FOUR-MINUTE LIMIT FOR CARDIAC RESUSCITATION

• Duration of cardiac arrest and the degree of cardiac and cerebral recovery were studied in 132 patients in whom cardiac arrest had occurred during anesthesia and surgery and postoperatively. It was found that 53 had not been revived and that 44 died after varying periods of survival. Complete recovery occurred in 33 patients, and in all of these cases resuscitative measures were found to have been started within four minutes after the cardiac arrest was noted. Two patients who survived despite a delay of more than four minutes have a cerebral impairment that is probably permanent. To reduce the danger of death or disability from this cause, physicians and surgeons must be trained to act with promptness and precision, solutions and apparatus must be ready for immediate use, and visual and auditory aids must be used to determine the earliest sign of cardiac arrest. Signs of cardiorespiratory embarrassment, of which bradycardia was the most common, usually gave warning when stoppage was imminent.