BY GEORGE L. RUFFIN GEORGE L. RUFFIN (1834-1885) the first Negro judge to be appointed in Massachusetts, graduated in Law from Harvard, 1869. He served in the legislature of Massachusetts two terms, and in the Boston Council two terms. [N... Read more of Crispus Attucks at Martin Luther King.caInformational Site Network Informational
Privacy


Home


Medical Articles


Mother's Remedies


Household Tips


Medicine History


Forgotten Remedies


Search

Medical Articles

Mumps

This is a contagious disease, consisting in an inflammation o...

More Facts!

I have been treating several hundred cases of eruptive fevers...

Dysentery

This disease is caused by inflammation of the mucous membrane...

Amaurosis Paralysis Of The Optic Nerve

Use B D current, moderate force, three or four times, and the...

Deformities Of The Urinary Bladder The Operations Of Sounding For Stone Of Catheterism And Of Puncturing The Bladder Above The Pubes

The urinary bladder presents two kinds of deformity--viz., co...

Demonstrations Of The Nature Of Congenital And Infantile Inguinal Herniae And Of Hydrocele

PLATE 39. Fig. 1--The descent of the testicle from the loins ...

Copper

Emetic, white of egg to follow. ...

Prussic Acid

Almost hopeless. Emetic; artificial respiration. ...

Nature's Teaching

NATURE is not only our one guide in the matter of phy...

Stoutness

See Breath, and the Heart. ...

Impossibility Of Answering For The Issue Of Every Typhoid Case

Although a _typhoid character_ of scarlatina will rarely set ...

Bronchoscopic Oxygen Insufflation

Bronchoscopic oxygen insufflation is a life-saving measure eq...

Uric Acid

This acid is found in persons of a gouty tendency, such tenden...

Medicinal Runic Inscriptions

The discovery of the script of the ancient Germans, suppose...

Diet

The composition of different articles of food varies. A turnip ...

Adherent Pericarditis

Following dry pericarditis or pericarditis with an exudate, ...

Benign Neoplasms Of The Esophagus

As a result of prolonged inflammation edematous polypi and gr...

Putrid Symptoms

Next to those most dangerous forms--most dangerous, because t...

Symptoms Of Prolonged Foreign Body Sojourn In The Bronchus

1. The time of inhalation of a foreign body may be unknown ...

What Kind Of Food Should We Eat?

Generally speaking, our Appetites will Guide us. Our whole bo...



Difficulties In The Introduction Of The Bronchoscope





Category: INTRODUCTION OF THE BRONCHOSCOPE
Source: A Manual Of Peroral Endoscopy And Laryngeal Surgery

The beginner
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



Add to Informational Site Network
Report
Privacy
ADD TO EBOOK


Viewed 1758