Edgar Pask - information Edgar Pask - information for the uninitiatedfor the uninitiated

Dr Gary R EneverDr Gary R Enever

Royal Victoria InfirmaryRoyal Victoria Infirmary

Newcastle upon Tyne, UKNewcastle upon Tyne, UK

Ralph Waters and the early years of Ralph Waters and the early years of British academic anaesthesiaBritish academic anaesthesia

Waters was the first Professor of Waters was the first Professor of anaesthesia in the worldanaesthesia in the world

Pioneer of anaesthesia in fields of Pioneer of anaesthesia in fields of teaching, research and teaching, research and professionalismprofessionalism

Visits to England in 1933 and 1936Visits to England in 1933 and 1936 Robert Macintosh, and the first Robert Macintosh, and the first

British professorship in the new British professorship in the new Nuffield department in Oxford Nuffield department in Oxford (1937), modelled on the (1937), modelled on the department in Madison, Wisconsindepartment in Madison, Wisconsin

Then, along came the Second Then, along came the Second World WarWorld War

Who was Pask?Who was Pask?

Born in Lancashire Born in Lancashire in 1912in 1912

Studied Medicine in Studied Medicine in Cambridge and Cambridge and London, qualified London, qualified 19331933

Became Macintosh’s Became Macintosh’s “first assistant” in “first assistant” in Oxford before the Oxford before the warwar

The Royal Air Force YearsThe Royal Air Force Years Macintosh and Pask went to work in the RAF’s Macintosh and Pask went to work in the RAF’s

physiological research institutephysiological research institute As the war progressed, aircrew were dying, As the war progressed, aircrew were dying,

perhaps unnecessarily, and every pilot was perhaps unnecessarily, and every pilot was needed - questions needed answeringneeded - questions needed answering

Could aircrew bale out at 40,000 feet and survive?Could aircrew bale out at 40,000 feet and survive? Could a drowned airman be ventilated in a Could a drowned airman be ventilated in a

speeding rescue launch?speeding rescue launch? What was the best lifejacket for an unconscious What was the best lifejacket for an unconscious

pilot?pilot? Could Winston Churchill still smoke a cigar with an Could Winston Churchill still smoke a cigar with an

oxygen mask on?oxygen mask on?

“convenient to use the author as an experimental subject”

Macintosh commented that Pask did most of the work for his MD thesis whilst anaesthetised...

(1)The Descent (1)The Descent ExperimentsExperiments

Pask used himself for the majority of Pask used himself for the majority of the descents, including the extremely the descents, including the extremely dangerous first fourdangerous first four

Mixtures of gases were used to Mixtures of gases were used to simulate the partial pressures of simulate the partial pressures of oxygen at high altitude experienced by oxygen at high altitude experienced by an airman descending by parachutean airman descending by parachute

All the subjects suffered from the All the subjects suffered from the effects of profound hypoxiaeffects of profound hypoxia

(2)The Artificial Ventilation (2)The Artificial Ventilation ExperimentsExperiments

Pask used himself as the experimental subjectPask used himself as the experimental subject He was deeply anaesthetised with ether, and He was deeply anaesthetised with ether, and

then connected to apparatus that measured then connected to apparatus that measured his expired tidal volumes.his expired tidal volumes.

He was used to evaluate available methods of He was used to evaluate available methods of articially ventilating the lungsarticially ventilating the lungs

In later experiments he was also paralysed In later experiments he was also paralysed with curare - this is before it had come into with curare - this is before it had come into common use in anaesthesiacommon use in anaesthesia

(3)The Floatation Trails(3)The Floatation Trails

Pask was anaesthetised with ether, intubated, Pask was anaesthetised with ether, intubated, and placed in a swimming pooland placed in a swimming pool

A variety of lifejackets and floatation suits were A variety of lifejackets and floatation suits were testedtested

He undoubtably suffered aspiration and lung He undoubtably suffered aspiration and lung damage during these experimentsdamage during these experiments

Incidently, the circuit used was developed by Incidently, the circuit used was developed by the team - it was later independently the team - it was later independently rediscovered and described. At the flows used rediscovered and described. At the flows used (20 litres min) it probably worked as a co-axial T (20 litres min) it probably worked as a co-axial T piecepiece

“Into the drink”

Some lifejackets worked

Pretty good

Not all experiments were successful

This floatation suit looks quite effective

Perhaps not…….

Back to the drawing board

Pask after the RAFPask after the RAF King George awarded Pask the Order of King George awarded Pask the Order of

the British Empire in 1944, for his selfless the British Empire in 1944, for his selfless actions that undoubtably helped to save actions that undoubtably helped to save the lives of many aircrew.the lives of many aircrew.

However, although he was a brave and However, although he was a brave and brilliant man, he had little experience of brilliant man, he had little experience of giving anaesthetics, or running a giving anaesthetics, or running a department.department.

In 1947 he went to Madison, Wisconsin, to In 1947 he went to Madison, Wisconsin, to finish his “training” under Ralph Waters.finish his “training” under Ralph Waters.

Pask and NewcastlePask and Newcastle At the end of 1947, Pask took up his newly At the end of 1947, Pask took up his newly

created post of Reader in Anaesthetics at the created post of Reader in Anaesthetics at the University of Durham.University of Durham.

He was based in King’s College, Newcastle upon He was based in King’s College, Newcastle upon Tyne, and became Head of the Department in the Tyne, and became Head of the Department in the Royal Victoria Infirmary.Royal Victoria Infirmary.

He was made a Professor in 1949, and remained He was made a Professor in 1949, and remained so until his death in 1966 at the age of 53 years.so until his death in 1966 at the age of 53 years.

He was provided with lab facilities and a He was provided with lab facilities and a workshop, with technicians to create his workshop, with technicians to create his inventionsinventions

Pask’s achievementsPask’s achievements

Established a University department that went Established a University department that went on to lead research and train a number of on to lead research and train a number of Britain’s influencial anaesthetists - People such Britain’s influencial anaesthetists - People such as Nunn and Vickersas Nunn and Vickers

Led research in artificial ventilation and the Led research in artificial ventilation and the development of ventilators, and monitoringdevelopment of ventilators, and monitoring

Continued work on lifejackets with “Sierra Continued work on lifejackets with “Sierra Sam”Sam”

Tradition of quality, teaching, research and co-Tradition of quality, teaching, research and co-operationoperation

Newcastle ventilatorsNewcastle ventilators After his personal After his personal

experiences of being experiences of being ventilated, Pask and ventilated, Pask and Norman Burn invented Norman Burn invented many devices - here is many devices - here is an early one using an early one using mercury switchesmercury switches

The threat of polio The threat of polio epidemics spurred epidemics spurred invention, after the invention, after the experiences in experiences in DenmarkDenmark

Newcastle ventilatorsNewcastle ventilators

This ventilator, This ventilator, from the mid 50’s, from the mid 50’s, could be used in could be used in theatre or on the theatre or on the wards. If a patient wards. If a patient was on the ward was on the ward ( this is before ITU) ( this is before ITU) the trainees the trainees stayed by the bed stayed by the bed in shiftsin shifts

Newcastle ventilatorsNewcastle ventilators

These very neat These very neat injector ventilators injector ventilators also date from the also date from the 50’s. One is brass, 50’s. One is brass, the other perspex. the other perspex. At the bottom is a At the bottom is a Beaver non return Beaver non return valvevalve

Newcastle ventilatorsNewcastle ventilators

This injector, This injector, known as the known as the “bluebird” has bits “bluebird” has bits of “Meccano” of “Meccano” inside. It dates inside. It dates from about 1967, from about 1967, and is probably and is probably the last that Pask the last that Pask had a direct had a direct influence oninfluence on

Newcastle ventilatorsNewcastle ventilators

This shows the This shows the last of the line, last of the line, which was which was produced semi produced semi commercially. A commercially. A ventilator using ventilator using Pask’s ideas was Pask’s ideas was produced by BOC produced by BOC - the Cyclator- the Cyclator

Sierra SamSierra Sam

Common sense precluded Common sense precluded using Pask for further using Pask for further lifejacket experimentslifejacket experiments

A specialist medical A specialist medical equipment manufacturer in equipment manufacturer in the Sierra Nevada created the Sierra Nevada created “Sam” for Pask“Sam” for Pask

Early Sam work in the poolEarly Sam work in the pool

Inside SamInside Sam

Ready for the plungeReady for the plunge

Sam in actionSam in action

Pask the manPask the man

Passionate about patient carePassionate about patient care Quiet, unassuming and almost shyQuiet, unassuming and almost shy A poor sleeper, and often found in A poor sleeper, and often found in

the hospital at night helping the hospital at night helping juniors, after his compulsory 11pm juniors, after his compulsory 11pm phone callphone call

Inventive and determinedInventive and determined A prolific and effective lecturerA prolific and effective lecturer Suffered poor health, not helped Suffered poor health, not helped

by his chain smokingby his chain smoking

Thank youThank you

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