Robert Berman

Biography

• 1914 – Born December in Brooklyn, New York
• 1936 – BA, University of North Carolina and commenced medical studies
• 1938 – Enrolled in University of Sheffield, England, for continued medical training
• 1939 – Visas revoked due to WWII outbreak while home; remained in the United States
• 1943 – MD, Chicago Medical School; internship at Israel Zion Hospital, New York
• 1944-1946 Served in the U.S. Coast Guard Public Health Service during WWII
• 1947 – Commenced anaesthesiology training Brooklyn Jewish Hospital, New York
• 1949 – Completed anaesthesiology training at Mount Sinai Hospital, New York City.
• 1949-1984 Director of Anesthesiology at St. Joseph’s Hospital in Far Rockaway, New York
• 1953 – Redrafted to US army. Administered anaesthesia in Korea and Japan during the Korea war
• 1950s–1970s – Invented Berman Oral and Intubating Airways, Resuscitube®, Respir-Aider, Quik Cuff®, blow-molded and anatomically shaped endotracheal tubes
• 1960s – Experimented with total body hyperthermia for cancer pain treatment
• 1973 – Presented tapered endotracheal tube at NYSSA Postgraduate Assembly
• 1979 – Released Berman Intubating Airway for blind and fiberoptic intubation
• 1999 – Died November 21, aged 84

Medical Eponyms

Berman Airway (1949 – US2599521A)

A rigid oropharyngeal airway used to maintain upper airway patency, designed to facilitate intubation and spontaneous ventilation.

In 1949, during residency, Berman was troubled by a near-miss when the safety pin from his black rubber multi-use Guedel airway he carried in his pocket, lodged in the pharynx during laryngoscopy. He developed a transparent, easily cleaned, non-occlusive airway

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…

The Berman airway revolutionized airway management by improving visibility, hygiene, and safety. Its design includes dual open channels to allow suctioning and passage of fiberoptic scopes, making it ideal for training and emergency settings.

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

Berman Intubating Airway (1978)

In 1978, 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