Saturday, September 28, 2013

An Anesthesiologist's Guide To Medical History

If you like reading history as much as I do, you have to get yourself a current issue of the Anesthesiology News (registration required) for a fascinating article on the history of anesthesiology. Titled "When Settled Isn't Settled: An Anesthesiologist's Guide to Medical History," it is written by regular commentator Dr. Steven Kron. The piece lists his personal "10 Best Anesthesia Paradigm Shifts." This is the kind of information that is never taught to busy students and residents. It's not until they have the luxury of free time do they finally get around to understanding how anesthesiology has gotten to the preeminence it holds today in patient safety.

Many of you may already know this, but I didn't know that ECG monitoring wasn't even considered a necessity as late as the 1970's. This was eighty years after the invention of the device by Einthoven in 1895. Nowadays I wouldn't even start a case until I have a decent ECG reading on my monitor.

The closed circle system found in all operating rooms was invented in 1924. It was developed by the father and son team of Heinrich and Bernhard Drager. That helps explain the source of the Drager name on anesthesia machines that are ubiquitous in operating rooms these days.

Health insurance wasn't even a purchasable product until well into the 20th century. Before that, there was sickness insurance which insured against lost income during illness but it didn't pay for physicians or treatments. At that time doctors had few remedies for treating patient so there was thought to be no need to pay for our work when it was God who decided who lived and who died. Then in 1929, a group of Dallas teacher worked with Baylor Hospital in Texas to pay $6 for 21 days of hospital care (!). This was the beginning of the current healthcare morass we face today.

There is a lot more fun stuff to be found in the article. Things such as the history of the hollow needle and the invention of the anesthesia record. You'll be astonished how much of our anesthesia practice we now take for granted but were revolutionary when first introduced into the practice of medicine.

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