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Poliovirus
Published in Patricia G. Melloy, Viruses and Society, 2023
In the acute stage of polio, a physician might need to put the patient in an iron lung to assist with breathing if weakness of the diaphragm muscles occurs. Some doctors like Lovett emphasized the need for bed rest during this stage. During convalescence or recovery, muscle manipulation and mineral baths/hydrotherapy were used. The United States president Franklin Delano Roosevelt (FDR), a polio survivor, helped to make hydrotherapy popular (Gould 1995; Oshinsky 2005). Some healthcare providers decided to splint the affected limbs or place them in casts at this stage of the disease, which potentially could affect recovery if kept on for too long (Oshinsky 2005; Paul 1971). A nurse/physical therapist from Australia named Sister Elizabeth Kenny advocated for getting the child’s muscles moving as soon as possible with light exercise and applying hot packs to the muscles. Her methods were controversial but popular among the public in the 1930s and 1940s (Gould 1995; Oshinsky 2005; Wilson 2005; Paul 1971). If a patient entered the chronic stage of the illness without being able to breathe on his or her own, the patient might need to be in the iron lung for life. Crutches or a wheelchair might be needed if partial paralysis remained in the limbs (Oshinsky 2005) (Figure 4.3).
The Neurologic Disorders in Film
Published in Eelco F. M. Wijdicks, Neurocinema—The Sequel, 2022
Respiratory support involved the infamous “iron lung.” This machine incorporated electrically driven blowers and created inspiration with negative pressures and expiration with positive pressure (Figure 4.14).111 Within the chamber—sealing the patient at the neck—a negative pressure caused the abdomen and thorax to expand with air flowing in. A cycle is produced by returning to atmospheric pressure. Patients in the iron lung have their chest expanded every four seconds. Many patients could be liberated from the device or transitioned to a cuirass ventilator. During the major epidemics, the iron lung was perceived as a temporary lifesaving machine, but later it became clear that weaning was not always possible and respiratory support would now have a permanent impact on the quality of the patient’s existence.
Polio
Published in Rae-Ellen W. Kavey, Allison B. Kavey, Viral Pandemics, 2020
Rae-Ellen W. Kavey, Allison B. Kavey
Until 1927, there was no effective treatment for what was often temporary paralysis of the muscles that control breathing. Researchers at the Harvard School of Public Health devised a negative pressure respirator called an iron lung that could maintain respiration artificially until a polio patent could breathe independently again. A pump alternately lowered and then raised the pressure inside a rectangular, airtight metal cylinder, passively pulling air in and out of the lungs. Inside the tank respirator, the patient lay on a bed that could slide in and out of the cylinder as needed. The iron lung was the first mechanical respirator, the very first method for temporary support of breathing. As muscle function recovered, patients could be weaned from the iron lung, but there are many well-described cases of polio patients with persistent paralysis of the muscles of respiration who lived in iron lungs for decades. To this day, the iron lung is virtually pathognomonic of polio.33
Hypothetical emergence of poliovirus in 2020: part 1. Consequences of policy decisions to respond using nonpharmaceutical interventions
Published in Expert Review of Vaccines, 2021
Kimberly M. Thompson, Dominika A. Kalkowska, Kamran Badizadegan
We explore the demand for treatment and assume that respirator support would last for a period of 90 days on average, although we emphasize that the actual clinical experience with polio included individuals who only needed respiratory support for short periods of time (i.e. weeks), while others depended on an iron lung for life-long support. Importantly, this differs from the experience with SARS-CoV-2, in which ventilation days during early phases of pandemic averaged approximately 2 weeks and carried a relatively high mortality risk [69]. We implicitly assume that the COVID-19 pandemic did not occur in 2020. We run the model with NR scenario showing the impact emergence of the nWPV in three different subpopulations with properties in the model like China, Indonesia, or India. We also run the model for scenarios that assume either significant decreases in mixing that aim to ‘flatten the curve’ (labeled as ‘FTC’) or global efforts to contain and eradicate the nWPV (labeled as ‘C&E’), as occurred in effect following the emergence of SARS in 2003 [47].
Long-term patients in an ICU: How a new patient group emerges
Published in Contemporary Nurse, 2020
Claire Minton, Lesley Batten, Annette Huntington
The polio epidemic of the 1950s is cited as the beginning of intensive care, perhaps due to the increased presence of medical staff, but nursing practices with sicker patients, formed the model for ICU services that developed during the 1950s (Fairman, 1992; Marini, 2013). The iron lung prolonged life, therefore creating a new cohort of long-term, ventilator-dependent patients. Without the iron lung these patients would have died, but this equipment did not provide the necessary airway protection and the mortality rate from polio with respiratory failure remained very high at 85%–90%. During the Copenhagen polio epidemic there were high mortality rates despite the use of the iron lung. That led to the development of intermittent positive pressure ventilation (IPPV) through a cuffed tracheostomy tube that saw the mortality rate drop from over 80% to 40% under this new treatment (Marini, 2013).
Queen Square: A history of the National Hospital and its Institute of Neurology
Published in Neuropsychological Rehabilitation, 2021
Some of the professionals described are to be admired for their brilliance and achievements, and sometimes even their personalities. Included are people such as Norman Dott who set up the Brain Injuries Unit near Edinburgh in the second world war. This is where Oliver Zangwill worked and where he became a neuropsychologist. I also found myself liking Roger Gilliatt who marched with CND, and John Marshall who invented the “iron lung” to help those afflicted with poliomyelitis (not to be confused with the neuropsychologist of the same name who worked in Oxford). The most famous neurologist employed there was Roger Bannister, the first man to run a mile in under four minutes in 1954.