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From The Hygienic Dictionary

Vitamins. [1] The staple foods may not contain the same nutr...

Saltrome

The disease known by this name in Canada breaks out in the han...

Painful Urination Incontinence Of Urine

_Involuntary Urination._ Where the discharge of urine prod...

Glands Of Bowels

See Bowels. ...

Examination Of The Trachea And Bronchi

All bronchial orifices must be identified seriatim; because ...

Circulation Of The Blood

Nothing is more important for the health or healing of any org...

Clothing

Clothes should be Loose and Comfortable. Man is the only anim...

Other Bad Symptoms

These symptoms may present themselves with the rash standing ...

Diets To Heal The Critically Ill

A critically ill person is someone who could expire at any mo...

Treatment Of The Mild Or Erethic Form Of Scarlatina Anginosa

The _mild_ or _erethic form_ of scarlatina anginosa requires ...

Diagnosis

If a more malignant form of endocarditis develops on a mild ...

Rose

See Erysipelas. ...

Deviation Of The Esophagus

Deviation of the esophagus may be marked in the presence of a...

Treatment

Bronchoscopy should be done in all cases of chronic pulmonar...

Care Of The Nails

Importance of Clean Nails. On account of their constant use, ...

Jaundice

This disease depends upon derangement of the liver. The skin ...

Rules For Endoscopic Foreign Body Extraction

1. Never endoscope a foreign body case unprepared, with the...

Water-drinking

As the patient should have a constant supply of pure air for ...

Upper-lobe-bronchus Forceps

Foreign bodies rarely lodge in an upper-lobe bronchus, yet w...

Lacing Tight

This produces such serious deformity, and in many ways so inte...



Bronchial Aspiration





Category: TRACHEOTOMY
Source: A Manual Of Peroral Endoscopy And Laryngeal Surgery

As mentioned above, bronchial aspiration is
often necessary. When the patient is unable to get up secretions, he
will, as demonstrated by the author many years ago, drown in his own
secretions. In some cases bronchoscopic aspiration is required
(Peroral Endoscopy, p. 483). Occasionally, very thick secretions will
require removal with forceps. Pus may become very thick and gummy from
the administration of morphin. Opiates do not lessen pus formation,
but they do lessen the normal secretions that ordinarily increase the
quantity and fluidity of the pus. When to this is added the
dessicating effect of the air inhaled through the cannula, unmoistened
by the upper air-passages, the secretions may be so thick as to form
crusts and plugs that are equivalent to foreign bodies and require
removal with forceps. Diphtheritic membrane in the trachea may require
removal with bronchoscope and forceps. Thinner secretions may be
removed by sponge-pumping. In most cases, however, secretions can be
brought up through an aspirating tube, connected to a bronchoscopic
aspirating syringe (Fig. 11), an ordinary aspirating bottle, or
preferably, a mechanical aspirator such as that shown in Fig. 12. In
this, combined with bronchoscopic oxygen insuflation (q.v.), we have a
life-saving measure of the highest efficiency in cases of poisoning by
chlorine and other irritant and asphyxiating gases. An aspirating tube
for insertion into the deeper air passages should be of copper, so
that it can be bent to the proper curve to reach into the various
parts of the tracheobronchial tree, and it should have a removable
copper-wire core to prevent kinking, and collapse of the lumen. The
distal end should be thickened, and also perforated at the sides, to
prevent drawing-in of the mucosa and trauma thereto. A rubber tube may
be used, but is not so satisfactory. The one shown in Fig. 10 I had
made by Mr. Pilling, and it has proved very satisfactory.





Next: Decannulation

Previous: Emergency Tracheotomy



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