Archie Brain

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Archie I J Brain
ArchieBrain2009.jpg
Brain in 2009
Born (1942-07-02) 2 July 1942 (age 81)
Kobe, Japan
NationalityBritish
Alma mater University of Oxford
Known forInventor of laryngeal mask airway
Scientific career
Fields Anaesthesia

Archie Brain (born 2 July 1942) is a British anaesthetist best known as the inventor of the laryngeal mask. The LMA has been used over 300 million times worldwide in elective anaesthesia and emergency airway management.

Contents

Biography

Brain returned to the UK in April 1980 and took up a post as a lecturer at the Royal London Hospital under Professor Jimmy Payne. He set out to determine the electromagnetic field strength required to block the action potential along a nerve. This involved encircling a frog nerve-muscle preparation with an electromagnetic coil. [1] In 1982, he had his first publication: a letter to the editor suggesting that alcuronium should be used instead of succinylcholine for "crash" induction. [2]

Brain submitted patent applications for 12 new devices, including one to assist venepuncture, one to prevent obstruction of anaesthetic trolleys by cables, one to apply a specific amount of cricoid pressure, and even a rotating bed for use in intensive care to prevent bed-sores. The laryngeal mask, LMA Classic was his 13th patent application and was granted in 1982. [3] The LMA Classic was sold by LMA International NV, a company sold to Teleflex Inc in 2012 for $276m. [4]

Related Research Articles

<span class="mw-page-title-main">Larynx</span> Voice box, an organ in the neck of amphibians, reptiles, and mammals

The larynx, commonly called the voice box, is an organ in the top of the neck involved in breathing, producing sound and protecting the trachea against food aspiration. The opening of larynx into pharynx known as the laryngeal inlet is about 4–5 centimeters in diameter. The larynx houses the vocal cords, and manipulates pitch and volume, which is essential for phonation. It is situated just below where the tract of the pharynx splits into the trachea and the esophagus. The word 'larynx' comes from the Ancient Greek word lárunx ʻlarynx, gullet, throat.ʼ

<span class="mw-page-title-main">Tracheal intubation</span> Placement of a tube into the trachea

Tracheal intubation, usually simply referred to as intubation, is the placement of a flexible plastic tube into the trachea (windpipe) to maintain an open airway or to serve as a conduit through which to administer certain drugs. It is frequently performed in critically injured, ill, or anesthetized patients to facilitate ventilation of the lungs, including mechanical ventilation, and to prevent the possibility of asphyxiation or airway obstruction.

<span class="mw-page-title-main">Laryngoscopy</span> Endoscopy of the larynx

Laryngoscopy is endoscopy of the larynx, a part of the throat. It is a medical procedure that is used to obtain a view, for example, of the vocal folds and the glottis. Laryngoscopy may be performed to facilitate tracheal intubation during general anaesthesia or cardiopulmonary resuscitation or for surgical procedures on the larynx or other parts of the upper tracheobronchial tree.

<span class="mw-page-title-main">General anaesthesia</span> Medically induced loss of consciousness

General anaesthesia (UK) or general anesthesia (US) is a method of medically inducing loss of consciousness that renders a patient unarousable even with painful stimuli. This effect is achieved by administering either intravenous or inhalational general anaesthetic medications, which often act in combination with an analgesic and neuromuscular blocking agent. Spontaneous ventilation is often inadequate during the procedure and intervention is often necessary to protect the airway. General anaesthesia is generally performed in an operating theater to allow surgical procedures that would otherwise be intolerably painful for a patient, or in an intensive care unit or emergency department to facilitate endotracheal intubation and mechanical ventilation in critically ill patients.

The pharyngeal reflex or gag reflex is a reflex muscular contraction of the back of the throat, evoked by touching the roof of the mouth, back of the tongue, area around the tonsils, uvula, and back of the throat. It, along with other aerodigestive reflexes such as reflexive pharyngeal swallowing, prevents objects in the oral cavity from entering the throat except as part of normal swallowing and helps prevent choking, and is a form of coughing. The pharyngeal reflex is different from the laryngeal spasm, which is a reflex muscular contraction of the vocal cords.

<span class="mw-page-title-main">Laryngeal mask airway</span> Medical device for maintaining an open airway

A laryngeal mask airway (LMA), also known as laryngeal mask, is a medical device that keeps a patient's airway open during anaesthesia or while they are unconscious. It is a type of supraglottic airway device. They are most commonly used by anaesthetists to channel oxygen or inhalational anaesthetic to the lungs during surgery and in the pre-hospital setting for unconscious patients.

<span class="mw-page-title-main">Airway management</span> Medical procedure ensuring an unobstructed airway

Airway management includes a set of maneuvers and medical procedures performed to prevent and relieve airway obstruction. This ensures an open pathway for gas exchange between a patient's lungs and the atmosphere. This is accomplished by either clearing a previously obstructed airway; or by preventing airway obstruction in cases such as anaphylaxis, the obtunded patient, or medical sedation. Airway obstruction can be caused by the tongue, foreign objects, the tissues of the airway itself, and bodily fluids such as blood and gastric contents (aspiration).

<span class="mw-page-title-main">Respiratory arrest</span> Medical condition

Respiratory arrest is a serious medical condition caused by apnea or respiratory dysfunction severe enough that it will not sustain the body. Prolonged apnea refers to a patient who has stopped breathing for a long period of time. If the heart muscle contraction is intact, the condition is known as respiratory arrest. An abrupt stop of pulmonary gas exchange lasting for more than five minutes may permanently damage vital organs, especially the brain. Lack of oxygen to the brain causes loss of consciousness. Brain injury is likely if respiratory arrest goes untreated for more than three minutes, and death is almost certain if more than five minutes.

In anaesthesia and advanced airway management, rapid sequence induction (RSI) – also referred to as rapid sequence intubation or as rapid sequence induction and intubation (RSII) or as crash induction – is a special process for endotracheal intubation that is used where the patient is at a high risk of pulmonary aspiration. It differs from other techniques for inducing general anesthesia in that several extra precautions are taken to minimize the time between giving the induction drugs and securing the tube, during which period the patient's airway is essentially unprotected.

<span class="mw-page-title-main">Recurrent laryngeal nerve</span> Nerve in the human body

The recurrent laryngeal nerve (RLN) is a branch of the vagus nerve that supplies all the intrinsic muscles of the larynx, with the exception of the cricothyroid muscles. There are two recurrent laryngeal nerves, right and left. The right and left nerves are not symmetrical, with the left nerve looping under the aortic arch, and the right nerve looping under the right subclavian artery then traveling upwards. They both travel alongside the trachea. Additionally, the nerves are among the few nerves that follow a recurrent course, moving in the opposite direction to the nerve they branch from, a fact from which they gain their name.

<span class="mw-page-title-main">Cricoid cartilage</span> Complete ring of cartilage around the trachea

The cricoid cartilage, or simply cricoid or cricoid ring, is the only complete ring of cartilage around the trachea. It forms the back part of the voice box and functions as an attachment site for muscles, cartilages, and ligaments involved in opening and closing the airway and in producing speech.

<span class="mw-page-title-main">Arytenoid cartilage</span> Part of the larynx, to which the vocal folds (vocal cords) are attached

The arytenoid cartilages are a pair of small three-sided pyramids which form part of the larynx. They are the site of attachment of the vocal cords. Each is pyramidal or ladle-shaped and has three surfaces, a base, and an apex. The arytenoid cartilages allow for movement of the vocal cords by articulating with the cricoid cartilage. They may be affected by arthritis, dislocations, or sclerosis.

<span class="mw-page-title-main">Genioglossus</span>

The genioglossus is one of the paired extrinsic muscles of the tongue. It is a fan-shaped muscle that comprises the bulk of the body of the tongue. It arises from the mental spine of the mandible; it inserts onto the hyoid bone, and the bottom of the tongue. It is innervated by the hypoglossal nerve. The genioglossus is the major muscle responsible for protruding the tongue.

The cough reflex occurs when stimulation of cough receptors in the respiratory tract by dust or other foreign particles produces a cough, which causes rapidly moving air which usually remove the foreign material before it reaches the lungs. This typically clears particles from the bronchi and trachea, the tubes that feed air to lung tissue from the nose and mouth. The larynx and carina are especially sensitive. Cough receptors in the surface cells (epithelium) of the respiratory tract are also sensitive to chemicals. Terminal bronchioles and even the alveoli are sensitive to chemicals such as sulfur dioxide gas or chlorine gas.

Guedel's classification is a means of assessing of depth of general anesthesia introduced by Arthur Ernest Guedel (1883-1956) in 1920.

Following is a list of instruments used in the practice of anesthesia

Cricoid pressure, also known as the Sellick manoeuvre or Sellick maneuver, is a technique used in endotracheal intubation to try to reduce the risk of regurgitation. The technique involves the application of pressure to the cricoid cartilage at the neck, thus occluding the esophagus which passes directly behind it.

The following outline is provided as an overview of and topical guide to anesthesia:

<span class="mw-page-title-main">Laryngeal tube</span> Type of airway management device

The laryngeal tube is an airway management device designed as an alternative to other airway management techniques such as mask ventilation, laryngeal mask airway, and tracheal intubation. This device can be inserted blindly through the oropharynx into the hypopharynx to create an airway during anaesthesia and cardiopulmonary resuscitation so as to enable mechanical ventilation of the lungs.

<span class="mw-page-title-main">Advanced airway management</span>

Advanced airway management is the subset of airway management that involves advanced training, skill, and invasiveness. It encompasses various techniques performed to create an open or patent airway – a clear path between a patient's lungs and the outside world.

References

  1. Wali FA, Brain AIJ. Inhibition of nerve conduction by electromagnetic induction of the frog sciatic nerve – gastrocnemius muscle preparation. Jap J Physiol 1989;39:303–310.
  2. Brain AI. The rapid induction tecnique for Caesarean section. Anaesthesia 1982;37:345.
  3. Joseph R. Brimacombe, Laryngeal Mask Airway: Principles and Practice, Second Edition (2005), pp. 10–11.
  4. "Teleflex to buy LMA International for $276 mln". Reuters. 14 August 2012. Retrieved 18 August 2020.

Further reading