Georgia Valve

WLMD ID: akxe
The medications used for anesthesia can disrupt normal breathing, for this reason anesthesiologists support their patients' breathing with ventilators, or manually with self-inflating bags. These work by blowing air, or air with other gases such as inhalation anesthetics and oxygen, into the lungs. Anesthesiologists Dr. Robert H. Smith (1910-2009) and Dr. Perry P. Volpitto (1905-1988) introduced this valve in 1959. Their aim was to provide more options for ‘volume controlled ventilation’, in which an exact volume of air is delivered to a patient’s lungs at varying pressures. Drs. Smith and Volpitto were concerned that patients might not get enough air with methods that employed ‘pressure controlled ventilation.’ Pressure ventilation delivers air to the patient until a set pressure, or limit, is reached. The valve that Drs. Smith and Volpitto designed opened to allow exhaled air to escape. It closed when air from the ventilator or bag was blown to the patient. This enabled anesthesiologists to administer specific volumes of air even if a higher pressure than normal was required to do so. The valve was commonly called the Georgia Valve because it was designed when Dr. Smith was an instructor, researcher and clinician for Dr. Volpitto’s anesthesiology department at the University of Georgia, Augusta. This valve is no longer in use as it has been replaced by newer valves. Modern ventilators allow for combinations of volume- and pressure-controlled modes.

Catalog Record: Georgia Valve

Access Key: akxe
Accession No.: 1995-09-15-1 C

Title: [Georgia valve.]

Author: Smith, Robert H. (Hudson), 1910-2009.
Author: Volpitto, Perry P. (Paul), 1905-1988.

Title variation: Alt Title
Title: Smith & Volpitto pressure-equalizing valve.

Title variation: Alt Title
Title: Volume ventilation valve.

Publisher: [Madison, Wisconsin] : Ohio Medical Products, [between 1962 and 1975].

Physical Descript: 1 safety valve : metals ; 5 x 2.5 x 2.5 cm.

Subject: Pressure Releif Valves.
Subject: Safety.
Subject: Pressure – instrumentation.
Subject: Anesthesia, Inhalation – instrumentation.
Subject: Respiration, Artificial – instrumentation.

Note Type: General
Notes: Because the patent number is on this valve, the early year in the date range
for the possible year of manufacture is based on the year that the patent for
the device was issued (1962). The later year in the date range is based on
the postmark on the package in which the valve is held (September 19, 1975).

Note Type: General
Notes: The title is based on the common name for the valve, as used in Dorsch and
Dorsch (1975).

Note Type: With
Notes: With a box that has a mailing label on the top; The date on the postage stamp
is September 19, 1975. The sender on the mailing label is Ohio Medical
Products; The recipient is Mercy Hospital of Pittsburgh, PA.

Note Type: Citation
Notes: Dorsch JA, Dorsch SE. The breathing system. I. General considerations. In:
Understanding Anesthesia Equipment. Baltimore: Williams & Wilkins Company;
1975:149.

Note Type: Citation
Notes: Dr. Joan Davidson Smith and Robert Hudson Smith [obituary]. The Seattle Times
October 31, 2009. https://www.legacy.com/obituaries/seattletimes/obituary.
aspx?n=joan-davidson-smith-and-robert-hudson-smith&pid=135223866. Accessed
April 9, 2014.

Note Type: Citation
Notes: Dr. Volpitto receives ASA’s Highest Honor, The DSA. ASA Newsl. December,
1974:38(12):3.

Note Type: Citation
Notes: Endolaryngeal topical anesthesia. Anesthesiology. 1959;20(1):119-120.
https://journals.lww.
com/anesthesiology/Citation/1959/01000/Endolaryngeal_Topical_Anesthesia.22.
aspx. Accessed April 9, 2014.

Note Type: Citation
Notes: Mushin WW, Rendell-Baker L, Thompson PW, Mapleson WW. Valves for use in
controlled ventilation. In: Automatic Ventilation of the Lungs. 2nd ed.
Oxford: Blackwell Scientific Publications; 1969:799.

Note Type: Citation
Notes: Smith RH, inventor. Anesthesia machines. US patent 3,017,881. January 23,
1962. https://docs.google.com/viewer?url=patentimages.storage.googleapis.
com/pdfs/US3017881.pdf. Accessed April 9, 2014.

Note Type: Citation
Notes: Smith RH. One solution to the problem of the prone position for surgical
procedures. Anesth Analg. 1974;53(2):221-224.

Note Type: Citation
Notes: Steinhaus JE. Perry P. Volpitto, M.D.: The South’s first academic
anesthesiologist. Bul Anesth Hist. April, 1999;17(2):1, 6-8.

Note Type: Citation
Notes: Volume ventilation valve [gadgets]. Anesthesiology. 1959;20(6):885-886.
https://journals.lww.com/anesthesiology/Citation/1959/11000/Precordial_Click.
20.aspx. Accessed April 9, 2014.

Note Type: Physical Description
Notes: One pressure relief valve for volume ventilation; It measures approximately 5
cm from top to bottom, and 2.3 cm in circumferences at its widest point; The
exterior is stainless steel, with the exception of the top surface of the
turn-screw, which seems to be a red, hard plastic; The side of the turn-screw
is knurled in a small diamond pattern, and measures approximately eight cm in
circumference; When the screw valve is turned clockwise the piston is drawn
upward to seal the O-ring and close the valve; Turning the screw
counter-clockwise opens the valve; The gas outlets are two .5 cm circular
openings in the upper portion of the valve; The approximately .7 cm opening
of the valve is threaded to screw into the breathing circuit; Manufacturer
markings on the valved include, “TURN RED KNOB CLOCKWISE TO [new line]
INCREASE VOLUME AVAILABLE FOR new line] INFLATION OR TO CLOSE VALVE [new
line] Ohio ANESTHESIA MACHINE PAT. NO. 3,017,881 Ohio”.

Note Type: Reproduction
Notes: Photographed by Mr. Steve Donisch, September 20, 2013.

Note Type: Historical
Notes: Medications used during anesthesia can disrupt normal breathing. For this
reason, anesthesiologists support their patients breathing with ventilators,
or manually with self-inflating bags. These work by blowing air, or air with
other gases (such as inhalation anesthetics and oxygen), into the lungs.

Note Type: Historical
Notes: Anesthesiologists Dr. Robert H. Smith (1910-2009) and Dr. Perry P. Volpitto
(1905-1988) introduced this valve in 1959. Their aim was to provide more
options for ‘volume controlled ventilation’, in which an exact volume of air
is delivered to a patient’s lungs at varying pressures. Drs. Smith and
Volpitto were concerned that patients might not get enough air with methods
that employed ‘pressure controlled ventilation.’ Pressure ventilation
delivers air to the patient until a set pressure, or limit, is reached.

Note Type: Historical
Notes: The valve they designed opened to allow exhaled air to escape. It closed when
air from the ventilator or bag was blown into the patient. This enabled
anesthesiologists to administer specific volumes of air even if a higher
pressure than normal was required to do so.

Note Type: Historical
Notes: The valve was commonly called the ‘Georgia Valve’ because it was created when
Dr. Smith was an instructor, researcher and clinician for Dr. Volpitto’s
anesthesiology department at the University of Georgia, Augusta.

Note Type: Historical
Notes: This valve is no longer in use as it has been replaced by newer valves.
Modern ventilators allow for combinations of volume- and pressure-controlled
modes.

Note Type: Historical
Notes: Dr. Robert H. Smith attended medical school after he and his wife raised five
children. He taught and practiced at the University of Georgia for a few
years before transferring to the University of California Medical School, San
Francisco, where he worked for the remainder of his career. Dr. Smith
designed other devices for anesthesiologists, including an endotracheal tube
with a mechanism for the intermittent application of topical anesthetics, and
a support for safely positioning patients on their abdomen during surgery. He
also authored the textbooks, Electrical Anesthesia and Pathological
Physiology for the Anesthesiologist.

Note Type: Historical
Notes: Dr. Perry P. Volpitto was born in Italy. When he was five years old is family
moved to Pennsylvania where he spent the remainder of his childhood. He
studied as a resident under Dr. Ralph Waters in Wisconsin and Dr. Emery
Rovenstine in New York. In 1937, at the Medical College of Georgia in Augusta
Dr. Volpitto became the first chairman of an academic anesthesiology
department and residency program in the American South. Dr. Volpitto served
the American Society of Anesthesiologists (ASA) in numerous positions,
including as president in 1965. His significant contributions to the
specialty were recognized in 1974 when he was awarded the ASA’s highest honor
the Distinguished Service Award.

Note Type: Publication
Notes: Smith RH, Cullen SC. One method of teaching anesthesia to medical students.
Anesthesiology. January/February, 1963;24(1):68-71.

Note Type: Publication
Notes: Smith RH. Electrical Anesthesia. Springfield, Illinois: Charles C Thomas;
1963.

Note Type: Publication
Notes: Smith RH. Pathological Physiology for the Anesthesiologist. Springfield,
Illinois: Charles C Thomas; 1966.

Note Type: Publication
Notes: Smith RH, Volpitto PP. Bucking and bronchospasm as problems of anesthesia.
JAMA. 1960;172(14):1499-1502.

Note Type: Exhibition
Notes: Selected for the WLM website.