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William Kouwenhoven (January 13, 1886 - November 10, 1975) Born in the United States Year of Discovery: 1957
Utility Linemen Electrocution Study Led to CPR!
In the 1920s electricity was poised to revolutionize life as we knew it, adding many of the latest conveniences to our homes. At the time, very little was understood about the dangers associated with electrocution. As companies scrambled to install electricity in the houses of their new customers, they noticed that many of their utility linemen were suffering sudden death, even from the smallest voltages. Scientists began to study the mechanism of these heart stopping shocks, but William Kouwenhoven and his laboratory at Johns Hopkins University went a step further and discovered that electricity could also re-start the beating of a heart. This work was the foundation of the life saving cardiac defibrillator and progressed to the development of the technique of external cardiac massage (chest compressions) during CPR (Cardiopulmonary Resuscitation).
Kouwenhoven was born in Brooklyn, New York on January 13, 1886 and joined the faculty of the Johns Hopkins University School of Engineering in 1914 as a professor of electrical engineering. He always had great interest on the effects of electricity on the body, so when Edison Electric decided to fund research into the sudden deaths by electrocution of their linemen, it was Kouwenhoven’s opportunity to shine. Even though he had no formal medical training, his laboratory became focused specifically on the effects of electricity on the heart, from both the inside and outside of the body.
The first investigations were done on rats in 1928. They found that high voltage shocks from electrodes placed on the head and one extremity would stop breathing and the heart from pumping. They also tried to massage the chests of the rats, as recommended by a German physician, Dr. Boehn, but this only resulted in paralysis of the rats from crushed cervical spines. By 1933, their work on dogs showed that an alternating electrical current applied directly to the heart could restore the heartbeat but this method required opening the dog’s chest, which was difficult and less than desirable. In the late 1940s this method of open chest heart re-starting (defibrillation) became used on human patients quite regularly because it was the only option available to save patients’ lives.
Kouwenhoven was convinced that he could develop a solution and a device (a defibrillator) that could shock the heart without opening up the patient. A lot of medical research was put on hold during World War II, but by 1957, Kouwenhoven and his team had finally perfected the defibrillator device. It consisted of a small box and two insulated cables with copper electrodes. Johns Hopkins Hospital immediately began using the device as a standard treatment for cardiac arrest.
Guy Knickerbocker, working toward his PhD in electrical engineering, started in Kouwenhoven’s laboratory on defibrillator experiments in 1954. He realized that by placing the heavy copper electrodes on the chests of animals , it caused their blood pressure to rise and when he pressed down with the electrodes, it rose even higher. This observation was critical in determining that once a heart had stopped, forceful, rhythmic chest compressions could cause blood to move through the body, keeping vital organs alive!
Kouwenhoven and Knickerbocker worked with cardiac surgeon, James Jude to test this life sustaining theory. They checked and double checked their findings on many patients for over a year before announcing the results of their discovery: Chest compressions could maintain 40% of a patient’s normal circulation when their heart had stopped beating. This was combined with mouth to mouth resuscitation to become universally known as Cardiopulmonary resuscitation, or CPR.
Kouwenhoven held the position of Dean at Johns Hopkins School of Engineering from 1938 until 1954. In 1969, he received the very first honorary degree ever given by the Johns Hopkins University School of Medicine.