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, a ...

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 anaesthesiology, anaesthetists in the United Kingdom and Republic of Ireland, Ireland. It was f ...

. 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. It was ...

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

World War I World War I or the First World War (28 July 1914 – 11 November 1918), also known as the Great War, was a World war, global conflict between two coalitions: the Allies of World War I, Allies (or Entente) and the Central Powers. Fighting to ...

. 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 for the techniques he devised to repair the faces of wounded soldiers returning from World War I. Early life ...

, 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 (often abbreviated as TCM), is an organochloride with the formula and a common solvent. It is a volatile, colorless, sweet-smelling, dense liquid produced on a large scale as a precursor to refrigerants and po ...

and

ether In organic chemistry, ethers are a class of compounds that contain an ether group, a single oxygen atom bonded to two separate carbon atoms, each part of an organyl group (e.g., alkyl or aryl). They have the general formula , where R and R� ...

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 the main settlement of the City of Westminster in Central London, Central London, England. It extends from the River Thames to Oxford Street and has many famous landmarks, including the Palace of Westminster, Buckingham Palace, ...

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 a 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. The concept of a knighthood ...

ed by

Elizabeth II Elizabeth II (Elizabeth Alexandra Mary; 21 April 19268 September 2022) was Queen of the United Kingdom and other Commonwealth realms from 6 February 1952 until Death and state funeral of Elizabeth II, her death in 2022. ...

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)Larne/Latharna
Placenames Database of Ireland. is a to ...

, 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 surgical tongs used to guide breathing tubes into the windpipe or retrieve obstructions from the throat without blocking the view of the larynx.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 blockerss *Bobbin

flowmeters Flow measurement is the quantification of bulk fluid movement. Flow can be measured using devices called flowmeters in various ways. The common types of flowmeters with industrial applications are listed below: * Obstruction type (differential pr ...

*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 Medical doctors from County Antrim Alumni of Queen's University Belfast