Transcript Edgar Pask - information for the uninitiated Dr Gary R Enever Royal Victoria Infirmary Newcastle upon Tyne, UK.

Edgar Pask - information for
the uninitiated
Dr Gary R Enever
Royal Victoria Infirmary
Newcastle upon Tyne, UK
Ralph Waters and the early years of
British academic anaesthesia
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Waters was the first Professor of
anaesthesia in the world
Pioneer of anaesthesia in fields of
teaching, research and
professionalism
Visits to England in 1933 and 1936
Robert Macintosh, and the first
British professorship in the new
Nuffield department in Oxford
(1937), modelled on the
department in Madison, Wisconsin
Then, along came the Second
World War
Who was Pask?
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Born in Lancashire
in 1912
Studied Medicine in
Cambridge and
London, qualified
1933
Became Macintosh’s
“first assistant” in
Oxford before the
war
The Royal Air Force Years
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Macintosh and Pask went to work in the RAF’s
physiological research institute
As the war progressed, aircrew were dying, perhaps
unnecessarily, and every pilot was needed - questions
needed answering
Could aircrew bale out at 40,000 feet and survive?
Could a drowned airman be ventilated in a speeding
rescue launch?
What was the best lifejacket for an unconscious pilot?
Could Winston Churchill still smoke a cigar with an
oxygen mask on?
“convenient to
use the author as
an experimental
subject”
Macintosh
commented that
Pask did most of
the work for his
MD thesis whilst
anaesthetised...
(1)The Descent Experiments
Pask used himself for the majority of
the descents, including the extremely
dangerous first four
 Mixtures of gases were used to simulate
the partial pressures of oxygen at high
altitude experienced by an airman
descending by parachute
 All the subjects suffered from the
effects of profound hypoxia
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(2)The Artificial Ventilation
Experiments
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Pask used himself as the experimental subject
He was deeply anaesthetised with ether, and then
connected to apparatus that measured his expired
tidal volumes.
He was used to evaluate available methods of
articially ventilating the lungs
In later experiments he was also paralysed with
curare - this is before it had come into common use
in anaesthesia
(3)The Floatation Trails
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Pask was anaesthetised with ether, intubated, and
placed in a swimming pool
A variety of lifejackets and floatation suits were
tested
He undoubtably suffered aspiration and lung damage
during these experiments
Incidently, the circuit used was developed by the
team - it was later independently rediscovered and
described. At the flows used (20 litres min) it
probably worked as a co-axial T piece
“Into the drink”
Some lifejackets
worked
Pretty good
Not all experiments were successful
This floatation suit looks quite effective
Perhaps not…….
Back to the drawing board
Pask after the RAF
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King George awarded Pask the Order of the
British Empire in 1944, for his selfless actions
that undoubtably helped to save the lives of
many aircrew.
However, although he was a brave and brilliant
man, he had little experience of giving
anaesthetics, or running a department.
In 1947 he went to Madison, Wisconsin, to
finish his “training” under Ralph Waters.
Pask and Newcastle
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At the end of 1947, Pask took up his newly created
post of Reader in Anaesthetics at the University of
Durham.
He was based in King’s College, Newcastle upon
Tyne, and became Head of the Department in the
Royal Victoria Infirmary.
He was made a Professor in 1949, and remained so
until his death in 1966 at the age of 53 years.
He was provided with lab facilities and a workshop,
with technicians to create his inventions
Pask’s achievements
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Established a University department that went on to
lead research and train a number of Britain’s
influencial anaesthetists - People such as Nunn and
Vickers
Led research in artificial ventilation and the
development of ventilators, and monitoring
Continued work on lifejackets with “Sierra Sam”
Tradition of quality, teaching, research and cooperation
Newcastle ventilators
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After his personal
experiences of being
ventilated, Pask and
Norman Burn invented
many devices - here is
an early one using
mercury switches
The threat of polio
epidemics spurred
invention, after the
experiences in Denmark
Newcastle ventilators
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This ventilator, from
the mid 50’s, could
be used in theatre
or on the wards. If a
patient was on the
ward ( this is before
ITU) the trainees
stayed by the bed in
shifts
Newcastle ventilators
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These very neat
injector ventilators
also date from the
50’s. One is brass,
the other perspex.
At the bottom is a
Beaver non return
valve
Newcastle ventilators
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This injector, known
as the “bluebird” has
bits of “Meccano”
inside. It dates from
about 1967, and is
probably the last
that Pask had a
direct influence on
Newcastle ventilators
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This shows the last
of the line, which
was produced semi
commercially. A
ventilator using
Pask’s ideas was
produced by BOC the Cyclator
Sierra Sam
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Common sense precluded using
Pask for further lifejacket
experiments
A specialist medical equipment
manufacturer in the Sierra
Nevada created “Sam” for Pask
Early Sam work in the pool
Inside Sam
Ready for the plunge
Sam in action
Pask the man
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Passionate about patient care
Quiet, unassuming and almost shy
A poor sleeper, and often found in the
hospital at night helping juniors, after
his compulsory 11pm phone call
Inventive and determined
A prolific and effective lecturer
Suffered poor health, not helped by his
chain smoking
Thank you
http://www.ncl.ac.uk/nsa/museum.html