A Simple Manikin With an Electrically Actuated Bronchus for Bronchoscopic Demonstrations

Abstract

The offending organisms are Str. haemolyticus, Staph. aureus and the influenza bacillus.The patient dies from suffocation and toxicity. There is no specific remedy for this condition. A free airway and elimination of the toxins are necessary to maintain life.The pathologic process is most marked in the larynx, trachea and bronchi and in the lungs surrounding the smaller bronchi and bronchioles.The disease resembles spasmodic croup at the onset ; a diagnosis of diphtheria and foreign body in the respiratory tract must be eliminated.Bronchoscopic aspiration has proved helpful in maintaining an open airway in many cases.Tracheotomy is more to be relied on than intubation for maintenance of an open airway.Recently we wished to construct a replica of a bronchus of the first order compromised by carcinoma. This was to form part of an educational exhibit of bronchogenic carcinomas at the annual session of the American Medical Association. As we did not wish to resort to the frequently used moulage process, we fashioned a bronchus in rubber, molded into it an irregular mass resembling carcinoma and painted the whole model with appropriate colors. A machine was then constructed which would make the bronchus expand and contract as it does in life, so that a view through a bronchoscope inserted into the bronchus through a dummy head would give a realistic illusion of seeing a bronchogenic carcinoma in a living patient. This was enhanced perhaps by an inspiratory and expiratory surge of 500 cc. of air, representing tidal air, eighteen times a minute.A number of bronchoscopists who viewed this apparatus suggested that it might be used as a teaching adjunct for demonstrating to practitioners and medical students the value of direct examination of the tracheobronchial tree and to impress them with the importance of this procedure in the diagnosis of certain obscure conditions. It could perhaps be utilized also in demonstrating to the same groups the removal of foreign bodies. We therefore wish to present it as a teaching aid in this field. DESCRIPTION OF APPARATUSThe purpose of the mechanical part of the breathing model was twofold: first, to make the artificial bronchus expand and contract and, second, to make a gush of air pass in and out of the mouth of the model in a manner simulating breathing.