Vital Times 2020 - Cover3

They discovered that PEEP or CPAP-novel concepts
at the time-could reverse neonatal lung dysfunction.
In 1978, Stanford anesthesiologist William " Bill "
New, MD, PhD, developed the Nellcor N100 pulse
oximeter, which could measure oxygenation
without puncturing skin. (While the first pulse
oximeter appeared in Japan, the Nellcor N100 was
the first to achieve clinical use.) It revolutionized
patient safety, first in the operating room, and
then in all other care settings. Not only was it
portable, it also used a sound that modulated
to heart rate and oxygen saturation.

WE ARE

CSA!

Due to the stressful nature of intubation and
ventilation, sedative and analgesic agents have
also been vital to critical care. Anesthesiologists
played a crucial role in developing these
drugs. British anesthesiologists first studied
propofol clinically in the late 1970s. In the
early 2000s, Stanford anesthesiologist Mervyn
Maze, MB, ChB, thoroughly examined the
pharmacologic properties of dexmedetomidine.
2020
Editor

Section Editors

Rita Agarwal, MD, FAAP, FASA

Ryan Field, MD

Publications Manager
Kate Peyser

Ludwig Lin, MD
Jane Moon, MD
Mark Singleton, MD, FASA

Furthermore, anesthesiologists led the
development of crisis simulation education.
Judson " Sam " Denson, MD, (USC, 1967) created
the first simulation mannequin; David Gaba, MD,
(Stanford, Palo Alto VA, 1988) developed the first
full operating-room simulator. Now, simulation is
widely used to help health care workers manage
resources and act decisively during crises.

COVID-19: Anesthesia History
in the Making
Business, Subscription and Editorial Office
1 Capitol Mall, Suite 800, Sacramento, CA 95814

Phone
Fax

916 -290-5830
916 - 444-7462

Frequency:
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Email csa@csahq.org
Website www.csahq.org

Our ability to serve on the front lines of
this pandemic builds in large part upon the
prior achievements of anesthesiologists.
Endotracheal intubation, positive-pressure
ventilation, intensive care units, blood gas
analysis, positive end-expiratory pressure,
pulse oximetry, modern sedatives, and crisis

simulation-all were once novel concepts that
are now essential elements of COVID-19 care.
Thus, we stand on the shoulders of giants
as we combat this disease. In the meantime,
the remarkable spirit of innovation-a true
trademark of physician anesthesia-carries on.
To fulfill our duty as doctors while minimizing
personal risk, anesthesiologists have devised novel
ways to decrease aerosolization during intubation
and extubation, to sterilize and reuse personal
protective equipment (PPE), and to create effective
masks from available supplies. To mitigate the
global shortage of ventilators, anesthesiologists
have participated in the creation of lower-cost,
simple respirators. Some are taking the form
of mechanized AmbuĀ® bags-a throwback to
the Danish polio epidemic of the 1950s, when
patients were painstakingly ventilated by hand.
Just as polio revolutionized the worlds of
anesthesia, physiology, and medicine in the 1950s,
COVID-19-an even more widespread disease-will
change us as well. It is our hope that when the
next pandemic occurs, we will be armed with even
newer solutions that will echo Dr. Flagg's idea that
we are physicians first, and specialists second.
References
1 Eger EI, Saidman LJ, Westhorpe RN. The Wondrous Story

of Anesthesia. New York, NY: Springer; 2014.

2 West JB. The physiological challenges of the 1952

Copenhagen poliomyelitis epidemic and a renaissance
in clinical respiratory physiology. J Appl Physiol.
2005;99(2):424-32.

3 Calmes SH. Why a paper on anesthesia and polio in 2016?

Anesth Analg. 2016;122(6):1748-51.

4 Larson MD. Paluel J. Flagg and the " art " of anesthesia.

CSA Bulletin. Winter 2009;88-92.

POSTMASTER: Send address changes to CSA office,
1 Capitol Mall, Suite 800, Sacramento, CA 95814.

Annual Publication 2020

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