In a nail-biting episode of ITV’s hit drama Endeavour, Inspector Morse had to perform cardiopulmonary resuscitation on young George Fancy after the mass shooting in Eddie Nero's pool hall. Sadly, in this instance, Fancy was unable to be revived owing to his gun shot wounds.
In a show that pays incredible attention to historical accuracy, getting every detail right is crucial to create an authentic and believable atmosphere for 1960s England - so when it came to knowing all about CPR in 1968, it was time to call the experts to ensure they got the details right.
We were delighted to hear from the team behind Endeavour - and also to have an excuse to dive into our archives for a interesting research project.
CPR in 1968
It was certainly possible for people to know and perform CPR in England in 1968. According to one of our clinical experts, combined compression and ventilation was reported on in 1960 (and he remembers first hand working in a cardiac arrest team in 1965 and using combined compressions and ventilation!)
While it would be less likely for people outside of the medical profession to be proficient in CPR, there were paths they could haven take to learn what it was and how to deliver it.
In 1962, a book was released called the ‘ABC Training Guide for the Public’ which detailed how to do CPR and was marketed to the general public. A video was also released in 1962 entitled the ‘Pulse of Life’ which demonstrated CPR.
The CPR of 1968 was different from what we know to do today, but we do have an idea of how this would have looked. Currently, we do a series of 30 pushes (at 2 per second) followed by 2 breaths, but in 1968 this would have likely been a different speed and a different ratio of pushes to breaths.
To see what this would have looked like, watch a ‘Pulse of Life’ video from 1968 which delivers CPR at a much slower speed to a 5:1 ratio (for every 5 pushes on the chest, you give one breath.) However, as there was no formal consensus for CPR it’s also possible that it could have been done at a 15:2 ratio (for every 15 pushes on the chest, you’d deliver two breaths.) Either pace and ratio would have been reasonable for Inspector Morse to know how to do when he tried to revive Fancy; and the 5:1 ratio was the method of choice.
While you may be less likely to be caught up in the turf war between Eddie Nero and Cromwell Ames, Ambulance Service Association figures suggest that 60,000 out of hospital cardiac arrests occur each year - and bystander CPR plays an essential role in giving someone their best chance of survival. Far more lay people are trained in CPR today, and the provision of defibrillators is helping survival odds increase drastically, but it still isn’t enough - and thousands of lives are lost every year to cardiac arrests.
•When someone has a cardiac arrest, every minute without CPR and defibrillation reduces their chances of survival by 7-10% (1)
•The chance of survival from out-of-hospital cardiac arrest can be increased two-to-threefold by the immediate provision of bystander CPR. (2)
•There are around 60,000 out-of-hospital cardiac arrests in the UK per year. (3)
•AEDs are known to drastically boost survival rates of out-of-hospital cardiac arrests.
•Defibrillation within 3–5 min can produce survival rates as high as 50%–70%. (4)
In 2018, there are many ways you can learn how to save a life - including something you can do right now. Play our award-winning free film-in-a-game, Lifesaver, on your computer, tablet or mobile phone by visiting https://life-saver.org.uk/ and to ensure you’d know what to do in an emergency.
(1) Holmberg M, Holmberg S, Herlitz J. Incidence, duration and survival of ventricular fibrillation in out-of-hospital cardiac arrest patients in Sweden. Resuscitation 2000; 44:7-17.
Larsen MP, Eisenberg MS, Cummins RO et al. Predicting survival from out-of-hospital cardiac arrest: a graphic model. Ann Emerg Med 1993; 22:1652-8.
(2) Ambulance Service Association. National Out-of-Hospital Cardiac Arrest Project 2006.
(3] Resuscitation to Recovery, https://www.resus.org.uk/publications/resuscitation-to-recovery/
(4) ↵ Valenzuela TD, 2. Roe DJ, 3. Nichol G, et al : Outcomes of Rapid Defibrillation by Security Officers after Cardiac Arrest in Casinos. N Engl J Med 2000;343:1206–9. doi:10.1056/NEJM200010263431701 CrossRefPubMedWeb of ScienceGoogle Scholar
↵ 1. Blom MT, 2. Beesems SG, 3. Homma PC, et al : Improved survival after out-of-hospital cardiac arrest and use of automated external defibrillators. Circulation 2014;130:1868–75. doi:10.1161/CIRCULATIONAHA.114.010905 Abstract/FREE Full TextGoogle Scholar
↵ 1. Ringh M, 2. Rosenqvist M, 3. Hollenberg J, et al : Mobile-phone dispatch of laypersons for CPR in out-of-hospital cardiac arrest. N Engl J Med 2015;372:2316–25. doi:10.1056/NEJMoa1406038 CrossRefPubMedGoogle Scholar