Drawing Blood for Transfusion
When the donor’s arm has been congested by gripping it above the elbow, or better by the application of a tourniquet drawn to the requisite degree of tightness, a suitable vein, usually the median basilic, is chosen. The area of puncture is washed with ether and a very small quantity, 2 to 3 minims, of 2 per cent. novocain is introduced over the vein with a hypodermic syringe. If a larger quantity is used, the vein may become obscured, but this small amount may be dispersed by a few moments’ pressure with the finger, and is usually enough to anæsthetize the very small area of skin that is to be operated upon. A tiny cut in the skin is then made with the point of a scalpel, and the needle is pushed through into the vein.
Kimpton-Brown Tube
Whole Blood Transfusion with Kimpton’s Tube. The principle of this method depends upon the use of paraffin wax as a coating for the vessel into which the blood is drawn, so that clotting is prevented or greatly delayed. The form of the vessel has been modified by different workers, but the essentials are the same in each. One form of the apparatus, known as the Kimpton-Brown tube, is illustrated in the accompanying diagram. It consists of a graduated glass cylinder, of about 700 cc. capacity, the lower end of which is drawn out into a cannula point at an acute angle with the body of the cylinder; the point is of a size convenient for introducing into a vein and its bore large enough to allow of a free flow of blood through it. Near the upper end is a side tube to which a rubber tube can be attached, and an opening at the top is closed by a rubber bung. An ordinary rubber double-bulb bellows is the only other apparatus that is needed.
Blundell’s Impellor
A more general interest in the subject was revived in England by the work of James Blundell, lecturer on physiology and midwifery at St. Thomas’s and Guy’s Hospitals. He published in 1818 his earliest paper on experimental transfusion with a special form of syringe invented by himself. His first apparatus consisted of a funnel-shaped receptacle for the blood, connected by a two-way tap with a syringe from which the blood was injected through a tube and cannula into the recipient. His experiments were[11] performed upon dogs, and he began by drawing blood from the femoral artery and re-injecting it into the same animal through the femoral vein. He then conducted a long series of investigations into the properties of blood, the effects of its withdrawal, and the resuscitation of an exsanguinated animal. Soon he had opportunities of transfusing patients with human blood, and the results are recorded in his paper of 1824. His apparatus had by then been elaborated, and an engraving of his Impellor, as he termed it, is reproduced here. It consisted as before of a funnel-shaped receptacle for the blood, but the syringe was now incorporated in one side of the funnel, and contained a complicated system of spring valves, which caused the blood to travel along the delivery tube when the piston was pushed down. The Impellor was fixed to the back of a chair in order to give it stability.