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Some have a predisposition to this most painful disease, and r...
Potatoes boiled and beaten up with buttermilk, spread out in t...
Destruction Of The Organ Of Hearing
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Hands Dry And Hard
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The Surgical Form Of The Deep Cervical And Facial Regions And The Relative Position Of The Principal Bloodvessels And Nerves
While the human cervix is still extended in surgical position...
The Form Of The Thoracic Cavity And The Position Of The Lungs Heart And Larger Bloodvessels
In the human body there does not exist any such space as cavi...
By this term is meant that condition of pulse in which, thoug...
There is no absolute contraindication to careful esophagosco...
Physical Signs Of Tracheal Foreign Body
If fixed in the trachea the only objective sign of foreign bo...
All too many of my cases are what I privately refer to as oni...
This is usually brought on by some excessive strain upon the b...
Training For Rest
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Gangrene Of The Lung
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Sometimes the red patches of the rash are covered with small ...
Biscuits And Water
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Persons suffering from nervous prostration have probably allow...
The Nerves In The Skin
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The nervous system of children is often damaged by shock or fr...
Period Of Incubation Or Hatching
The time which passes between the reception of the contagious...
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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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