ABSTRACT
Although the importance of providing appropriate facilities for all newborn babies has only been generally appreciated over the last 40 years, a recommendation that every accoucheur should carry along with him to every labor a tracheal pipe, a little tube of silver designed to pass down the trachea, was first made by Blundell, an obstetrician at Guy’s Hospital in 1834.28 He recommended that the fourth finger of the left hand be slid down ‘the roof of the tongue and into the rim of the glottis and then, using the tube with the right hand, insert the tube’. The lungs were then to be inflated from the operator’s own lungs. Although not in regular use since then, this was re-described in 1941 by Russ and Strong,96 and recently by neonatologists from Washington.51 In 1842, Evanson and Maunsell recommended the use of oropharyngeal suction followed by mouth-to-mouth resuscitation.32 This was very much against the recommendation of the Royal Humane Society,95 which deprecated the use of mouth-to-mouth resuscitation on the grounds that ‘stale’ air was unlikely to be of value in resuscitation. In 1889, Doe and Braun described the use of a box ventilator, a rather clumsy precursor of the tank ventilators which were used extensively for the treatment of poliomyelitis victims.24 In the 1920s, a paper published in the Journal of the American Medical Association recommended the use of T-piece face mask resuscitation (see below).54 The main claim for the introduction of neonatal resuscitation must be ascribed, however, to Flagg who, in 1928, advocated intubation 39
An alternative approach recommended by Blaikley and Gibberd of Queen Charlotte’s and Guy’s Hospitals, London in 1935 was that of intubation and high level continuous positive airways pressure.10 Despite this, there remained interest in other forms of resuscitation including gastric oxygen2 and hyperbaric oxygen.64 Although these approaches did have some advocates who were perhaps having problems coming to terms with the skills of intubation and ventilation, interest in them has now disappeared!
