5. Cardiac Emergency Drugs.--Besides some of the drugs alread...
Our Relations With Others
EVERY one will admit that our relations to others sho...
Flour, And Other Matters Relating To Seeds
One of the largest degradations to human health was caused by...
JOHANN BAPTIST VAN HELMONT, a celebrated Belgian physician, s...
Entirely different treatment from the above is needed for such...
Auricular Fibrillation Auricular Flutter
Auricular fibrillation is at times apparently a clinical enti...
This troublesome disease is also known as St. Anthony's Fire, ...
Bruises Case Xviii
Mrs. C. aged 40, was detained on a journey by a bruised wound...
Heart Disease In Children And During Pregnancy
A common characteristic in a large proportion of middle-age...
Cicatricial Stenosis Of The Esophagus
Etiology.--The accidental swallowing of caustic alkali in sol...
Rupture And Trauma Of The Esophagus
These may be spontaneous or may ensue from the passage of an ...
To Prevent Colds
Keep the _arms_, _hands_ and _chest_ well clothed and warm. ...
Pulmonary Insufficiency Pulmonary Regurgitation
If this rare condition occurs, it is probably congenital. A ...
Blood Pressure In Children
May Michael, [Footnote: Michael, May: A Study of Blood Pressu...
As the patient should have a constant supply of pure air for ...
It is customary to locate esophageal lesions by denoting the...
Raw Food Healing Diets
Next in declining order of healing effectiveness is what I ca...
Torpid Reaction Asthenic
The more violent the contagious poison, and the weaker the or...
The esophagoscope, like the bronchoscope, is a hollow brass ...
Stage I Entering The Right Pyriform Sinus
The operator standing (as in Fig. 66), inserts the esophagos...
Extraction Of Soft Friable Foreign Bodies From The Tracheobronchial Tree
Category: MECHANICAL PROBLEMS OF BRONCHOSCOPIC FOREIGN BODY EXTRACTION
Source: A Manual Of Peroral Endoscopy And Laryngeal Surgery
The difficulties here consist in the liability of crushing or
fragmenting the object, and scattering portions into minute bronchi,
as well as the problem of disimpaction from a ring of annular edema,
with little or no forceps space. There is usually in these cases an
abundance of purulent secretion which further hinders the work. The
great danger of pushing the foreign body downward so that the swollen
mucosa hides it completely from view, must always be kept in mind.
Extremely delicate forceps with rather broad blades are required for
this work. The fenestrated peanut forceps are best for large pieces
in the large bronchi. The operator should develop his tactile sense
with forceps by repeated practice in order to acquire the skill to
grasp peanut kernels sufficiently firmly to hold them during
withdrawal, yet not so firmly as to crush them. Nipping off an edge by
not inserting the forceps far enough is also to be avoided. Small
fragments under 2 mm. in diameter may be expelled with the secretions
and fragments may be found on the sponges and in the secretions
aspirated or removed by sponge pumping. It is, however, never
justifiable deliberately to break a friable foreign body with the hope
that the fragments will be expelled, for these may be aspirated into
small bronchi, and cause multiple abscesses. A hook may be found
useful in dealing with round, friable, foreign bodies; and in some
cases the mechanical spoon or safety-pin closer may be used to
advantage. The foreign body is then brought close to, but not crushed
against the tube mouth.
 Removal of animal objects from the tracheobronchial tree is
readily accomplished with the side-curved forceps. Leeches are not
uncommon intruders in European countries. Small insects are usually
coughed out. Worms and larvae may be found. Cocaine or salt solution
will cause a leech to loosen its hold.
Foreign bodies in the upper-lobe bronchi are fortunately not common.
If the object is not too far out to the periphery it may be grasped by
the upper-lobe-bronchus forceps (Fig. 90), guided by the collaboration
of the fluoroscopist. These forceps are made so as to reach high into
the ascending branches of the upper-lobe bronchus. Full-curved
coil-spring hooks will reach high, but must be used with the utmost
caution, and the method of their disengagement must be practiced
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Previous: The Extraction Of Tightly Fitting Foreign Bodies From The Bronchi