Jordan Francke, MD, MPH: Uncuffing the Legacy of Arthur Guedel's Cuffed Endotracheal Tube

Jordan Francke, MD, MPH

November 28, 2022

"October 4, 1928

Arthur Guedel MD (Beverly Hills, CA) to Ralph Waters MD (Madison, WI)

'It was my first case at St. Vincents Hospital, the young wife of one of our (Los Angeles) X ray men… She died within three minutes after the anesthesia was started, and before the operation was begun. I don’t know what happened… Some cyanosis, and I felt the pulse to be indefinite. Seemed feeble, but still passable. As cyanosis increased I inflated with Oxygen. No pink. More Oxygen. No pink. No Pulses. I put a catheter into her larynx… and conducted artificial respiration by inhaling my own lungs full of oxygen and blowing it into her lungs through the catheter.  I dont know and you dont know. After all medicine some times seems damned futile.'

If the above attempt to resuscitate an apneic patient were performed by a contemporary anesthesiologist, it would likely be considered malpractice. However, less than a century ago, this effort might have been considered sophisticated, using a groundbreaking innovation that had yet to be popularized: the endotracheal tube."

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