As CPR training started to reach the emergency response community in the early 70's, the words "Annie..Annie..Are You OK?" started almost every CPR training session as new EMT's, nurses, firefighters and police officers learned the first step -ESTABLISH UNRESPONSIVENESS.
Many of that generation continue as todays CPR instructors , but have long ago learned to alter the opening salvo to simply "Are You OK?", as the call for Annie ocassionally was carried out into the streets with real patients. But Annes legacy continues, as she and her family make the past 50 years of CPR training possible.
Asmund Laerdal was a successful toy maker who turned to making soft plastic, realistic dollls in the 50's. Laerdal also was manufacturing imitation wounds for Red Cross first aid training in Norway and Sweden, when he learned of the new CPR resuscitation technique, and envisioned life sized mannequins as the ideal training tool.
The first Resusci Anne was developed by Asmund Laerdal and Anaesthesiologist Bjorn Lind, making its debut in September 1960 in Stavanger Norway. Anne was introduced to the First International Symposium on Resuscitation in Stavanger, attended by US pioneers Drs. Peter Safar, James Elam, Archer Gordon, Henning Ruben and Rudolf Frey. Drs. Safar and Elam continued with Laerdal, refining Anne.
At the turn of the 19th century, the body of a young girl was pulled from the River Seine in Paris. There was no evidence of violence and it was assumed she had taken her own life. Because her identity could not be established, a death mask was made; which was customary in such cases.
The young girl’s delicate beauty and smile added to the enigma of her death, which inspired stories and poetry of her demise, thought to be from suicide to escape an unrequited love. THe story of L’Inconnue de la Seine (“The Unknown of the Seine”) became popular throughout Europe, as did reproductions of her death mask.
Asmund Laerdal knew the story of the death mask of an unknown young woman whose body had been fished out of the Seine River at Quai du Louvre in Paris in the late 1880s. Her features were beautiful and perfect for the purpose. Laerdal chose to make its face female, recognizing that men might be reluctant to kiss a male image. He kept the name of the popular toy doll he was successfully manufacturing, and named the mannequin Rescusci Anne.
The first Resusci Annes were crude and simple compared to todays electronic descendants. But they were very effective, and gave thousands the opportunity to practice hands on, the skills that for many would be very rarely used. Between students, the mouth was cleansed with an alcohol swab. The face and upper airway were a single piece of plastic that had to be removed after each class and thoroughly cleaned and disinfected. This was often a labor intensive job when a class with many Annes were involved. The need to properly extend the neck in order to open the airway and ventilate was successfully demonstrated to the student , and the neck had embedded rubber bladders by which the instructor could produce a carotid pulse with a hand held bulb.
The body consisted of a spring metal hoop which simulated the ribs, and provided the foundation for the chest upon which compressions could be done. Attached was a plastic "lung", and a simulated anterior thorax/breast plate. The remainder of the body was essentially a plastic balloon which the instructor inflated for each class with a provided foot pump. Successful performance of ventilation and compression were measured by pressure developed within the lungs on aneroid guages visible to the student. Between classes, the body was deflated, and Anne was folded and returned to her storage box. The tradition of the Resusci Anne jogging suit began.
The next generation of Resusci Anne eliminated the blow up body, replaced with foam. Measurement of successful ventilation and compression was provided by pressure sensors whilch lit a display on a mounted pod. The pod also contained an electronic metronome to teach the appropriate compression rates. Perfection in performance became the requirement for earning certification, and students were expected to produce an EKG like paper strip, demonstrating proper timing, depth and sequence of events. Carotid pulse could still be simulated, and now the pupils could also be dilated and constricted with an inflatable bulb. Cleaning was also simplified. Later versions would now have individual mouth/lips for each student to apply, and replaceable lungs that no longer required cleansing.
An infant Resusci Baby was introiduced, followed by a child mannequin. An African American version was also introduced. As ALS training progressed, Laerdal developed an Anne with electrodes capable of mating with their arrythmia simulator, and accepting a reduced but actual defibrillation.
In the 1990s there was much focus on sufficient hands-on practice. Little Anne was introduced in 1995 as a supplemental trainer to meet the need for a lower cost/ lower student-manikin ratio.
In the 2000s growing concern about patient safety and cost efficiency caused increased focus on patient simulation and self-directed learning as means to have more healthcare providers trained in a safe and effective manner. Research also demonstrated that even professionals deliver poor quality CPR and that measurement and feedback help improve CPR performance. This led to the current generation of computer mated displays and full simulation. SimMan 3G is the culmination of this experience, creating a durable and user friendly patient simulation.
So you thought you wanted to learn CPR
Keywords: Resusci Anne, Annie, Asmund Laerdal, Bjorn Lind, Peter Safar, CPR, mannequin, Seine,
Last Revision Date: 8/7/11 - 5:54 PM