|VIEW THE MOBILE VERSION of www.homemedicine.ca|| Informational|
Medical ArticlesComplete Recovery Of The Seriously Ill
Its a virtual certainty that to fully recover, a seriously il...
Physical Signs In Esophageal Foreign Body
There are no constant physical signs associated with uncompli...
Inspection of the hypopharynx and upper esophagus is readily...
Dripping Sheet Substitute For The Half-bath
To apply the _dripping sheet_, a tin bathing hat or a large w...
The Ammonium Carbonicum
recommended by Peart, has been considered by many as a specif...
The first decision to be made is what constitutes a slow puls...
Affection Of The Cerebellum And Spine
In affections of the _cerebellum_ and _spinal marrow_, the pa...
Where Sugar is Obtained. The other great member of the starch...
Bruises Case Xx
It frequently occurs to surgeons to receive slight wounds upo...
An ulcer is an "eating sore": that is, a sore containing matte...
The patient should be placed in the recumbent position, with...
Suck the wound, and apply a drop or two of strong ammonia to t...
Much, if not all, of the success in any case of treatment depe...
Social/cultural/psychological Obstacles To Fasting
Numerous attitudes make it difficult to fast or to provide mo...
Period Of Eruption Or Appearing Of The Rash
Commonly, on the second day, towards evening, sometimes on th...
The presence of a well marked case of exophthalmic goiter is ...
Where this is recommended the cold-drawn oil is meant, not the...
The regular type of laryngoscope shown in Fig. I (A, B, C) i...
This may with advantage to the health of the skin and body in ...
This affection, though it somewhat resembles a common boil, a...
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
Next: Penetrating Projectiles
Previous: The Extraction Of Tightly Fitting Foreign Bodies From The Bronchi