalist there for three summers more than a decade before. One thing I really wanted to do was drive out to the East Rim for sunrise at the Watchtower. As can happen with families, we were not all ready in time. So we drove to a point, close to where we were staying on the South Rim. The point was crowded. As soon as I headed for the point itself, one of the bus drivers was coming up the trail, asking Ïs there a doctor?” Ïs there a doctor?” I paused for about 30 seconds, waiting for a young male doctor to come running, Ï’m a doctor. I’m a doctor!” No one responded. I followed the bus driver. An elderly man was down, and a woman was checking for a pulse. She did not find a pulse. She was German and spoke little English, but was also a doctor. I spoke little German, but we both spoke “medicine.” Neither of us felt a pulse, and we began CPR. Even at the time I was amazed at how smoothly we worked together, trading spots when the one breathing tired. (Elevation at the South Rim is 7,000 feet above sea level.) We were an efficient team.

There were a lot of people standing around, but they all stood back and out of the way. At one point, someone handed me a clean handkerchief to place between the mouth of the man and my own. I always appreciated that.

Getting Help

My then-husband drove into Grand Canyon Village to try to rouse the Rangers. He ended up breaking a window to get in to use the call system (he had been a park Ranger at the time I had been a Ranger-Naturalist). I did not know until later how difficult it was to rouse help that morning. It took 45 minutes for help to arrive from the time the German doctor and I started CPR. Once you start, you cannot stop CPR until help arrives.

Help finally did arrive, and with it, a kit for intubation and an ambubag for ventilation. The German doctor reached for it, and the Park Service would not give it to her. I said, “we’re doctors.” That did not matter, the kit sat on the ground for about 2-5 minutes until the voice of a young male could be heard, Ï’m a doctor! I’m a doctor!” The Park Service allowed him to intubate the man, an ambulance arrived, and he rode with the man to the hospital. The woman German doctor and I just looked at each other. We were tired after 45 minutes of CPR at 7,000 feet.

How the Story Ended

As the EMTs were taking the man to the ambulance, his wife, who had been there all the time, came up and thanked us. They were from England, and he had had two prior heart attacks at sea level. He had left his nitroglycerin in the hotel room that morning. (I do not believe that would have made much difference, though.) I was very glad that the German doctor and I had been able to keep him pink for all that time, with his wife watching. At that point, that day, I believed the value of that CPR was a woman knowing that even though she was not in her own country, people helped when help was needed.

Chances for a good outcome for an unwitnessed third heart attack outside of a hospital setting are low. He was transported to the small local Grand Canyon Hospital and formally coded for 30 minutes, and then pronounced dead.

My personal belief is that feeling well enough after two prior heart attacks to undertake major travel, and then dying suddenly at sunrise at the Grand Canyon is not necessarily a bad way to go. Given any options, I might choose it for myself.

His wife is a different story. That is where my sympathy lies. I’m sure she had a lot of red tape and paperwork to get through before returning home with her husband’s body, to be with family and friends. To this day, I consider the gift of CPR to the wife from two unknown women doctors from different countries to be one of my finer moments in medicine.

After that experience, I obtained what is now an old CPR kit (and others through the years). I had one with me at all times, and each room in the office had one, although we also had ambubags in each room. Finding this old CPR kit certainly brought back some vivid memories, only one of which I have shared here. I probably won’t share more memories dredged up by an old CPR kit. However, I am finding other medical artifacts as I attempt to declutter the house, and I imagine I will have other stories. I also will probably obtain a new CPR kit to keep with me, in place of this old CPR kit!

To my regular readers, thank you for your patience! 🙂

8 Replies to “An Old CPR Kit”

  1. Interesting find. I found a 16mm film named “Breath of Life” my dad had stored away. The film is about mouth to mouth resuscitation made in 1964 or 65. The film has my brother and my dad in it. It also has Resusci Anne. The canister is in a mailing case that has a mailing label from Archer S. Gordon, M.D. (Albuquerque) to James O. Elam, M.D. (Kansas City). Dr. Elem helped develop Resusci Anne and Gordon and Elam were pioneers in mouth to mouth resuscitation. My dad worked on test equipment for Dr. Gordon and often volunteered as a guinea pig. I remember going to work with my dad and watching them work with test equipment and Resusci Anne when I was 7 years old. I’ve thought about having the film put onto DVD, but I’ve never gotten around to it.

    1. Hi, Tim. I hope you do get the film put on DVD. I would love to see it! I sometimes forget about how much research came out of Lovelace in addition to the early astronaut research.

      The entire time I was in Medicine, Re-SusceAnnie was what was used in all of the CPR certification classes I took. I really did not know until several years ago about the change to compression only for laypeople learning CPR. One of the sports trainers at the gym teaches Community classes in that, and periodically there’s now there’s something like little Annie. As far as I can tell when I’m observing from a distance, all that does is measure whether or not a person can do firm enough compressions at the rate of 100 a minute. But I’ll ask a little more when I see it out again.

      I haven’t done A CPR certification since I’ve been retired. If I had occasion where I had to do CPR, I don’t know if I would do the full blown CPR now or if I would just go with the compressions. Also a lot of public places now have defibrillators, and at what time I would been very comfortable using those. But it’s been so long I would not do that now without a review class.

      I guess I’m rambling on here. I really hope that you get the film converted to DVD, and I would love to see it. Thank you for adding the really interesting history of the development of resusciAnnie.

  2. How reassuring it was to that wife on travel to see you two doctors doing everything you could to save her husband. A sad ending, but as you said, not the worst way to go. Thanks for sharing the story.

  3. It was interesting to watch the CPR recommendations change over time. When I did my first CPR stuff it was one rescue breath per four pumps Over time it became eight, and as I recall finally sixteen before the rescue breaths were abandoned entirely.

    1. Hi, Bob. Thanks for dropping by! I will admit I was surprised when the breaths were dropped. Then I think of all the changes everywhere in medicine since then. I think I am going to do the next community class the gym offers, “just because.” ? I think the ratio at the time of this incident was 1:4, but I’m not positive.Nice to see you.

  4. That is some story, Susan! Good thing you and woman German doctor were there. Too bad the Park Service did not let you or the German doctor use the kit when it arrived and waited for a male physician to come along, but I have been reading about the culture of the Park Service recently, and it isn’t pretty.

    1. Lavinia, thank you. Sometimes I’m really surprised when a memory pops up, after not being thought about for a long time. The outcome for the man would not have been different. Given his medical history, he was pretty much gone the minute he went down. If an ambulance had been able to transport him immediately for a full code, that might have made a difference, but I cannot even say that for sure.
      I’m now signed up to take a “hands only”class later this month, hoping I never have to use it. I am interested to see how it is taught.
      Very nice to see you. Thank you for commenting.

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