Sir Ivan Whiteside Magill KCVO (23 July 188825 November 1986) was an Irish-born

anaesthetist Anesthesiology, anaesthesiology, or anaesthesia is the medical specialty concerned with the total perioperative care of patients before, during and after surgery. It encompasses anesthesia, intensive care medicine, critical emergency medicine, ...

who is famous for his involvement in much of the innovation and development in modern anaesthesia. He helped to establish the

Association of Anaesthetists of Great Britain and Ireland The Association of Anaesthetists, in full the Association of Anaesthetists of Great Britain and Ireland (AAGBI), is a professional association for anaesthetists in the United Kingdom and Ireland. It was founded by Dr Henry Featherstone in 193 ...

. Several medical devices are named after him.

Biography

Originally a general practitioner, he accepted a post at the Queen's Hospital,

Sidcup Sidcup is an area of south-east London, England, primarily in the London Borough of Bexley. It is south-east of Charing Cross, bordering the London Boroughs of London Borough of Bromley, Bromley and Royal Borough of Greenwich, Greenwich. Before ...

, in 1919 as an anaesthetist. The hospital had been established for the treatment of facial injuries sustained in

World War I World War I (28 July 1914 11 November 1918), often abbreviated as WWI, was one of the deadliest global conflicts in history. Belligerents included much of Europe, the Russian Empire, the United States, and the Ottoman Empire, with fightin ...

. Working with plastic surgeon

Harold Gillies Sir Harold Delf Gillies (17 June 1882 – 10 September 1960) was a New Zealand otolaryngologist and father of modern plastic surgery. Early life Gillies was born in Dunedin, New Zealand, the son of Member of Parliament in Otago, Robert Gillies ...

, he was responsible for the development of numerous items of anaesthetic equipment but most particularly the single-tube technique of endotracheal anaesthesia. This was driven by the immense difficulties of administering "standard" anaesthetics such as

chloroform Chloroform, or trichloromethane, is an organic compound with chemical formula, formula Carbon, CHydrogen, HChlorine, Cl3 and a common organic solvent. It is a colorless, strong-smelling, dense liquid produced on a large scale as a precursor to ...

and

ether In organic chemistry, ethers are a class of compounds that contain an ether group—an oxygen atom connected to two alkyl or aryl groups. They have the general formula , where R and R′ represent the alkyl or aryl groups. Ethers can again be c ...

to men with severe facial injury using masks; they would cover the operative field. Following the closure of the hospital, and the diminishing numbers of patients seen from the war era, he continued to work with Gillies in private practice but was also appointed to the

Westminster Westminster is an area of Central London, part of the wider City of Westminster. The area, which extends from the River Thames to Oxford Street, has many visitor attractions and historic landmarks, including the Palace of Westminster, Bu ...

and

Brompton Hospital Royal Brompton Hospital is the largest specialist heart and lung medical centre in the United Kingdom. It is managed by Guy's and St Thomas' NHS Foundation Trust. History Consumption in the 19th Century In the 19th century, consumption was a co ...

s, London. He was

Knight A knight is a person granted an honorary title of knighthood by a head of state (including the Pope) or representative for service to the monarch, the church or the country, especially in a military capacity. Knighthood finds origins in the Gr ...

ed by

Elizabeth II Elizabeth II (Elizabeth Alexandra Mary; 21 April 1926 – 8 September 2022) was Queen of the United Kingdom and other Commonwealth realms from 6 February 1952 until her death in 2022. She was queen regnant of 32 sovereign states during ...

in 1960. He was closely involved in the establishment of the

as well as the Faculty of Anaesthesia of the Royal College of Surgeons where he developed the Diploma in Anaesthesia, the first professional examination in the specialty. Doctors can still be awarded the Magill medal for outstanding performance in the December sitting of the Final Fellowship examination. In 2010, a plaque marking his birthplace was unveiled in the town of

Larne Larne (, , the name of a Gaelic Ireland, Gaelic territory) is a town on the east coast of County Antrim, Northern Ireland, with a population of 18,755 at the United Kingdom census, 2011, 2011 Census. It is a major passenger and freight Roll-on/ro ...

, Northern Ireland.Plaque marking Magill's birthplace in Larne unveiled
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History of the endotracheal tube

The original tubes were cut from a roll of rubber industrial tubing by his assistant, hence the natural curve of the tube. A curved metal adaptor was designed (Magill oral and nasal connectors) and a 4" black rubber connecting hose to fit to the anesthetic circuit was adapted from an MG car brake hose and named the 'catheter mount' by Magill's theatre technician at Westminster Hospital. Originally, there was no inflatable cuff. The tube was packed either side of the sub-glottis by two green anaesthetic swabs, with ribbon gauze sewn on by hand to aid extraction at extubation of the endotracheal tube. Anaesthetic gel or ointment was used to lubricate the tube and provide some relief for the patient's sore throat post-procedure.

Magill's developments

*Endotracheal tube, anaesthesia (The Magill endotracheal tube, oral & nasal designs) *An anaesthetic breathing system (Magill circuit and expiratory valve) *Intubating forceps (

Magill forceps Magill forceps are angled forceps used to guide a tracheal tube into the larynx or a nasogastric tube into the esophagus under direct vision.Laryngoscope Laryngoscopy () is endoscopy of the larynx, a part of the throat. It is a medical procedure that is used to obtain a view, for example, of the vocal folds and the glottis. Laryngoscopy may be performed to facilitate tracheal intubation during ge ...

(a straight bladed version) *Catheter mount (endotracheal tube-to-circuit connector) *Endotracheal tube connectors, oral & nasal versions *Magill tracheal spray (glottic anaesthetic) *Single-lung anaesthesia *Endobronchial tubes and

bronchial blockers An bronchial blocker (also called endobronchial blocker) is a device which can be inserted down a tracheal tube after tracheal intubation so as to block off the right or left main bronchus of the lungs in order to be able to achieve a controlled one ...

s *Bobbin

flowmeters Flow measurement is the quantification of bulk fluid movement. Flow can be measured in a variety of ways. The common types of flowmeters with industrial applications are listed below: * a) Obstruction type (differential pressure or variable area) ...

*Helped establish the Diploma in Anaesthesia *Helped found the Association of Anaesthetists in 1932 *Initiated the foundation of Association of Operating Theatre Technicians in 1945 (Now the College of Operating Department Practitioners)

Papers

* Magill IW. "Endotracheal Anaesthesia" ''Proc RSM'', 1928, 22(2):85-88 * Magill I. "Warming Ether Vapour for inhalation" ''Lancet'' 1921,i:1270 (letter) * Magill I. "An apparatus for the Administration of Nitrous Oxide, Oxygen and Ether" ''Lancet'' 1923,ii: 228 * Magill I. "The Provision for Expiration in Endotracheal insufflation" ''Lancet'' 1923,ii: 68-9 * Magill I. "A Portable Apparatus for Tracheal Insufflation Anaesthesia" ''Lancet'' 1921,i: 918 * Rowbotham ES, Magill I. "Anaesthetics in the Plastic Surgery of the Face and Jaws" ''Proc RSM'' 1921, 14: 17-27 * Magill also contributed a chapter to Gillies HD, Millard R: ''Principles and Art of Plastic Surgery'' (Boston, Little Brown & Co, 1957)

References

{{DEFAULTSORT:Magill, Ivan 1888 births 1986 deaths Irish anaesthetists People from Larne