Oxford Inflating Bellows

WLMD ID: aqtb
Anesthesiologists are responsible for maintaining the patient's vital functions during surgery. A mechanical ventilator may be used either to assist or to control the patient's respiration. In 1953, two new pieces of equipment were introduced by the Nuffield Department of Anaesthetics at the University of Oxford: the Epstein Macintosh Oxford (EMO) Inhaler, and the hand-operated Oxford Inflating Bellows (OIB). The EMO Inhaler was made by Longworth Scientific Instruments. The Oxford Inflating Bellows was made by Owen Mumford, Ltd.

The two devices could be used separately or together. In tandem with the EMO inhaler, the OIB could deliver intermittent positive pressure ventilation in a Mapleson "A", or partial rebreathing, system.  The Mapleson A was the poorest of the Mapleson configurations to be used with positive pressure ventilation. The OIB was also used as a stand-alone resuscitator. It contains a spring that causes it to partially refill with air whenever manual pressure on the bellows is released. The EMO Inhaler and the OIB ventilator were especially useful in military medicine and other situations where compressed gas cylinders, or electricity, were not available. The Oxford Inflating Bellows continued in use through the 1990s.

Catalog Record: Oxford Inflating Bellows Oxford Inflating Bellows

Access Key: aqtb

Accession No.: 2000-09-17-1

Title: Oxford inflating bellows / designed by Sir Robert R. Macintosh.

Author: Macintosh, R. R. (Robert Reynolds), Sir, 1897-1989.

Corporate Author: University of Oxford. Nuffield Dept. of Anaesthetics.

Publisher: Woodstock, Oxfordshire, England : Owen Mumford, Ltd., [between 1958 and 1969].

Physical Description: 1 ventilator : metals, plastics, glass, rubber ; 25 x 22 x 11.5 cm.

Subject: Anesthesia, Inhalation – instrumentation.
Subject: Epstein, H. G. (Hans G.), 1909-2002.
Subject: Macintosh, R. R. (Robert Reynolds), Sir, 1897-1989.
Subject: University of Oxford. Nuffield Dept. of Anaesthetics.
Subject: Respiration, Artificial – instrumentation.
Subject: Ventilation, Mechanical.
Subject: Ventilators, Mechanical.

Note Type: General
Notes: The first year in the range of possible dates of manufacture is based on the year that the manufacturer moved from Oxford to Woodstock, England. The second year in the date range is based on the inspection certificate found inside the carrying case, dated May 27, 1969.

Described with the stopcock facing forward. When in use, the anesthesiologist might have positioned the unit at her right or left side.

Note Type: With
Notes: Various hoses and connectors.

Note Type: Citation
Notes: Macintosh RR. Oxford inflating bellows. British Medical Journal. July 25, 1953;2(4829):202.

Note Type: Citation
Notes: Mushin Museum website. http://mushinmuseum.org.uk/oxfordinflatingb.html. Accessed April 24, 2018.

Note Type: Citation
Notes: Owen Mumford website. https://www.owenmumford.com/us/about/heritage/. Accessed April 24, 2018.

Note Type: Citation
Notes: Penlon Company File. Archives. Located at Wood Library-Museum of Anesthesiology, Schaumburg, Illinois.

Note Type: Citation
Notes: Pearson JW, Safar P. General anesthesia with minimal equipment. Anes Analg. November-December, 1961;40(6):664-671.

Note Type: Physical Description
Notes: One ventilator; The height stated in the short physical description is that with the bellows extended by hand as much as can be done without forcing; When the bellows is at rest, the height is approximately 20 centimeters; The base of the unit is an oblong, gray metal housing; The bottom of this housing is covered with a ridged, plastic panel (possibly vinyl);

The front of the housing is marked, from left to right: “[left-facing arrow] TO PATIENT [new line] [upward-facing arrow] OXYGEN [new line] INLET”;

On top of the housing there are two pop-up valves, one mounted on either side of the stem that holds the bellows; Each valve is covered with a thick glass dome; In the right side of the base there is a round opening that leads to that valve on the right; Below this the housing is marked “INLET”; Between the two valves there is a stopcock that faces forward; Below this stopcock the housing is marked with an upward-pointing arrow and the word “OXYGEN”;

Mounted on the rim of that valve on the left there is an elbow tube or connector that reaches toward the left over the top of the valve; This connector has a red plastic fitting at the open end; Below this the base is marked with a left-facing arrow and the words “TO PATIENT”; In the left side of the base there is a round opening fitted with a metal tube that extends approximately 2 centimeters from the housing;

A label plate on the back of the housing reads: “OXFORD INFLATING BELLOWS [new line] REG. DES. NO. 868986. Serial No. 4995 [new line] OWEN MUMFORD LTD. [new line] WOODSTOCK, OXFORD, ENGLAND”; To the right of this label, a bracket is mounted on the housing; This bracket holds a small red magnet; When applied to the top of the valve on the right (labeled “To Patient”), the magnet pulls the disc on this valve to the top of the dome.

Note Type: Reproduction
Notes: Photographed by Mr. Steve Donisch, January 15, 2018.

Note Type: Acquisition
Notes: Gift of George S. Bause, M.D.

Note Type: Historical
Notes: Anesthesiologists are responsible for maintaining the patient’s vital functions during surgery. A mechanical ventilator may be used either to assist the patient’s respiration or to do all of the patient’s breathing for her.

British anesthesiologist Sir Robert R. Macintosh (1897-1989) was the founding Chair of the University of Oxford’s Nuffield Department of Anaesthetics. He and his staff worked with local manufacturers to develop new apparatus. Two such devices were the Epstein Macintosh Oxford (EMO) Inhaler, and the Oxford Inflating Bellows (OIB), both introduced in 1953. The EMO Inhaler was made by the Longworth Scientific Instrument Co., later called Penlon. The OIB, a hand-operated ventilator, was made by Owen Mumford, Ltd. In his original description of the Oxford Inflating Bellows, Dr. Macintosh thanked his colleagues H. G. Epstein, M.D. and Mr. R. Salt for their “advice and help in the design”.

Owen Mumford, Ltd. was founded in Oxford in 1952, by engineering partners Ivan Owen and John Mumford, with financial backing from Mr. Owen’s father, Thomas Owen. The company’s first product was an improved version of the Macintosh Laryngoscope. The second was the Oxford Inflating Bellows. In 1958, Owen Mumford moved from Oxford to nearby Woodstock, England, where its headquarters remain today. The cataloged object was made in Woodstock.

Although made by different manufacturers, the two devices were intended to be used together. They could also be used separately. The original distributor for the OIB was Medical and Industrial Equipment, Ltd. (also called MIE.) By the late 1960s, the OIB was being sold by Longworth Scientific Instruments as an accessory to the Epstein Macintosh Oxford Inhaler. In the 1970s, production of the OIB was transferred to Penlon.

In tandem with the Oxford Inflating Bellows, the EMO Inhaler could deliver intermittent positive pressure ventilation. According to the website of the Mushin Museum of the Department of Anaesthetics, School of Medicine, Cardiff University this assembly constitutes a Mapleson “A”, or partial rebreathing, system.

The OIB was also used as a stand-alone resuscitator. It contains a spring that causes it to partially refill with air whenever manual pressure on the bellows is released. The EMO Inhaler and the OIB ventilator were especially useful in military medicine and other situations where compressed gas cylinders, or electricity, were not available. The Oxford Inflating Bellows continued in use through the 1990s.

Note Type: Publication
Notes: Fahey DG. The self-inflating resuscitator – evolution of an idea. Anaesthesia and Intensive Care. 2010;38 (Supp. 1):10-15.

Note Type: Publication
Notes: Morrison D, Cashen D, Coonan T. Understanding draw-over anesthesia. Canadian Journal of Respiratory Therapy. Summer, 2011;47(2):6-10.

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

Relationships: Issued with
Title: Epstein Macintosh Oxford (EMO) Inhaler.