ANZAC day is an opportunity for us to reflect on how fortunate we are to live in a peaceful, democratic country like Australia or New Zealand. It’s also the one day when most of us stop to think about and appreciate our armed forces.

Many of the advances in resuscitation, anaesthesia and surgery have developed through the tragedies of war.

Today I want to pay tribute to Dr Arthur Guedel (1883-1956), an American anesthesiologist who served with the US Army during World War I, in France.

guedel_1 Dr Arthur Guedel

Faced with thousands of wounded, he devised a method of training nurses and medics to give simple open ether anesthesia. Guedel’s four stages of anaesthesia, and the associated breathing patterns, eye signs etc. are still referred to today. A fascinating training film (made in 1945) on the stages of anaesthesia can be viewed here.

guedel_4Guedel’s Stages of Anaesthesia

Guedel is best remembered for his eponymous oropharyngeal airway. Originally made of black rubber, it improved upon earlier metal airways, and instantly became an essential tool for airway management.

guedel_3 Guedel airway

Guedel was also involved with the development of cuffed endotracheal tubes. To prove that the cuff would prevent aspiration, he anaesthetised his own dog, inserted a cuffed tube, and then submerged him under water in a fish tank. One hour later, the dog was woken up, with perfectly dry lungs. The trivia buffs out there would already know that Guedel’s dog was named “Airway”.


Thanks to all the military anaesthetists, past and present, who have made so many advances to our specialty.

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