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In Britain, the great boost to performing mouth-to-mouth resuscitation for the "suddenly apparently dead" came from William Tossach's 1744 documentation of his own successful case, and then from promotion by John Fothergill and other enthusiasts. Some civic authorities on the Continent were exhorting citizens to employ it from as early as the mid-1...
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... intubation technique is also widely quoted as "men- tioned by Mr Portal [Baron Antoine Portal (1742-1832) 46 On the third page written from this lecture, Secundus now recommends that "instead of clapping a tube or our own mouth to the mouth of the drowned person we should blow the air through a tube put into the nostrils, which is the natural pa sage for it" (Figure 2). ...
Citations
... Prana vayu is compared with the atmospheric oxygen that was called amlajan, meaning the base constituents of acids is necessary to carry out the vital functions of life. e facts as described by ayurvedic scholars in earlier days in the Gupta period depict a clear and categorical feature mentioned in the process of respiration in human subjects [3,[6][7][8][9][10][11][12][13]. ...
... e resuscitation was performed by the surgeon William Fossach [6]. He presented the case of mouth-to-mouth rescue [7]. In the late eighteenth century, Baron Antoine Portal gave a proposition for typical cases related to respiratory disorders, to inflate the lungs of the neonatal subjects with air. ...
... e Scottish surgeon John Hunter (13 February 1728-16 October 1793) propagator of such instrumental strategies in medical treatment and finally arduously fabricated human bellows equipped with pressure relief valves. He subsequently gave recommendations to the Royal Human Society for the urgent requirement of using mechanical ventilation on an emergency basis for resuscitation [3,7,33]. In addition to that, he stated that in order to decrease inflation of the stomach mild pressing of the larynx against the vertebrae will be an effective strategy measure [2,7]. ...
The outbreak of novel COVID-19 has severely and unprecedentedly affected millions of people across the globe. The painful respiratory distress caused during this disease calls for external assistance to the victims in the form of ventilation. The most common types of artificial ventilating units available at the healthcare facilities and hospitals are exorbitantly expensive to manufacture, and their number is fairly inadequate even in the so-called developed countries to cater to the burning needs of an ever-increasing number of ailing human subjects. According to available reports, without the provision of ventilation, the novel COVID-19 patients are succumbing to their ailments in a huge number of cases. This colossal problem of the availability of ventilator units can be addressed to a great extent by readily producible and cost-effective ventilating units that can be used on those suffering patients during an acute emergency and in the absence of conventional expensive ventilators at hospitals and medical care units. This paper has made an attempt to design and simulate a simple, yet effective, mechanized ventilator unit, which can be conveniently assembled without a profuse skillset and operated to resuscitate an ailing human patient. The stepper motor-controlled kinematic linkage is designed to deliver the patient with a necessitated discharge of air at optimum oxygen saturation through the AMBU bag connected in a ventilation circuit. With the associated code on MATLAB, the motor control parameters such as angular displacement and speed are deduced according to the input patient conditions (age group, tidal volume, breathing rate, etc.) and thereafter fed to the controller that drives the stepper motor. With a proposed feedback loop, the real-time static and dynamic compliance, airway resistance values can be approximately determined from the pressure variation cycle and fed to the controller unit to adjust the tidal volume as and when necessary. The simplistic yet robust design not only renders easy manufacturability by conventional and rapid prototyping techniques like 3D printing at different scales but also makes the product easily portable with minimal handling difficulty. Keeping the motto of Health for All as envisioned by the WHO, this low-cost indigenously engineered ventilator will definitely help the poor and afflicted towards their right to health and will help the medical professionals buy some time to manage the patient with acute respiratory distress syndrome (ARDS) towards recovery. Moreover, this instrument mostly includes readily available functional units having standard specifications and can be considered as standard bought-out items.
... He also built the first human low-pressure chamber and described his experiences when the pressure was reduced to the equivalent of an altitude of ∼2400 m [12]. Until the mid-18th century, some authorities were encouraging the use of mouth-to-mouth method [13]. The method was criticized due to use of expired air and aesthetic distaste [14]. ...
Health systems, which have been under great pressure
with the COVID-19 outbreak, encountered problems in accessing
some urgently needed medical resources. One of these resources has
been the medical ventilators needed in acute respiratory distress
syndrome developing with COVID-19. As a result of the calls made,
many manufacturers have modified their facilities to produce med-
ical ventilators and the problem has been solved to a great extent.
While we focus on the urgent requirement for ventilators in these
troubled days of COVID-19, we do not seem to be worth discussing
their technical developments. How did the countries perform in the
development of novel respiratory technologies in the pre-COVID
period? While patents are seen as a measure of inventive activ-
ity, we attempt to draw a general picture of patents granted in
the field of medical respiratory technologies. Our study examines
27 397 respiratory patents listed in the Derwent Innovations Index
database at the last 50 years and focuses on the last decade for
further evaluation. In addition to the analysis of patent numbers, we
identified the core ventilation technologies of the last two decades
with the topic modeling technique and compared them. We used
the claims section of the patents collected. It is seen that focus of
ventilation patents granted between 2001 and 2010 was on oxygen,
flow generation, and pressure sensors while it shifted to the pipes,
measurement methods, and plates between 2011 and 2022.
... In 1732, the first mouth-to-mouth ventilation case was reported on a coal miner. This latter revival was performed by the surgeon William Fossach [12]. He presented in 1744 at Edinburgh the case study of his mouth-to-mouth rescue [13]. ...
Mass casualty incidents such as those that are being experienced during the novel coronavirus disease (COVID-19) pandemic can overwhelm local healthcare systems, where the number of casualties exceeds local resources and capabilities in a short period of time. The introduction of patients with worsening lung function as a result of COVID-19 has strained traditional ventilator supplies. Mechanical ventilator is a medical device which is usually utilized to ventilate patients who cannot breathe adequately on their own. Among many types of ventilators Bag Valve Mask (BVM) is a manual ventilator in which a bag is pressed to deliver air into the lungs of the patient. In present work, a mechanical system along with speed controller has been developed to automate the operation of BVM. The constructed prototype contains crank, powered by servo motor, supported by wooden frame. To bridge the gap during ventilator shortages and to help clinicians triage patients, manual resuscitator devices can be used to deliver respirations to a patient requiring breathing support. With principal dimensions of 0.54*0.64 m2 , bvm weighs 0.9 kg and DC power convertor for supplying power for a continuous operation, the prototype can be moved easily. The dimensions of the frame are selected as such to be compatible with the physical dimension of Ambu bag. The performance of the device was tested using Airflow meter which illustrates that the Tidal Volume vs. Time graph of the automated system is similar to the graph produced by manual operation of the BVM, but with a mean deviation of 0.182 Litres with manual operation and 0.1 Litres with prototype. For patients who require ventilatory support, manual ventilation is a vital procedure. It has to be performed by experienced healthcare providers that are regularly trained for the use of bag-valve-mask (BVM) in emergency situations. Keywords: Mechanical Ventilator, Automated BVM, BPM, COVID-19, Ventilator design, Airflow meter
... In 1732, the first mouth-to-mouth ventilation case was reported on a coal miner. This latter revival was performed by the surgeon William Fossach [12]. He presented in 1744 at Edinburgh the case study of his mouth-to-mouth rescue [13]. ...
Mass casualty incidents such as those that are being experienced during the novel coronavirus disease (COVID-19) pandemic can overwhelm local healthcare systems, where the number of casualties exceeds local resources and capabilities in a short period of time. The introduction of patients with worsening lung function as a result of COVID-19 has strained traditional ventilator supplies. To bridge the gap during ventilator shortages and to help clinicians triage patients, manual resuscitator devices can be used to deliver respirations to a patient requiring breathing support. For patients who require ventilatory support, manual ventilation is a vital procedure. It has to be performed by experienced healthcare providers that are regularly trained for the use of bag-valve-mask (BVM) in emergency situations. We will present, a historical view on manual ventilation’s evolution throughout the last decades. Artificial ventilation has developed progressively and research is still going on to improve the actual devices used. Throughout the past years, a brand-new generation of ventilators was developed, but little was done for manual ventilation. Manual ventilation through BVM can be replaced by automatic ventilation which illustrates that the Tidal Volume vs. Time graph of the automated system is similar to the graph produced by manual operation of the BVM and to the graph produced by a human subject. The use of an automatic manually operated device may improve ventilation efficiency and decrease the risk of pulmonary overdistention, while decreasing the ventilation rate.
... In 1767, the first rescue organization named "Amsterdam Rescue Society" has been established in the Netherlands (Bierens, 2017). They have started rescuing drowned people in Amsterdam and saved 150 victims since the past 4 years (Trubuhovich, 2006). ...
... The chief aspects of CPR procedure were chest compression and mouth-to-mouth breathing (rescue breathing). These two skills have been part of the CPR procedures since the beginning (Trubuhovich, 2006). In the guidelines 2000, chest compression was more highlighted than rescue breathing. ...
This review aims to determine the changes made in the cardiopulmonary resuscitation (CPR) guidelines from 2000 to the present. The study was mainly undertaken by using International Guidelines from American Heart Association. The main change of CPR was chest compression skill. The guidelines have improved high-quality CPR through the change of chest compression skill. The latest adult CPR guidelines are as follows: (a) push chest quickly (100-120/min), (b) compress appropriately (5-6 cm), (c) relax chest fully (complete chest recoil), (d) avoid interruption of compression, and (e) avoid hyperventilation. The understanding of the latest CPR skills will be helpful in improving survival rate from sudden cardiac death.
... Here, the difficult route and fizzled intubation envelop a range including difficult cover ventilation, difficult laryngoscopy, difficult intubation and failed intubation. The most feared circumstance is that we can't ventilate-respiratory events [12][13][14]. The acclimated specifications of the equipment manage a level of weight that probably won't be all around endured, and causes consequent slash and hampers the desired result. ...
Endotracheal tube (ETT) is a widely used lifesaving tool in case of moderate to severe medical predicaments. It enables an alternative means of mechanical ventilation for tranced or comatose patients. The gadget also helps in ventilation in case of giving general anaesthesia during major surgical procedures. Along the symbiotic use of the system comes the delicate maintenance and adequate monitoring of the instrument. One of the important features of the system is the air-filled cuffs or simply the air balloons that are availed to sustain the optimal intrinsic conditions of the pharmacological actions desired for the patient. The mechanism is to prevent aspiration of secretion of nasal mucosa. Because these secretions can cause aspiration pneumonia which is a life-threatening complication of these morbid patients. However, this requires periodic monitoring of pressure levels and facile adjustments to avoid aspiration, which might be even fatal. The subtlety of the course of action is often overlooked and negligence gives rise to unsought fatality in some patients. To reverse the course of this mishap, we came about our vocational modification to the conventional endotracheal tubes and air cuffs. The embodiment of automation ensures the inviolability as well as omission of professional lapse. The automatic apparatus facilitates the automatic detection of the pressure distortion and alarms the designated healthcare expert as a forewarning and hence the patient is bypassed any associated threat.
... This latter resuscitation was performed by the surgeon William Fossach [5]. He presented in 1744 at Edinburgh the case study of his mouth-to-mouth rescue [6]. In 1787, Baron Antoine Portal proposed, for respiratory insufficiency cases, to inflate the lungs of the new-born with air. ...
... In 1787, Baron Antoine Portal proposed, for respiratory insufficiency cases, to inflate the lungs of the new-born with air. The Scottish surgeon John Hunter, advocate of the experimental method in Medicine, who developed human bellows with pressure relief valve, recommended to the Royal Human Society in 1776 the need to apply artificial ventilation immediately for resuscitation [2, 6]. Furthermore, in order to reduce stomach inflation, the major problem with bellows ventilation, he suggested pressing gently the larynx against the vertebrae [2, 7]. ...
... The bellows ventilation was condemned by the Royal Human Society and the French Academy of Medicine for lack of safety due to their first adverse effects. In 1745, John Fothergill listed singular advantages of mouth-to-mouth expired air ventilation compared to the bellows ventilation during resuscitation [2, 6]. He said that " the warmth and moisture of the breath would be more likely to promote the circulation than the chilling air forced out of a pair of bellows and that the lungs of one man may bear, without injury, as great a force as those of another can exert, which by the bellows cannot always be determined " [2]. ...
Manual ventilation is a vital procedure, which remains difficult to achieve for patients who require ventilatory support. It has to be performed by experienced healthcare providers that are regularly trained for the use of bag-valve-mask (BVM) in emergency situations. We will give in this paper, a historical view on manual ventilation's evolution throughout the last decades and describe the technical characteristics, advantages, and hazards of the main devices currently found in the market. Artificial ventilation has developed progressively and research is still going on to improve the actual devices used. Throughout the past years, a brand-new generation of ventilators was developed, but little was done for manual ventilation. Many adverse outcomes due to faulty valve or misassembly were reported in the literature, as well as some difficulties to ensure efficient insufflation according to usual respiratory parameters. These serious incidents underline the importance of BVM system routine check and especially the unidirectional valve reassembly after sterilization, by only experienced and trained personnel. Single use built-in devices may prevent disassembly problems and are safer than the reusable ones. Through new devices and technical improvements, the safety of BVM might be increased.
... A strong volatile salt, like spirit of salt ammoniac, must be applied to temples and nostrils; nostrils and throat must only be tickled, without introducing any liqueur, till the patient has recuperated the respiratory and swallowing faculties. In order to reactivate the lungs, a mouth-to-mouth resuscitation is practiced: the assistant blows into the mouth of the patient, blocking both nostrils with one hands and using the other to exercise pressure on the chest to breath the air out (Cogan T., 1773; Trubuhovich RV., 2006). ...
... A strong volatile salt, like spirit of salt ammoniac, must be applied to temples and nostrils; nostrils and throat must only be tickled, without introducing any liqueur, till the patient has recuperated the respiratory and swallowing faculties. In order to reactivate the lungs, a mouth-to-mouth resuscitation is practiced: the assistant blows into the mouth of the patient, blocking both nostrils with one hands and using the other to exercise pressure on the chest to breath the air out (Cogan T., 1773;Trubuhovich RV., 2006). In France in 1771, Nicholas Pia, pharmacist and alderman of the Municipal Guards of Paris is in charge of distributing public advices concerning drowned persons life saving techniques, and organizing a police service for the town municipality. ...
... In this article, I consider MMV also in the context of other History of mouth-to-mouth ventilation Part 3: the 19th to mid-20th centuries and "rediscovery" Ronald V Trubuhovich Footnote 1. In the two previous articles in this series, 6,8 I used the phrases "expired air ventilation" (EAV) and "mouth-to-mouth rescue breathing". I note the 1959 preference of the American Medical Association's Council on Medical Physics for "expired air inflation", 7 and, although that term seems perhaps more apposite than expired air ventilation, the latter has become established and will be continued with here. ...
... In 1841, while still a "surgeon-apothecary, or general practitioner in emerging parlance", 42[pp. [3][4][5][6] but already with ...
The start of the 19th century saw the enthusiasm of the previous one for mouth-to-mouth ventilation (MMV) dissipated. To inflate the lungs of the asphyxiated, the Royal Humane Society in the United Kingdom had recommended bellows since 1782. Principal determinants for change were aesthetic distaste for mouth-to-mouth contact and the perceived danger of using expired air, although MMV survived in the practice of some midwives. Following the 1826-9 investigations of Jean-Jacques Leroy d'Etiolles then François Magendie, all positive pressure ventilation methods were generally abandoned, after 1829 in France, and 1832 in the UK; but not chest compressions. During the next quarter century, rescuers lost understanding of the primary need for "artificial respiration", apart from researchers such as John Snow and John Erichsen, until Marshall Hall's "Ready Method" heralded the second half-century's various methods of negative pressure ventilation. Some of those methods continued in use until the 1940s. Sporadic anecdotal cases of MMV rescues were documented throughout. In the 20th century, inadequate mechanical inhalators were also tried from 1908, while obstetricians devised indirect methods of expired air ventilation (EAV). Anaesthetists in the 1940s, such as Ralph Waters, Robert Dripps, and the pair, Robert Macintosh and William Mushin, described the usefulness of MMV, and James Elam was "re-discovering" it. Following World War II, "Cold War" concerns stimulated research at the Edgewood Medical Laboratories in Maryland in the United States into the possibilities of MMV, and Elam et al confirmed and expanded on brief experiments at Oxford (United Kingdom) on the efficacy of mouth-to-tube EAV. Studies, 1957-9, by Archer Gordon, Elam and especially Peter Safar resulted in the resolution of previous airway problems, established the primacy of MMV, and incorporated it into an integrated system for basic cardiopulmonary resuscitation. Ready adoption of MMV in the US was followed by worldwide spread, especially after endorsement from the 1962 international symposium at Stavanger in Norway. However, already there were occasional rumblings of reluctance to perform MMV. In this article, I consider MMV also in the context of other ventilatory modes for resuscitation.
Neonatal resuscitation, an early and critical intervention in human life, has dramatically evolved. This procedure has gone through phases from uncivilized practices that were sometimes based on myths to the current evidence-based approaches. In this review, we will shed light on the evolution of neonatal resuscitation from early centuries to the current day. Our goal is to highlight the value of clinical research and its role in invalidating hazardous practices and establishing evidence-based guidelines.
