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Medical ArticlesPhysical CareREST, fresh air, exercise, and nourishment, enough of each in... Burns Case Xxxv The following case will present a specimen of my trials of th... The Digestive System How the Food Reaches the Stomach. Our body, then, has an open... Amputations These are often performed in cases in which proper treatment o... Diet Is Not Enough Those isolated, long-lived peoples discovered by Weston A. Pr... The Confusions About Diets And Foods Like my daughter, many people of all ages are muddled about t... Piles This very common trouble is caused by one or more of the veins ... Burns For slight burns, immerse the injured part in cold water, and ... From The Hygienic Dictionary 2 Toxemia. [1] "Toxemia is the basic cause of all so-called dise... Enemas Cold Water Prejudice often exists against cold treatment of any kind, but... Symptoms Dysphagia is the most frequent complaint in cases of esophag... Wounds Syringing Very great good can often be done by a little careful syringin... The Effect Of Drugs On Venous Blood Pressure Capps and Matthews [Footnote: Capps, J. A., and Matthews, S. ... Cardiovascular Renal Disease Treatment While it is urged, in preventing the actual development of th... Fomentation Some general remarks on this important treatment we give here.... Chronic Myocarditis Fibrous Chronic myocarditis may develop on an acute myocarditis, but ... Internal Relaxation Pain is often felt in parts of the back or sides which will yi... Ulcers Case Xxiii Mr. Marshall, aged 60, had a troublesome ulcer under the oute... Papilloma Forceps Papillomata do not infiltrate; but superficial repullulation... The Prognosis under a well conducted course of hydriatic treatment is, in g... |
Care Of InstrumentsCategory: 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 house. [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
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