Rediscovery of Expired Air Methods for Emergency Ventilation

  • James O. Elam


During the poliomyelitis epidemic in Minnesota in 1946, I did mouth-to-mouth breathing as an instinctive reflex many times on patients with combined spinal-bulbar paralysis at times of equipment failure. The tank respirators and medical personnel were in short supply. There were no Danes to point out the virtues of IPPV with oxygen via tracheal tube, bag, and anesthesia nurse. Henning Ruben was still a dentist, not even dreaming of the “squeeze bag” (He designed and introduced the self-refilling bag-valve-mask unit in the late 1950s.) The private anesthesiologists were busy in the OR, so Maurice Visscher, my Professor of Physiology, assigned me, his only graduate fellow with an MD degree, to the polio floor. Allan Hemingway of the same department had just returned from active duty in the Air Force with an oximeter he had “borrowed” from Glen Millikan. I was the boy given this new device and sent for data (1, 2).


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  1. 1.
    Elam JO, Hemingway A, Gullickson G, et al: The impairment of pulmonary function in poliomyelitis. Oximetry studies in spinal and bulbar patients. Arch Intern Med 81: 649, 1948Google Scholar
  2. 2.
    Elam JO: Poliomyelitis. The physiological management of respiratory dysfunction in poliomyelitis. Proc Am Acad Pediatr 1: 691, 1948Google Scholar
  3. 3.
    Kubicek WG, Holt GW, Elam JO, et al: Oxygen therapy in poliomyelitis. A tracheotomy inhalator incorporating humidification and the optional use of positive pressure for oxygen therapy in patients with tracheotomy. Arch Phys Med 29: 217, 1948PubMedGoogle Scholar
  4. 4.
    Elam JO: Respiratory and circulatory resuscitation. In American Physiological Society: Handbook of Physiology, Section 3, Respiration. Baltimore, Williams & Wilkins, 1965, pp 1265 - 1312Google Scholar
  5. 5.
    Brown ES, Elam JO: Resuscitation with mouth-to- mouth methods. Artificial ventilation for emergency and prolonged periods in normal or contaminated atmospheres. Special Report No. 28. U.S. Army Chemical Corps Medical Laboratories, Edgewood, Md. 1953, p 41Google Scholar
  6. 6.
    Elam JO, Brown ES, Elder JD Jr: Artificial respiration by mouth-to-mask methods. N Engl Med J 250: 749, 1954CrossRefGoogle Scholar
  7. 7.
    Greene DG, Bauer RO, Janney CD, et al: Crossed ventilation in apneic patients. I. Blood gas changes. Am J Physiol 187: 602, 1956Google Scholar
  8. 8.
    Elam JO, Greene DG, Brown ES, et al: Oxygen and carbon dioxide exchange and energy cost of expired air resuscitation. JAMA 167: 328, 1958Google Scholar
  9. 9.
    Elam JO, Greene DG: Mission accomplished. Successful mouth-to-mouth resuscitation. Anesth Analg 40: 440, 578, 672, 1961Google Scholar

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© Springer-Verlag New York Inc. 1977

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  • James O. Elam

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