A few random physicians attempted the procedure in order to save a life, or to perform some difficult operation, yet successes were far and few between. Yet thanks to those who dreamed of helping their fellow human beings, and who never gave up despite past failures, the procedure was slowly
By the turn of the 20th century the medical community was becoming increasingly confident in recommending and performing the procedure of . We have to realize that initially the medical community rejected the procedure altogether
1940: Miller
It was also during this decade that Robert Miller refined the so it was straight, and it's referred to as either the Miller or straight blade. Roger refined the so it was curved, and it's to as either the or curved blade. Variations of both are still used to this day, and both come with a handle with a battery that the blades attach to. At the end of the blades are a small so the person can visualize the vocal cords. During WWI Sir Ivan was the first to use rubber tubes which he inserted through the nose and assisted their transfer into the airway with forceps we now refer to as forceps. In this way he also dubbed the term "blind ." (2) was said to have "mastered the technique of
References:
, etal, "A brief history of and tracheal , from the Bronze Age to the Space Age," Intensive Care Medicine, 2008, 34, pages 222-228, reference to page 227
, , "A primer of anesthesia," 2008, MO, Brothers Medical Publishers
1947: Piston Ventilator: Dr. Ernst Tier designed one of the first ventilators that provided positive pressure breaths to a patient. It became one of the first such ventilators available in the United States and Europe. It allowed for inhaled air to both be humidified and oxygenated, and provided an alternative respirator to the iron lung in ventilating polio victims. It was also used during abdominal surgeries. A second and third model would be introduced during the . (3) It was the first modern type volume ventilator on the market. (4) One major disadvantage is that it only allowed for controlled ventilation, which made it very difficult to ventilate patients who were awake and alert and orientated because it would be very uncomfortable. Bucking of the vent would be quite common. Another problem is alarms were limited.
1948: Continuous Positive Airway Pressure: During WWII Alvin supervised experiments whereby Continuous Positive Airway Pressure () was used on a variety of pilots who traveled to high altitudes. After the war he studied the use of on a variety of patients, although his work was relatively ignored until the when studies would confirm was beneficial for and sleep patients. would also be studied in the as a means of preventing a patient from requiring . )
1948: Respirator: It was the first machine that could be used as a ventilator and provide intermittent positive pressure breathing (). According to Dennis W. Glover in his book, "The History of Respiratory Therapy: Discovery and Evolution," these machines were used during WWII as ventilators. It was also during this time therapy was first used. The machines were introduced to hospitals in 1948. At this time positive pressure breathing either by or machine were provided by inserting a cuffed tracheotomy tube into the patient's airway. A rubber mask could also be used. Cuffed rubber were also available if necessary.
-: Rubber masks: Positive pressure breaths were often provided by using a rubber mask over the patient's mouth and nose. One of the major complications of the rubber masks used at this time was that they were opaque and concealed aspiration or foaming pulmonary edema, and this was noted as a major disadvantage of such masks. Another disadvantage was prolonged use caused facial skin breakdown. Another disadvantage is air would often leak around the masks. And yet another complication was the masks required a person to hold the mask securely on the patient's face. When done over a prolonged period of time this could become very tiresome. When used on polio patients nursing assistants or respiratory therapists would often work in two hour shifts. The disadvantages of these masks could be compensated for by tracheotomies and inserting a catheter, and later by .
1952: The Bird Mark I: Roger Manley was an anesthesiologist who was initially concerned with ventilating patients given anesthetics. It could be used as a ventilator and to provide . It was often referred referred to as the Manley Ventilator. He later refined it and re-branded it as the Mark II.
1952: Bennett Pressure Breathing Unit: It was studied in 1948 and marketed as the main alternative to the Bird Mark 1 by creator V. Ray Bennett. Like the Mark I and Mark II it was a pressure cycled ventilator. It had a cut for the of (a ) and (mucus thinner), () and ethyl alcohol (to cut allay the bubbles in foaming pulmonary edema). The machines was commonly used as a ventilator instead of iron lungs when suctioning of the airway was required. Iron Lungs and being used as ventilators were pretty much phased out when volume ventilators were proven to be more effective and safer ventilators. later refined this machine and re-branded it as the Bennett PR 1 and PR 2, both of which were still mentioned in respiratory therapy texts through the 1990 as you can see here. (t7)
1951: ventilator: Carl-invented a respirator that would allow "efficient control of gas volume delivered to the patient and also allows for active exhalation. It can also be used for both adults and children, and it is the first apparatus suitable for long-term ventilation as well as for use during anesthesia." wrote a paper suggesting how inadequate iron lungs were and how much better volume ventilators were for long term ventilation of patients. (8) Like the Ventilator, it was among the first volume ventilators. However, also like the Ventilator, alarms were limited and the only mode was was controlled ventilation.