What does an iron lung look like and how does it work?

Question

I'm curious after reading this article.

http://www.msnbc.msn.com/id/17249223/wid/11915773?GT1=9033

How do people use the bathroom in it, get fed, etc.?

So, in the old style iron lung in the case of this woman, because she had to be in it 24 hours a day, did they have to change her diaper or colostomy bag in record time? I mean, because she would essentially stop breathing while the iron lung was open at any point... yes? Did she just go without air while they did this?

Answer 1

The "iron lung" is an antiquated piece of equipment that fell out of use in the 1950's. It looked like a long steel tube with tubes and dials on the side, and a person inside with their head sticking out of a rubber gasket at one end. There was a small shelf at the end to hold a pillow, and inside the tube, a bedframe supported a narrow mattress. The gasket end was a hinged door with a rubber seal.

The job of the iron lung was to make people breathe who were paralyzed from the neck down. The nerves to the diaphragm (the major muscle of breathing) exit the spinal cord high up in the neck at levels C3,C4 and C5. Fractures of the neck at or above this level would completely denervate the diaphragm and make it just as paralyzed as arms or legs. Additionally, several medical diseases involving progressive paralysis might lead people to require mechanical breathing assistance.

The function of the unit involved mechanical pumping of air in and out of the chamber. When air was forced into the chamber, it would gently pressurize the space around the patient's abdomen and chest, thereby forcing them to exhale. When air was pumped back out, it would drop the pressure around the patient's abdomen and chest, and air would enter the patient's trachea through the normal routes of nose or mouth. This was a gentle, sustainable long term solution to breathing paralysis. Patients could be supplied with adequate breathing rates for as long as they needed it.

The problem with this method is that it hides the patient from examination and makes it difficult to care for their other bodily needs. The patient would need to be flipped over regularly in order to minimize skin breakdown, and opening the chamber to do this was a big deal. Basically the patient would be unable to breathe properly until the system was reconnected. Skin breakdown with open non-healing sores, infections, and fever was common, and was a frequent cause of death. So was urinary infection, pneumonia, and aspiration (choking).

The modern method that has long since supplanted this involves positive pressure ventilation instead of negative. Rather than placing the whole body into a low pressure space in order to "draw" air into the lungs, we put a tube into the airway and "push" the air in with small amounts of positive pressure. For short periods (days to weeks) this can be done with an oral endotracheal tube, or "ET tube". The ET tube is a clear plastic tube with an inflatable cuff that goes down through the mouth or nose, past the vocal cords and then the balloon is inflated to form a gentle seal. With this in place, a mechanical ventilator can deliver cyclic lung inflations as needed. For long term (weeks to months - or permanently) a small operation is performed to exchange the oral tube for one that implants into the base of the throat. This is called a tracheostomy tube.

The current method of respiratory support for chronically paralyzed people involves a permanent tracheostomy and mechanical ventilation. The person is tied to a machine which cycles the pressure in and out of the lungs through a flexible hose, almost like a diver. For people who are alert and otherwise capable, portable ventilators can be carried on mechanical wheel chairs. People in this state can still be functional and interactive, even if they need significant amounts of help.

As you may have seen with Christopher Reeves, when he was alive and struggling with his paralysis, there are new methods currently under study to make people even more mobile. Mr. Reeves underwent a surgical implantation of an electrical device which would cause cyclic contractions of his diaphragm. He actually came off the ventilator for a time, breathing "on his own". Just because the nerve to the diaphragm had been severed didn't mean that it was gone. With appropriate electrical stimulation it was still capable of contractions.

Like many people with debilitating paralysis, Mr. Reeves still ended up succumbing to complications of his disease process. I do not remember the specifics, but my impression was that he became septic from infected pressure sores or something equally common.

We obviously still have a long way to go, in terms of being able to effectively treat these devastating injuries!

Hope that helps.

Answer 2

An iron lung is a large machine that enables a person to breathe when normal muscle control has been lost or the work of breathing exceeds the person's ability. It is a form of medical ventilator. Properly, it is called a negative pressure ventilator.

Persons using the iron lung are placed into the central chamber, a cylindrical steel drum. A door allowing the head and neck to remain free is then closed, forming a sealed, air-tight compartment enclosing the rest of the person's body. Pumps that control airflow periodically decrease and increase the air pressure within the chamber, and particularly, on the chest. When the pressure falls below that within the lungs, the lungs expand and air from outside the chamber is sucked in via the person's nose and airways to keep the lungs filled; when the pressure rises above that within the lungs, the reverse occurs, and air is expelled. In this manner, the iron lung mimics the physiologic action of breathing: by periodically altering intrathoracic pressure, it causes air to flow in and out of the lungs. The iron lung is a form of non-invasive therapy.

pictures and more info here: http://en.wikipedia.org/wiki/Iron_lung

Answer 3

Iron Lung Polio

Answer 4

The tank respirator is better known as the iron lung. It's cyclindrical (started off being rectangular in 1927but was later updated), metal and opens at one end and has windows on the side. The patient lays on a bed (cookie tray) that slides in and out of the tank respirator. It's powered by a pump that changes the pressure inside the tank respirator, which is airtight, and the pressure changes pull air in an out of the lungs. Patients would wear disposable diapers (incontinence undergarments) and can changed or be fed through the windows. I would imagine that someone could be pulled out on the cookie tray for brief periods. Very good question. I hope I've given a decent answer.

Answer 5

http://en.wikipedia.org/wiki/Iron_lung
definition and pictures

That msnbc story was unbelievable, 57 years in an Iron lung!



Shadow of Polio: A Personal and Social History.

"However, patients were essentially stuck in a box. Some were completely paralyzed; others could move their arms and legs, though the muscles for breathing were paralyzed, and some models did have armholes. The lucky patients had radios, or occasionally even a TV to keep them occupied; others had books in overhead racks but were forced to wait for someone else to turn the pages. It could also get a little unpleasant inside the box, since patients were not able to get out to a bathroom. For patients who couldn't breathe unassisted long enough to have the sheets inside changed, it was possible to exchange the bed linens through side vents, but the wrinkled results could dig into a paralyzed person's body. Many of the paralyzed patients had a tracheotomy, so they couldn't speak normally and had to click their teeth together, make popping sounds with their lips, or compress and release air between cheek and tongue (like urging a horse forward) to summon help. They also couldn't cough, sneeze, blow nose, rendering secondary infections a problem.

And the machines were noisy, with the sound of a rhythmic bellows pumping, wheezing and squeaking; one person described it as sounding like windshield wipers. Sleep might be difficult for the patient in an iron lung ward.

Patients could be transferred from one hospital to another still inside the iron lung (attached to a generator) in trucks, trains, or even planes. There were smaller portable iron lungs made, but they were too confining for long-term use, so most transferred people stayed in a full-sized one (requiring the use of transportation with wide enough doors for the machine to fit). "

Answer 6

It looks like a big metal tank that encloses the whole body except for the head. It alternates positive and negative air pressure, providing artificial respiration by expanding and contracting the chest walls. People with an iron lung most likely have a catheter/colostomy bag to use the bathroom as their entire body is enclosed in this air-tight monstrosity.

Answer 7

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Answer 8

Sorry I can't give you any specifics only that they make an awful sound like a machine inhaling and are very loud. When I was little, I never forgot seeing a woman lying in one years ago (in the late 1940's). It was very freaky, like a completely enclosed coffin and she had a small mirror above her head. I felt so very sorry for her because she spent every day, every hour in it.

Answer 9

1

Answer 10

they dont spend ALL their time in it, they can get up to go to the bathroom (sometimes with assistance though) but they spend a lot of time in one

heres a picture.

http://upload.wikimedia.org/wikipedia/commons/thumb/5/51/Womanonsideinlung.jpg/300px-Womanonsideinlung.jpg

if you are ever in minneapolis go to a store called ax man, they have a really old vintage one on display. its pretty freaky.