AN INEXPENSIVE SUBSTITUTE FOR OXYGEN THERAPY

AN INEXPENSIVE SUBSTITUTE FOR OXYGEN THERAPY

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Crewe JE. BRINGING OUTSIDE AIR INSIDE: AN INEXPENSIVE SUBSTITUTE FOR OXYGEN THERAPY. JAMA. 1936;107(14):1125. doi:10.1001/jama.1936.92770400001011

Abstract

For many years, in cases of pneumonia or tuberculosis, and in a few cases of advanced cardiac diseases, I have used with excellent results the apparatus that is here described. The apparatus consists essentially of a small blower and a pipe about 2 inches in diameter. The blower is attached to an aperture in a board of adjustable length, so made that it can be fitted beneath a raised window. The pipe extends from the blower to near the patient's face. The middle portion of the pipe is rigid but can be made of adjustable length. To this portion of the pipe is attached a cord and counterweight. The cord runs through a hook or pulley that can be screwed into the ceiling or into an overhead frame. The ends of the pipe are flexible. Thus, the pipe can be hung in any convenient position.

The purpose of the apparatus, obviously is to supply gently moving outdoor air directly to the patient. In extremely cold weather, the patient chest is adequately protected and sometimes a woollen cap is worn. but it is rare for patients to complain of the cold air. They obtain so much relief from it that they object to having the air supply discontinued.

The chief advantage of the apparatus is that it can be used where oxygen is not available because of problem of transportation or of expense. The other advantage is that the atmosphere in the patient's room can be kept in a comfortable temperature and he lies or sits with his movements unhampered. by heavy bed clothes or a tent. Moreover it is sad to say that in many dwellings of our country the patient does not have a room to himself. In fact a large family must live in  one or two rooms. In such cases the atmosphere of the room must be kept warm in winter and is vitiated by heating stoves and by the breathing of other members of the family.

Those physicians those who practice in rural districts which have been hard hit in recent years will appreciate the circumstances which first suggested me an apparatus of the sort that has been described. I was called to see a child aged 5 years, who had pneumonia. The child was cyanotic and the air in the small, tightly closed home was very bad because of the crowded condition of the house and the  fumes from a kerosene stove. The outdoor temperature was 20F. I asked the father to find , if possible , a piece of 3 or 4 inch pipe. He was fortunate in finding an old boiler flue about 7 feet long. A hole, large enough to admit the pipe, was cut in  a board and the board was fitted snugly into a partly opened window. The cold air was rushed in and almost at once the cyanosis disappeared. The simple apparatus was used until the child recovered.

Since then, on occasions, I have reverted to this crude apparatus. For instance, in homes where electricity has not been available to operate the blower, I have used rain spout or any other pipe that could be procured and have fitted elbows to the external end of the pipe to catch the prevailing wind.

In one case, during an extremely hot spell, a patient aged 75 years, who had pneumonia, was experiencing great difficulty in breathing. With all windows open and several fans running, he was not relieved. The pipe was attached to a window, all other windows were closed, and as spray from a garden hose was directed past the inlet of the pipe. At once the breeze of cool, moist, outdoor air that was directed near the patient's face gave much relief from air hunger. After that experience I attached to the inlet of the pipe an automobile hot water heater and caused cold water to circulate through it.

Considerable experience over many years has convinced me that, by the methods described, most patients can be given all the oxygen they require, in nature's own mixture. Recently the apparatus was exhibited at the meeting of the Minnesota State Medical Association and attracted favourable interest, particularly among rural practitioners.

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