Angela Smith: April 2020
We have all heard about coronavirus patients needing help with breathing and the NHS needing enough special ventilators for intensive care patients. Angela Smith takes us back to the lower tech days of 1973...
The Senior Consultant Paediatrician had just returned from a course, when he came to do his round, one morning. It was 1973 and I was then in charge in the Special Care Baby Unit. In the far end room, a baby was lying in her incubator, suffering with severe breathing problems. When we got back to the office, the doctor was suddenly filled with enthusiasm.
"What I need," he said, "Is a plastic bag, an elastic band and a bulldog clip." I found him a bag and an elastic band.
"Now, I need a bulldog clip," he said. I opened the desk drawer and at the back, a rather rusty, medium sized bulldog clip was lurking. He couldn't use that. I was about to shut the drawer, when he spied it.
"Just the thing," he said, pouncing on it. He fixed the bag over the baby's head, using the clip to hold it loosely in place, around her neck. A tube bringing oxygen was fixed into a hole in the bag. It was a very primitive version of a Constant Positive Airways Pressure machine. We used it in the absence of the more sophisticated equipment, which we acquired later.
Once we had got it going, the doctor departed and the nursing officer appeared. I told her about our exciting morning and took her to see the baby, who was then looking nice and pink.
"The only thing is," I said, "I feel very ashamed about using that bulldog clip. He would insist on using it, but it is so old and rusty.
"It's not doing any harm," she reassured me. "It's not touching the baby." Then she went off for a meeting with the matron of the General hospital.
At lunch time, she returned. Her face was wreathed in smiles. In her hand was the sweetest, cleanest, smallest bulldog clip, I had ever seen.
"Matron had it on her desk," she told me. She had said, "That is exactly what I want." Matron had not looked up.
"You can order them from Supplies," she had murmured. My boss had responded. "No, that won't do. I need it now, for a baby."
That was how we got our first CPAP apparatus to work.
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