Ambu´s Role in the History of Resuscitation

Today, manual resuscitation with a BVM, mouth-to-mouth resuscitation and cardiac compressions are the most recognised forms of resuscitation. The manual resuscitator was first developed in 1956 by Ambu whilst mouth-to-mouth resuscitation was introduced slightly later in the early 1960s. 

It can be argued that mouth-to-mouth resuscitation dates back as early as to 850BC, where the first resuscitative event ever was recorded in the Scriptures (the Second Book of Kings, 4:32-34). The prophet Elisha is said to have revived a child by lying on top of him, his mouth on his mouth, his eyes on his eyes, and his hands on his hands, whereupon the boy sneezed and woke up.

Whether the child was merely sleeping or whether Elisha performed mouth-to-mouth resuscitation because the child needed reviving is a matter of some debate.

Heat Method

The next known method of resuscitation to be documented in the pre 1500s was the heat method. One of the earliest realisations made by man about a lifeless body was that dead means cold. So, in attempts to restore life to a person, hot ashes and coals were placed on the victim’s chest. The heat method was remarkably successful when used on people that were merely asleep. It was much less successful when used on victims actually in respiratory or cardiac arrest.

Flagellation Method

It was difficult to distinguish between someone who was sleeping or unconscious and someone who was in cardiac or respiratory arrest, particularly in the 1500s when the human anatomy had yet to be fully explored. It was generally recognised during this period that the best way to establish the gravity of a person’s condition was to check their levels of responsiveness. It was not unusual to do this with a whip.

Again, this method was most successful when used on people who were merely sleeping and not so successful on those who needed resuscitating. However, the flagellation method has left its mark on history, since the first thing a rescuer will do is to check a patient’s responsiveness through a push or shake.

Bellows Method

In the 1530s and based on the knowledge that when people breathed air escaped from their mouth, the bellows method was developed. It seemed only logical to try to restore the breathing of a victim of respiratory arrest by blowing air into the mouth. Fireside bellows proved a very useful tool.

Compared to the previous forms of resuscitation the bellows method compared favorably in that it actually proved useful in a couple of cases. However, at this time, the medical authorities were not aware that the neck needed to be extended to clear the airway for the method to be more effective.

Fumigation Method

In the early 1700s an alternative technique was developed. Smoke was blown into an animal bladder and then into the victim’s rectum. This came to be known as the fumigation method. Again, this form of resuscitation was largely unsuccessful.

In the mid 1700s it was discovered that people in drowning accidents had water in their lungs, so victims were tied by their ankles and hung upside down, hence, the inversion method. Once all the water had been emptied the victim was alternately raised and lowered. In some cases this method was successful, since the raising and the lowering of the body resulted in a compression of the patient’s diaphragm in movements similar to artificial respiration.

Barrel Method

A Swiss pamphlet from 1766 contains the following description of the barrel method: ”...place the victim face and stomach down on a barrel. Placed in this position and shaken back and forth, the body will usually be emptied of water, slime and froth”. Unintentionally, this method proved effective, as the rolling of the body across the barrel compresses the chest and thus creates an under pressure. On the way back, the chest expands and air could therefore be drawn into the lungs.

Trotting Horse Method

The trotting horse method was related to the barrel method. The victim’s body was hoisted onto a horse and the horse would be made to trot. Besides helping to empty the victims lungs, the bouncing up and down of the body resulted in an alternate compression and decompression of the lungs, forcing air in and out.

Holger Nielson Method

The Holger Nielsen method, introduced around 1932, involved the rescuer putting the patient on the ground, face down. The patient’s arms were then alternately lowered and raised in a fixed rhythm. This was the first resuscitation method to become universal and official. But it was soon made obsolete with the arrival of a breakthrough new product and a re-introduction of a much earlier technique.

Ambu Bag

In 1956 Ambu developed the first ever manual resuscitator bag. This was, and still is, by far the most effective form of resuscitation that has ever been researched. It is now considered a standard technique across the developed world today.

The resuscitation bag can give a patient the equivalent amount of oxygen as the patient would receive if he or she were respiring independently. It can be used safely and hygienically for extended periods of time by a trained rescuer. Nowadays every hospital and every ambulance will carry an “Ambu bag” to aid in emergency situations.

Training

Since only trained rescuers could effectively use an Ambu bag, mouth-to-mouth resuscitation was re-introduced, not to replace the “Ambu bag” but to be used in the absence of one. However, many were prevented from training in this alternative lifesaving technique since real volunteers could not be used. To aid the instruction of mouth-to-mouth resuscitation and to train the emergency services in how to use an “Ambu bag” Ambu developed its first manikin.

The pioneering nature of Henning Ruben and the founder of Ambu, Holger Hesse, thus changed the future of resuscitation forever. Thousands of lives are saved every day that would otherwise be lost, if it were not for the courage and quick thinking of our emergency services and the innovative personality of our Company's founder.