Anaesthesia and intensive care
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Anaesth Intensive Care · Jul 2015
Historical ArticlePioneering early Intensive Care Medicine by the 'Scandinavian Method' of treatment for severe acute barbiturate poisoning.
Between the 1920s and the mid-1950s, barbiturates were the sedative-hypnotic agents most used in clinical practice. Their ready availability and narrow therapeutic margin accounted for disturbingly high rates of acute poisoning, whether suicidal or accidental. Until the late 1940s, medical treatment was relatively ineffective, with mortality subsequently high - not only from the effects of coma, respiratory depression and cardiovascular shock with renal impairment, but also from complications of the heavy use in the 1930s and 1940s of analeptic stimulating agents. ⋯ Clemmesen's Intoxication Unit opened at the Bispebjerg Hospital, Copenhagen, on 1 October 1949. ICU pioneer Bjørn Ibsen suggested it was the initial ICU, while noting that it supplied Intensive Therapy for one type of disorder only (as had HCA Lassen's Blegdam Hospital unit for Denmark's 1952 to 1953 polio epidemic). Treatment for barbiturate poisoning during the 1950s in some other Scandinavian hospitals will also be considered briefly.
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The Heister mouth gag is attributed to Lorenz Heister, an eighteenth century German surgeon. There is no evidence that Heister designed the mouth gag, the earliest known illustration of which is in the 1719 edition of Heister's Chirurgie. In the first half of the twentieth century, the Heister gag was widely available for use during anaesthesia. It is now rarely used by anaesthestists, but occasionally used by surgeons during oral surgery.
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Anaesth Intensive Care · Jul 2015
Editorial Historical ArticlePresenting and getting published in the history of anaesthesia-why and where?