Jackson Tracheotomy Tube

WLMD ID: aqsp
Anesthesiologists use many tools to ensure that their patients can breathe properly, and to administer air and anesthetic gases. Tracheotomy is a surgical procedure to make an opening through the neck into the trachea (windpipe).  This may be needed because of an obstruction in the patient's airway. The breathing tubes made for insertion through the opening are called trachea, tracheostomy or tracheotomy tubes. These are equipped with an obturator (a plug) to keep the tube clear while it is being inserted. The obturator is withdrawn immediately after insertion, but it is kept handy in case the tube must be re-inserted.

Chevalier Jackson, M.D. (1865-1958) is honored as the father of bronchoscopy and laryngoscopy. He is also credited with standardizing the modern technique of tracheotomy. Jackson invented numerous instruments for airway management, including the first modern laryngoscope. He called his tracheotomy tube a "tracheotomic cannula". It was commercially available by 1911, and continues to be made today in a range of sizes. The example shown here is small enough to have been used for pediatric patients. It was made by Propper Manufacturing Co., Inc. in Long Island City, New York.

Catalog Record: Jackson Tracheotomy Tube Jackson Tracheotomy Tube

Access Key: aqsp

Accession No.: 2009-12-03-1 B

Title: Tracheal Tube, Jackson Full Curved / Propper Manufacturing Co., Inc.

Author: Jackson, Chevalier, 1865-1958.

Corporate Author: Propper Manufacturing Co., Inc.

Title variation: Alt Title
Title: Jackson pediatric tracheotomy tube.

Title variation: Alt Title
Title: Jackson tracheotomic cannula.

Publisher: Long Island City, New York : Propper Manufacturing Co., Inc., [between 1935 and 2009].

Physical Description: 1 tracheotomy tube : silver ; 2.5 x 8 x 4 cm.

Subject: Anesthesia, Inhalation – instrumentation.
Subject: Tracheotomy-instrumentation.

Note Type: General
Notes: The first year in the range of possible dates of manufacture is the year that the manufacturer was founded. The second year in the date range is the date that the object was acquired; it is likely that the tube was made much earlier.

Described from the patient’s perspective.

The clasp on the back of the bracket should hold the obturator in place but cannot do so, leading to the speculation that this obturator may not be the original mate to this tube.

Note Type: With
Notes: Cardboard box measures approximately 6.5 x 9 x 3 centimeters. Fragile, end flaps broken. Printed on front panel: “One. Cat. No. [new line] CROWN [logo] BRAND [new line] TRACHEAL TUBE [new line] Type: Jackson Full Curved [new line] Size: [new line] Material: STERLING SILVER [new line] PROPPER MFG. CO., INC. L. I. C. 1, NY.”

Note Type: Citation
Notes: Hagberg CA, ed. Benumof and Hagberg’s Airway Management. Philadelphia: Elsevier Saunders, 2013:613-619.

Note Type: Citation
Notes: Hung O, Murphy MF, eds. Management of the Difficult and Failed Airway, 2nd ed. New York: McGraw Hill Medical, 2012: 319, 342-347.

Note Type: Citation
Notes: Jackson C, Jackson CL. Bronchoesophagology. Philadelphia: Saunders, 1950:139.
Note Type: Citation
Notes: Lentz, Charles, & Sons. Illustrated Catalogue and Price List of Surgical Instruments Hospital Supplies Orthopedic Apparatus, Trusses, etc., 7th ed. Philadelphia: Charles Lentz & Sons, 1911:263.

Note Type: Citation
Notes: Sklar website. http://www.sklarcorp.com/tracheal/trachea-tubes/jackson-tracheotomy-tube.html. Accessed June 7, 2018.

Note Type: Physical Description
Notes: One tracheotomy tube; Consists of two parts, a curved tube with a flat, circular flange, and an attached bracket (also called a shield) and an obturator (a stylet that ends in a plug); The ends of the tube are straight, not beveled; The interior diameter of the tube is approximately .5 centimeter; The tube in inserted through a round opening in the center of the bracket;

The flange of the tube has three extensions on the back, these being a flat narrow wing on the left and another on the right, as well as a post mounted at the top edge of the flange that extends outward from the back; This post is approximately .5 centimeter in depth, and holds a flat, semicircular clasp that swivels from left to right; The back of the flange is stamped: “P25” and “5”;

The horizontal bracket has a round opening that fits over the tube; There are two vertical slits in the bracket on either side of this opening; On the back of the bracket, a flattened loop is soldered over each of the two slits that are closest to the opening; Each loop is approximately 1 centimeter long; The horizontal wings of the flange are inserted in these loops; While the clasp of the flange is set in a horizontal position, the tube can swivel from side to side within these loops; When the clasp is set in a vertical position the flange cannot swivel; The front of the bracket is stamped: “925”;

The obturator is one piece with three distinct sections; That end which is inserted in the tube has a solid, teardrop-shaped plug; The plug is approximately 1 centimeter deep and .5 centimeter wide at the thick end where it meets the shaft; The shaft of the obturator is less than a millimeter in diameter, and spans a depth of approximately 6 centimeters, with an arch approximately 2 centimeters in height; At the opposite end of the shaft is a solid hub with an hourglass shape that is similar to those used in many spinal needles; The hub is slightly less than 1.5 centimeters in depth and the flattened end is 1 centimeter in diameter; This end is stamped: “5”; This mark aligns with the number “5” on the back of the bracket; When the hub is held in place, the plug of the obturator fills the front opening of the tube.

Note Type: Reproduction
Notes: Photographed by Mr. Steve Donisch, January 16, 2018.

Note Type: Acquisition
Notes: Gift of Jonathan S. Jahr, M.D., in memory of his mother, Noel Nancy Grean, M.D.

Note Type: Historical
Notes: Anesthesiologists use many tools to ensure that their patients are able to breathe properly, and to administer air and anesthetic gases. These tools include laryngoscopes, tracheal tubes, and artificial airways and more.

Tracheotomy is a surgical procedure to make an opening through the neck into the trachea (windpipe). Operations of this kind have been performed for thousands of years. This may be done because of an obstruction in the patient’s airway, or to improve the delivery of oxygen. Tracheotomy can offer some advantages over long-term intubation, as well.

The opening made by the procedure is called a tracheostomy. The insertion of a breathing tube through the opening dates from the late 19th century. These tubes are called trachea, tracheostomy or tracheotomy tubes. They are equipped with an obturator (a plug) to keep the tube clear while it is being inserted. The obturator is withdrawn immediately after insertion, but it is kept handy in case the tube must be re-inserted.

Chevalier Jackson, M.D. (1865-1958) is honored as the father of bronchoscopy and laryngoscopy. He is also credited with standardizing the modern technique of tracheotomy. Jackson invented numerous instruments for airway management, including the first modern laryngoscope. He called his tracheotomy tube a “tracheotomic cannula”. It may have been introduced as early as 1903 and was commercially available by 1911. The Jackson tracheotomy tube continues to be made today in a range of sizes. The cataloged object is small enough to have been used for pediatric patients. It was made by Propper Manufacturing Co., Inc. The company was founded in Long Island City, New York in 1935, and continues in business there today.

Note Type: Publication
Notes: Jackson C. Presentation of instruments. September, 1903;13(9):691-695.

Note Type: Publication
Notes: Jackson C. Tracheotomy. Laryngoscope. April, 1909;19(4):285-290.

Note Type: Publication
Notes: Jackson C. Treatment of laryngeal steonsis by corking the tracheotomic cannula. Laryngoscope. January,
1919;25(1):1-4.

Note Type: Citation
Notes: Morch ET, Saxon GA, Gish G. Artificial respiration via the uncuffed tracheostomy tube.” JAMA. 1956;160: 864-867.

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