Medical ArticlesFever Influenza
This is a slow, smouldering kind of fever. For treatment, pack...
Whether any drug should be used which acts directly on the he...
Ulcers Case Xxx
C. Cocking, aged 17, has an ulcer of the size of half-a-crown...
Baths And Bathing
Bathing as a Means of Cleanliness. It has been said that one ...
The Relations Of The Principal Bloodvessels To The Viscera Of The Thoracico-abdominal Cavity
The median line of the body is occupied by the centres of the...
These will be found dealt with under many headings throughout ...
The Tired Emphasis
"I AM so tired, so tired--I go to bed tired, I get up...
WHEN we face the matter squarely and give it careful ...
Pimples On The Face
See Face. ...
Bowels Locking Of
Sometimes when one part of the bowels is much more active than...
The Guidance Of The Body
THE literature relating to the care of the human body...
See Baths for Head. ...
The Dissection Of The Oblique Or External And The Direct Or Internal Inguinal Herniae
The order in which the herniary bowel takes its investments f...
Length Of The Fast
How long should a person fast? In cases where there are serio...
Where persistent weariness is felt, and the least exertion bri...
This condition is generally termed by the patient a "palpitat...
As in cholera morbus, keep the patient on his back, still as ...
TO argue with nervous anxiety, either in ourselves or...
In the non-cicatricial forms, galvanocaustic puncture applie...
Fixation of the crico-arytenoid joints with an approximation...
Care Of Instruments
Category: ANATOMY OF LARYNX, TRACHEA, BRONCHI AND ESOPHAGUS, ENDOSCOPICALLY CONSIDERED
Source: A Manual Of Peroral Endoscopy And Laryngeal Surgery
The endoscopist must either personally care
for his instruments, or have an instrument nurse in his own employ,
for if they are intrusted to the general operating room routine he
will find that small parts will be lost; blades of forceps bent,
broken, or rusted; tubes dinged; drainage canals choked with blood or
secretions which have been coagulated by boiling, and electric
attachments rendered unstable or unservicable, by boiling, etc. The
tubes should be cleansed by forcing cold water through the drainage
canals with the aspirating syringe, then dried by forcing
pipe-cleaning worsted-covered wire through the light and drainage
canals. Gauze on a sponge carrier is used to clean the main canal.
Forceps stylets should be removed from their cannulae, and the
cannulae cleansed with cold water, then dried and oiled with the
pipe-cleaning material. The stylet should have any rough places
smoothed with fine emery cloth and its blades carefully inspected; the
parts are then oiled and reassembled. Nickle plating on the tubes is
apt to peel and these scales have sharp, cutting edges which may
injure the mucosa. All tubes, therefore, should be unplated. Rough
places on the tubes should be smoothed with the finest emery cloth,
or, better, on a buffing wheel. The dry cells in the battery should be
renewed about every 4 months whether used or not. Lamps, light
carriers, and cords, after cleansing, are wiped with 95 per cent
alcohol, and the light-carriers with the lamps in place are kept in a
continuous sterilization box containing formaldehyde pastilles. It is
of the utmost importance that instruments be always put away in
perfect order. Not only are cleaning and oiling imperative, but any
needed repairs should be attended to at once. Otherwise it will be
inevitable that when gotten out in an emergency they will fail. In
general surgery, a spoon will serve for a retractor and good work can
be done with makeshifts; but in endoscopy, especially in the small,
delicate, natural passages of children, the handicap of a defective or
insufficient armamentarium may make all the difference between a
success and a fatal failure.
A bronchoscopic clinic should at all times be in the same state of
preparedness for emergency as is everywhere required of a fire-engine
[PLATE I--A WORKING SET OF THE AUTHOR'S ENDOSCOPIC TUBES FOR LARYNGOSCOPY,
BRONCHOSCOPY, ESOPHAGOSCOPY, AND GASTROSCOPY:
A, Adult's laryngoscope; B, child's laryngoscope; C, anterior
commissure laryngoscope; D, esophageal speculum, child's size; E,
esophageal speculum, adult's size; F, bronchoscope, infant's size, 4
mm. X 30 cm.; G, bronchoscope, child's size, 5 mm. X 30 cm.; H,
aspirating bronchoscope for adults, 7 mm. X 40 cm.; I, bronchoscope,
adolescent's size, 7 mm. x 40 cm., used also for the deeper bronchi of
adults; J, bronchoscope, adult size, g mm. x 40 cm.; K, child's size
esophagoscope, 7 mm. X 45 cm.; L, adult's size esophagoscope, full
lumen construction, 9 mm. x 45 cm.; M, adult's size gastroscope. C,
I, and E are also hypopharyngoscopes. C is an excellent esophageal
speculum for children, and a longer model is made for adults.
If the utmost economy must be practised D, E, and M may be omitted.
The balance of the instruments are indispensable if adults and
children are to be dealt with. The instruments are made by Charles J.
Pilling & Sons, Philadelphia.]
Next: Anatomy Of Larynx Trachea Bronchi And Esophagus Endoscopically Considered
Previous: List Of Instruments