For slight bruises, such as children frequently get by falling...
_Aconite_ and _Bell._ are two important remedies in this affe...
Amenorrhea Suppressed Menstruation
Treat as for chlorosis. But if the case be recent--the effect...
The symptoms are increased tension, which means, sooner or la...
On The Treatment By Eschar And Poultice
In many cases in which it is impossible to adopt either the m...
As in cholera morbus, keep the patient on his back, still as ...
Deformities Of The Prostate Distortions And Obstructions Of The Prostatic Urethra
The prostate is liable to such frequent and varied deformitie...
From The Hygienic Dictionary
Doctors.  In the matter of disease and healing, the peopl...
Boiled potatoes beaten up with fresh buttermilk make an excell...
Malignant disease of the esophagus is rarely seen early, bec...
ONCE a young woman who had very hard work to do day a...
Training For Rest
BUT how shall we gain a natural repose? It is absurd ...
This acid is found in persons of a gouty tendency, such tenden...
Dysmenorrhoea - Painful Menstruation
For this disorder, I know of no one remedy so valuable as the...
This is the accumulation of gases in the body, usually caused ...
The Relative Position Of The Cranial Nasal Oral And Pharyngeal Cavities
On making a section (vertically through the median line) of t...
See Headache. ...
Difficulties Of Direct Laryngoscopy
The larynx can be directly exposed in any patient whose mout...
The key to action in case of epidemics prevailing in the distr...
Of Fungous Ulcer Of The Navel In Infants
It sometimes occurs that a little fungous sore exists upon th...
Difficulties In The Introduction Of The Bronchoscope
Category: INTRODUCTION OF THE BRONCHOSCOPE
Source: A Manual Of Peroral Endoscopy And Laryngeal Surgery
may enter the esophagus instead of the trachea: this might be
a dangerous accident in a dyspneic case, for the tube could, by
pressure on the trachea, cause respiratory arrest. A bronchoscope thus
misplaced should be resterilized before introducing it into the air
passages, for while the lower air passages are usually free from
bacteria, the esophagus is a septic canal. If the given technic is
carefully carried out the bronchoscope will not be contaminated with
mouth secretions. The trachea is recognized as an open tube, with
whitish rings, and the expiratory blast can be felt and tubular
breathing heard; while if by mistake the bronchoscope has entered the
gullet it will be observed that the cervical esophagus has collapsed
walls. A puff of air may be felt and a fluttering sound heard when the
tube is in the esophagus, but these lack the intensity of the tracheal
blast. Usually a free flow of secretion is met with in the esophagus.
In diseased states the tracheal rings may not be visible because of
swollen mucosa, or the trachea itself may be in partial collapse from
external pressure. The true expiratory blast will, however, always be
recognized when the tube is in the trachea. Wide gagging of the mouth
renders exposure of the larynx difficult.
[FIG. 62.--Insertion of the bronchoscope. Note direction of the
trachea as indicated by the bronchoscope. Note that the patient's head
is held above the level of the table. The assistant's left hand should
be at the patient's mouth holding the bite-block. This is removed and
the assistant is on the wrong side of the table in the illustration in
order not to hide the position of the operator's hands. Note the
handle of the bronchoscope is to the right.]
[FIG. 63.--The heavy laryngoscope has been removed leaving the light
bronchoscope in position. The operator is inserting forceps. Note how
the left hand of the operator holds the tube lightly between the thumb
and first two fingers of the left hand, while the last two fingers are
hooked over the upper teeth of the patient anchoring the tube to
prevent it moving in or out or otherwise changing the relation of the
distal tube-mouth to a foreign body or a growth while forceps are
being used. Thus, also, any desired location of the tube can be
maintained in systematic exploration. The assistant's left hand is
dropped out of the way to show the operator's method. The assistant
during bronchoscopy holds the bite-block like a thimble on the index
finger of the left hand, and the assistant should be on the right side
of the patient. He is here put wrongly on the left side so as not to
hide the instruments and the manner of holding them.]
Next: Examination Of The Trachea And Bronchi
Previous: Technic Of Bronchoscopy