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Medical ArticlesGangrene Of The LungPulmonary gangrene has been followed by recovery after the e... Piles This very common trouble is caused by one or more of the veins ... Cures As Self-applied Often young people in lodgings are in difficulty for want of s... The Teeth The Ivory Keepers Of The Gate Why the Teeth are Important. The teeth are a very important... Worry One of the most fruitful causes of ill-health is the habit of ... Diet Is Not Enough Those isolated, long-lived peoples discovered by Weston A. Pr... Beef Tea It is well to bear in mind that there is scarcely any nourishm... Felon - Whitlow For this disease, in the early stage, when the sensation is t... Working Restfully ONCE met a man who had to do an important piece of sc... Cholera Morbus Keep the patient still as possible on his back. Use A D curre... Lumbago Lumbago differs from both paralysis and cramp of the lower bac... Cicatricial Stenosis Of The Esophagus Etiology.--The accidental swallowing of caustic alkali in sol... Soapy Blanket The It seems necessary, in getting people to use the best means fo... Acquiring Skill Endoscopic ability cannot be bought with the instruments. As ... My Own 56 Day Long Fast Fasters go through a lot of different emotional states, these... Tracheobronchial Diphtheria Urgent dyspnea in diphtheria when no membrane and but slight... Bruises Case Xiv The first case of bruise which I shall detail was not severe,... Foreign Bodies In The Stomach Gastroscopy is indicated in cases of a foreign body that ref... Eyes Inflamed With General Eruptions Over The Body In some cases the eye trouble is only a part of a general skin... The Prime Rules Of Fasting Another truism of natural hygiene is that we dig our own grav... |
Practice On The Rubber-tube ManikinCategory: ACQUIRING SKILL Source: A Manual Of Peroral Endoscopy And Laryngeal Surgery This must be carried out in two ways. 1. General practice with all sorts of objects for the education of the eye and the fingers. 2. Before undertaking a foreign body case, practice should be had with a duplicate of the foreign body. It is not possible to have a cadaver for daily practice, but fortunately the eye and fingers may be trained quite as effectually by simulating foreign body conditions in a small red rubber tube and solving these mechanical problems with the bronchoscope and forceps. The tubing may be placed on the desk and held by a small vise (Fig. 72) so that at odd moments during the day or evening the fascinating work may be picked up and put aside without loss of time. Complicated rubber manikins are of no value in the practice of introduction, and foreign body problems can be equally well studied in a piece of rubber tubing about 10 inches long. No endoscopist has enough practice on the living subject, because the cases are too infrequent and furthermore the tube is inserted for too short a space of time. Practice on the rubber tube trains the eye to recognize objects and to gauge distance; it develops the tactile sense so that a knowledge of the character of the object grasped or the nature of the tissues palpated may be acquired. Before attempting the removal of a particular foreign body from a living patient, the anticipated problem should be simulated with a duplicate of the foreign body in a rubber tube. In this way the endoscopist may precede each case with a practical experience equivalent to any number of cases of precisely the same kind of foreign body. If the object cannot be removed from the rubber tube without violence, it is obvious that no attempt should be made on the patient until further practice has shown a definite method of harmless removal. During practice work the value of the beveled lip of the bronchoscope and esophagoscope in solving mechanical problems will be evidenced. With it alone, a foreign body may be turned into favorable positions for extraction, and folds can always be held out of the way. Sufficient combined practice with the bronchoscope and the forceps enable the endoscopist easily to do things that at first seem impossible. It is to be remembered that lateral motion of the long slender tube-forceps cannot be controlled accurately by the handle, this is obtained by a change in position of the endoscopic tube, the object being so centered that it is grasped without side motion of the forceps. When necessary, the distal end of the forceps may be pushed laterally by the manipulation of the bronchoscope. [FIG. 72.--A simple manikin. The weight of the small vise serves to steady the rubber tubing. By the use of tubing of the size of the invaded bronchus and a duplicate of the foreign body, any mechanical problem can he simulated for solution or for practice, study of all possible presentations, etc.] Next: Practice On The Dog Previous: Cadaver Practice
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