Robert Berman

Robert Alvin Berman (1914-1999) was an American anesthesiologist and inventor.

Berman designed and developed products to solve the problems of airway management. His ideas for using plastic to make single-use medical equipment were at the forefront of this field.

In 1949, during residency an incident occurred which heralded the development of a translucent oropharangeal airway. Whilst performing a laryngoscopy he noted a safety pin in the pharynx. He deduced the pin had come from inside one of the black rubber multi-use Guedel airway that he and his fellow residents kept in their pockets along with safety pins (…of course these were washed between patients…)

Berman discussed the option of a translucent airway device with his neighbour (Meyer Moch – a plastic fabricator) to prevent the issue from recurring. In Moch’s basement they fashioned the original Berman airway from some butyrate tubing heated over an open flame. As luck would have it, Moch had no pharyngeal reflexes and Berman was able to use his mouth to model the fit…

Biography

• Born in December 1914 in Brooklyn, New York
• 1936 – BA, University of North Carolina and commenced medical school at the same institution before leaving following a dispute with the Dean to enrol at the University of Sheffield, England in 1938 – however in 1939 with the outbreak of WWII and whilst visiting home, visas were revoked and he remained in the Unites States
• 1943 – MD, Chicago Medical School with internship at Israel Zion in New York
• 1944-1946 Drafted to the Coast Guard Public Health Service during World War II.
• 1947 – Commenced anesthesiology training Brooklyn Jewish Hospital, Brooklyn, New York
• 1949 – Completed anesthesiology training at Mount Sinai Hospital, New York City. Director of Anesthesiology at St. Joseph’s Hospital in Far Rockaway, New York (a position he held for 35 years).
• 1953 – Redrafted to US army. Administered anesthesia in Korea and Japan during the Korea war
• Died on November 21, 1999

Medical Eponyms

Berman Airway (1949 – US2599521A)

In one aspect my invention comprises a respiratory airway having two coextensive passageways open along the full length thereof and separated by a rib. The use of open passageways makes for easy cleaning under direct vision; it is impossible in the respiratory airway of my invention for any mucous or other foreign matter to go undetected.

Berman 1949

Berman Resuscitube (1952 – US2758593A)

In the 1950s, as more attention was focused on resuscitation, he developed the Resuscitube and a hand bellows for resuscitation, the Respir-Aider. Berman felt mouth-to-mouth resuscitation was unsanitary but met resistance from anesthesiologist and resuscitation researcher James Otis Elam (1918-1995)

…to provide a novel mouth-to-mouth resuscitator which may be readily manipulated and will eliminate the necessity of physical contact between the mouth of the person being treated and the mouth of the person seeking to accomplish the resuscitation and which at the same time may be readily sanitized, and produced and stored under sanitary conditions.

Berman 1956

Berman and Elam later became friends and worked on airway management ideas together. Dr. Berman later helped Dr. Elam sell his idea for an Ambu Bag. Also during this time, he patented a plastic blood pressure

Berman Quik Cuff (1956 – US2981251A)

Berman patented a plastic blood pressure cuff, Quik Cuff® feeling that the blood pressure cuff was easily soiled and not hygienic to use repetitively from patient to patient.

Berman’s innovations with plastic were at the forefront of utilizing plastic in medicine and allowed the era of disposability to begin.

In the 1970s, Berman tried to further tackle innovations in airway management by making a blow-molded endotracheal tube; anatomically shaped endotracheal tubes; and presented a tapered endotracheal tube

In 1979, Berman resurrected an idea he had in residency, an intubating airway. His new Berman Intubating Airway led the way for a generation of intubating devices for blind and fiberoptic intubation.

The Berman Intubating Pharyngeal Airway, provides a tubular airway having an openable side to allow passage of appropriate medical and surgical appliances, such as an endotracheal tube, into the larynx and trachea without the use of a laryngoscope. The side opening airway permits blind oral intubating of the larynx and esophagus with ease even in difficult cases of cardiopulmonary-resuscitation and anesthetic procedures.

The intubating airway is designed to place an endotracheal tube into the larynx and trachea while at the same time providing an adequate pharyngeal airway itself.

The lateral opening at the side of the airway allows the airway to be removed from the mouth, leaving endotracheal tube in place. The airway is designed primarily to place the endotracheal tube into the trachea and at the same time provide an adequate pharyngeal airway by itself. The extra large lumen of the airway separates the tongue from the pharynx allowing a wider unobstructed air passageway from the lips to the larynx.

Berman 1978

Major Publications

Publications

• Adelman MH, Berman RA, Touroff AS. A new method of automatic controlled respiration. J Thorac Surg. 1950 May;19(5):817-20
• Berman RA, Safar P. Mouth-to-mouth resuscitation. Anesthesiology. 1958 Sep-Oct;19(5):685-7
• Berman RA. Lighted stylet. Anesthesiology. 1959 May-Jun;20(3):382-3.
• Berman RA, Turbin J, Jentile K. Nonrebreathing respirator-controlled anesthesia utilizing methoxyflurane. Anesthesiology. 1963 Mar-Apr;24:254-5.
• Bailenson G, Turbin J, Berman R. Awake intubation–indications and technique. Anesth Prog. 1967 Dec;14(10):272-8.
• Berman RA. A method for blind oral intubation of the trachea or esophagus. Anesth Analg. 1977 Nov-Dec;56(6):866-7

Patents

• Berman RA. Respiratory mouthpiece device. Patent US2599521A. 1952
• Berman RA. Plastic inflatable blood pressure cuff. Patent US2758593A. US2981251A 1956
• Berman RA. Mouth-to-mouth resuscitator. Patent US2758593A. 1958
• Berman RA. Naso-pharyngeal-esophageal device. Patent US3260258A. 1963
• Berman RA. Respiratory device. Patent US3419004A. 1966
• Berman RA. Endotracheal tube. Patent US3880168A. 1973
• Berman RA. Adjustable oral airway. Patent US3930507A. 1975
• Berman RA. Intubating pharyngeal airway. Patent US4069820A. US4067331A. 1976

References

Biography

• Robert Alvin Berman, 1914-1999. Anaesthesia Heritage Centre
• Sim P. Robert Alvin Berman, M.D., 1914-1999 A Career which embodies the Spirit of Anesthesiology. Bulletin of Anesthesia History 2000; 18(3): 2
• Maltby R. Robert Alvin Berman. In: Notable Names in Anaesthesia. The Choir Press, 2013: 16-17

Eponymous terms

• Berman JC. Robert Alvin Berman MD Airway Inventor. American Society of Anesthesiologists September 1999; 63(9): 17-19
• Berman Oral Airways. Wood Library Museum

Rowan Lo

Emergency Medicine Registrar at Sir Charles Gairdner Hospital. BM BS, BMed Sci, MMed Sci from the University of Southampton.

Enjoying life in Australia currently with the view to returning to the UK to train in Anaesthetics and Intensive Care Medicine.

Mike Cadogan

Associate Professor Curtin Medical School, Curtin University. Emergency physician MA (Oxon) MBChB (Edin) FACEM FFSEM Sir Charles Gairdner Hospital.  Passion for rugby; medical history; medical education; and asynchronous learning #FOAMed evangelist. Co-founder and CTO of Life in the Fast lane | Eponyms | Books | Twitter |