Low Technology for the Clinical Armamentarium

W x rhen Kouwenhoven et al' introduced the technique of closed-chest cardiac massage in 1960, they wrote, perhaps somewhat exuberantly, that "anyone, anywhere can now initiate cardiac resuscitative procedures. All that is needed are two hands." It is somehow fitting that in this era of high technology medicine more than 30 years later, a promising advance in resuscitation technique, reported by Sack et a12 in this issue of Circulation, also involves use of the hands. In this sense, the technique of manual interposed abdominal compression-CPR (IAC-CPR)3 represents a novel "low technology" approach to health care at the opposite end of the complexity and cost continuum from high technology imaging.