DC MUSEUM

HOLGER-NIELSEN METHOD

1. POSITION OF PATIENT FOR BACK-PRESSURE ARM-LIFT METHOD. Place the subject in a face down, prone position. Bend his elbows and place hands one upon the other. Turn his face to one side, placing the cheek upon his hand.
    
   POSITION OF THE OPERATOR. Kneel on either the right or left knee, at the head of the subject, facing him. Place the knee at the side of the subject’s head close to the forearm. Place the opposite foot near the elbow. If it is more comfortable, kneel on both knees, one on either side of the subject’s head. Place your hands upon the flat of the subject’s back so that the heels of the hands lie just below a line running between the arm pits. With the tips of the thumbs just touching, spread the fingers outward and downward.
    
   MOVEMENT. Rock forward until the arms are approximately vertical and allow the weight of the upper part of your body to exert slow, steady, even pressure downward on the hands. Your elbows should be kept straight and the pressure exerted almost directly downward on the back. Release the pressure, avoiding a final thrust, and commence to rock slowly backward. Place your hands upon the subject’s arms just above his elbows, and draw his arms upward and toward you. Apply just enough lift to feel resistance and tension at the subject’s shoulders. Then drop the arms gently to the ground. This completes the full cycle. Repeat cycle 12 times per minute at a steady, uniform rate.
    
   Operator change must be made without losing the rhythm of respiration.
    
   
2. POSITION OF PATIENT FOR BACK-PRESSURE HIP-LIFT METHOD. Place the patient in same position as for back-pressure arm-lift method except that arms may be placed in any position, depending upon extent of injuries.
    
   POSITION OF THE OPERATOR. Kneel on one knee at level of patient’s hips, place hands in same place as for back-pressure arm-lift method.
    
   MOVEMENT. Rock forward, keeping your elbows straight, until your arms are approximately vertical. This forces the air from the patient’s lungs. Rise backwards slowly allowing your hands to slide down to the patient’s hips, grasp the patient beneath the hips as shown in the illustration and lift. This allows the patient’s rib cage to expand and air enters the lungs. Lower the patient’s hips slowly and repeat the movement. This cycle should be repeated 12 times a minute at a steady, uniform rate.
    
   
3. GENERAL INFORMATION. Continue artificial respiration without interruption until natural breathing is restored. If natural breathing stops, artificial respiration should be resumed at once.
    
   An assistant should loosen any tight clothing about the patient’s neck, chest, or waist.
    
   TO KEEP THE PATIENT WARM DURING ARTIFICIAL RESPIRATION IS MOST IMPORTANT.
    
   To avoid strain on the heart when the patient revives, he should be kept lying down and not allowed to stand or sit up. When the patient has revived, he should be given some stimulant, such as one teaspoonful of aromatic spirits of ammonia in a small glass of water or a hot drink of coffee or tea, etc.

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