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Medical ArticlesVeins SwollenThe swelling of veins in the leg is a very common trouble, esp... Symptoms Of Prolonged Foreign Body Sojourn In The Bronchus 1. The time of inhalation of a foreign body may be unknown ... Elbow Joint See Armpit Swelling and Bone. ... Eyes Hazy Sight Frequently, after inflammation, and even when that has ceased,... Forceps Delicacy of touch and manipulation are an absolute necessity... Diphtheria The most striking symptom of diphtheria is the growth of a sub... Eczema Skin eruptions, known under this name, have very various cause... Hepatitis Inflammation Of Liver Use the B D current, with what force the patient can bear. Pl... Acute Stenosis Of The Larynx Etiology.--Causes of a relatively sudden narrowing of the lum... Perspiration By this term we mean not only the sensible perspiration which ... Papillomata Of The Larynx In Children Of all benign growths in the larynx papilloma is the most fre... Fatty Heart The cause of deposits of fat around the heart or in between i... Saltrome The disease known by this name in Canada breaks out in the han... The Use Of The Brain LET us now consider instances where the brain alone i... Etiology The lodgement of foreign bodies in the esophagus is influenc... Angioneurotic Edema Angioneurotic edema manifests itself by a pale or red swolle... Circulation Of The Blood Nothing is more important for the health or healing of any org... Itch I shall say but little about this very common and very obstin... Feet Cold Continued coldness of the feet gives rise to many more serious... Prognosis A foreign body lodged in the esophagus may prove quickly fat... |
Acquiring SkillCategory: ACQUIRING SKILL Source: A Manual Of Peroral Endoscopy And Laryngeal Surgery Endoscopic ability cannot be bought with the instruments. As with all mechanical procedures, facility can be obtained only by educating the eye and the fingers in repeated exercise of a particular series of maneuvers. As with learning to play a musical instrument, a fundamental knowledge of technic, positions, and landmarks is necessary, after which only continued manual practice makes for proficiency. For instance, efficient use of forceps requires that they be so familiar to the grasp that their use is automatic. Endoscopy is a purely manual procedure, hence to know how is not enough: manual practice is necessary. Even in the handling of the electrical equipment, practice in quickly locating trouble is as essential as theoretic knowledge. There is no mystery about electric lighting. No source of illumination other than electricity is possible for endoscopy. Therefore a small amount of electrical knowledge, rendered practical by practice, is essential to maintain the simple lighting system in working order. It is an insult to the intelligence of the physician to say that he cannot master a simple problem of electric testing involving the locating of one or more of five possibilities. It is simply a matter of memorizing five tests. It is repeated for emphasis that a commercial current reduced by means of a rheostat should never be used as a source of current for endoscopy with any kind of instrument, because of the danger to the patient of a possible grounding of the circuit during the extensive moist contact of a metallic endoscopic tube in the mediastinum. The battery shown in Fig. 8 should be used. The most frequent cause of trouble is the mistake of over-illuminating the lamps. The lamp should not be over-illuminated to the dazzling whiteness usually used in flash lights. Excessive illumination alters the proper perception of the coloring of the mucosa, besides shortening the life of the lamps. The proper degree of brightness is obtained when, as the current is increased, the first change from yellow to white light is obtained. Never turn up the rheostat without watching the lamp. Next: Testing For Electric Defects Previous: Retrograde Esophagoscopy
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