History of British intensive care, c.1950-c.2000 : the transcript of a Witness Seminar held by the Wellcome Trust Centre for the History of Medicine at UCL, The Wellcome Trust, on 16 June 2010

2011·1.9 MB·English

by  Reynolds, L. A

History of BritisH intensive Care,
c.1950–c.2000
The transcript of a Witness Seminar held by the Wellcome Trust Centre
for the History of Medicine at UCL, The Wellcome Trust, on 16 June 2010
edited by L a reynolds and e M tansey
volume 42 2011
©the trustee of the Wellcome trust, London, 2011
first published by Queen Mary, University of London, 2011
the History of Modern Biomedicine research Group is funded by the Wellcome trust, which is
a registered charity, no. 210183.
isBn 978 090223 875 6
all volumes are freely available online at www.history.qmul.ac.uk/research/modbiomed/
wellcome_witnesses/
Please cite as: reynolds L a, tansey e M. (eds) (2011) History of British intensive care,
c.1950–c.2000. Wellcome Witnesses to twentieth Century Medicine, vol. 42. London: Queen
Mary, University of London.
Contents
illustrations and credits v
abbreviations ix
Witness seminars: Meetings and publications; acknowledgements
E M Tansey and L A Reynolds xi
introduction
Sir Ian Gilmore xxiii
transcript
Edited by L A Reynolds and E M Tansey 1
appendix 1
Dr Alan Gilston’s draft structure for the Intensive Care Society, 1970 87
appendix 2
Outline curriculum in general intensive care nursing
for State Registered Nurses, Course Number 100, c. 1974 91
appendix 3
Excerpt from 'Priorities in the use of physiotherapy'
by the Chartered Society of Physiotherapy, c. 1970 103
appendix 4
Intensive Care and High Dependency: definitions 105
appendix 5
Twenty-four Nursing Times articles claiming a nursing contribution to
the establishment of intensive care units, arranged by date, 1965–98,
collated by Dr Tony Gilbertson 107
references 109
Biographical notes 135
index 145

iLLUstrations anD CreDits
figure 1 Coventry Alligator iron lung, c.1966.
Photograph provided and reproduced by permission
of Dr Geoffrey Spencer. 5
figure 2 A cuirass shell ventilator connected to a 12 volt
alternating suction pump, in use in an Alvis car,
c. early 1950s. Photograph provided and reproduced
by permission of Dr Geoffrey Spencer. 6
figure 3 Oxford ventilator: Radcliffe, Mark 1 prototype,
c.1955. Provided by Professor Sir Keith Sykes,
© Nuffield department of anaesthetics,
University of Oxford. 7
figure 4 Anne Isberg, aged 8 in 1952, receiving artificial
respiration from a dental student. Provided by
Dr Geoffrey Spencer and reproduced by permission
of the British Polio Fellowship. 9
figure 5 A British iron lung flanked by the Australian designer
E T Both (right), next to Lord Nuffield with Robert
Macintosh (1938). Caption and photo provided
by Sir Keith Sykes, ©Nuffield department of
anaesthetics, University of Oxford. 18
figure 6 Local organizing committee of the First World
Congress on intensive care, London, 1974. Provided
by and reproduced with permission of Professor Iain
Ledingham. 25
figure 7 Broadgreen Hospital Intensive Care Unit, 1964:
(a) floor plan; (b) view from nurses’ station. Provided
by Ms Pat Ashworth and ©Liverpool Regional
Hospital Board, East Liverpool Hospital Management
Committee. 28
v
figure 8 Ron Bradley’s equipment in use on a patient
after cardiac surgery in St Thomas’ north theatre
recovery room, c.1964. Provided by Dr Margaret
Branthwaite and reproduced by permission of
Professor Ron Bradley. 31
figure 9 Equipment that Ron Bradley and Margaret
Branthwaite wheeled round St Thomas’ before
the designated intensive care unit, the Mead ward,
was opened in 1966. Provided by Dr Margaret
Branthwaite and reproduced by permission of
Professor Ron Bradley. 31
figure 10 The aftermath of a session investigating cardiac
output: Ron Bradley sterilizing the pressure
transducers and Margaret Branthwaite ‘counting
squares’. Provided by Dr Margaret Branthwaite and
reproduced by permission of Professor Ron Bradley. 34
figure 11 Ron Bradley measuring a patient’s cardiac output
by thermodilution, assisted by staff nurse Douglas,
Mead ward, St Thomas’ Hospital London, c.1973.
Photograph provided by Dr Margaret Branthwaite
and reproduced by permission of the Royal College of
Physicians of London. 39
figure 12 Floor plan of St Thomas’ intensive care unit, which
opened in September 1966. Provided by and
reproduced with permission of Dr Geoffrey Spencer. 40
figure 13 The first council meeting of the Intensive Care
Society in 1973. Provided by and reproduced with
permission of Professor Iain Ledingham. 51
vi
figure 14 Meeting of the International Scientific Committee
of the Intensive Care Society at the Royal Society of
Medicine, 26 June 1973. Provided by and reproduced
with permission of Professor Iain Ledingham; names
researched by Ms Alice Nicholls and corroborated by
Professor Ledingham. 53
figure 15 The technician at Royal Victoria Infirmary, Newcastle
upon Tyne, 1982. Photo provided by Dr J C
Stoddart, ©anaesthesia and critical care department,
University of Newcastle upon Tyne. 70
table 1 Outline programme for ‘History of British intensive
care’ Witness Seminar. 3
vii

aBBreviations
AC alternating current
ARDS acute respiratory distress syndrome
APACHE Acute Physiology, Age, Chronic Health Evaluation critical
illness scoring system
BACCN British Association of Critical Care Nurses
BBC British Broadcasting Corporation
BTA Been to America
CoBaTrICE Competency Based Training programme in Intensive Care
Medicine for Europe
CVP central venous pressure
DC direct current
DIPEx Database of Individual Personal Experiences
ECCO R extra-corporeal carbon dioxide removal
2
ECG electrocardiogram
ECMO extracorporeal membrane oxygenation
ENB English National Board for Nursing, Midwifery and Health
Visiting
ENT ear, nose and throat
FICM Faculty of Intensive Care Medicine
GGHB Greater Glasgow Health Board
GMC General Medical Council
HBN27 Hospital Building Note 27 (Health Building Note after 1992)
HDU high dependency unit
HP house physician
ICNARC Intensive Care National Audit and Research Centre
ICS Intensive Care Society
ix
ICU/ITU intensive care/therapy unit
IPPR intermittent positive pressure respiration
IPPV intermittent positive pressure ventilation
ITU intensive therapy unit
JBCNS Joint Board of Clinical Nursing Studies
MGH Massachusetts General Hospital, Boston, Massachusetts
NICG Nursing Intensive Care Group
NIPPV non-invasive positive pressure ventilation
NMC Nursing and Midwifery Council
PAC pulmonary artery catheter
PCO arterial blood partial pressure of carbon dioxide
2
PO arterial blood partial pressure of oxygen
2
PRCP President of the Royal College of Physicians of London
RAF Royal Air Force
RAP resident assistant physician
RCN Royal College of Nursing
RCP Royal College of Physicians of London
SCCM Society of Critical Care Medicine
TEG thrombo-elastograph monitoring equipment
UKCC UK Central Council for Nursing, Midwifery and Health
Visiting
x