|VIEW THE MOBILE VERSION of www.homemedicine.ca|| Informational|
Medical ArticlesDiet For The Lean
To a large extent the preceding article will suggest what is s...
I KNEW an old German--a wonderful teacher of the spea...
Often very serious trouble takes the form of simple overwhelmi...
Vital Forces Animal And Vegetable
Upon these points I must be permitted to offer a few words. ...
Punctures Case Ii
Mrs. Middleton, aged 40, wounded her wrist, on the ulnar side...
Suggestions For The Control Of Athletics
1. Gymnasiums and athletic grounds in connection with all col...
To Prevent Colds
Keep the _arms_, _hands_ and _chest_ well clothed and warm. ...
Mechanical Effect Of Each Pole
The mechanical effect of the forward end of the current, or t...
Aphonia Loss Of Voice
This affection requires treatment variously, as it depends on...
A subacute or a chronic infective endocarditis should be trea...
The spinal cord is continuous with the back part of the brain....
Malignant disease of the esophagus is rarely seen early, bec...
For this take two tablespoonfuls of hot water every five minut...
Sitz-bath Anchor Of Safety
If there be much delirium, the sitz-bath may be required long...
The Dissection Of Femoral Hernia And The Seat Of Stricture
Whilst all forms of inguinal herniae escape from the abdomen ...
Hair Coming Off
There are many forms of this disfiguring trouble, both in the ...
This is best treated by a good large BRAN POULTICE (see) on th...
See Abscess; Ankle; Armpit; Bone, Diseased. ...
A snake bite is only one of a large class of injuries which ma...
Children In Fever
Fevered children, whether in any actual fever, as scarlet, typ...
Preparation Of The Patient For Peroral Endoscopy
Category: ANESTHESIA FOR PERORAL ENDOSCOPY
Source: A Manual Of Peroral Endoscopy And Laryngeal Surgery
The suggestions of the author in the earlier volumes in regard to
preparation of the patient, as for any operation, by a bath, laxative,
etc., and especially by special cleansing of the mouth with 25 per
cent alcohol, have received general endorsement. Care should be taken
not to set up undue reaction by vigorous scrubbing of gums
unaccustomed to it. Artificial dentures should be removed. Even if no
anesthetic is to be used, the patient should be fasted for five hours
if possible, even for direct laryngoscopy in order to forestall
vomiting. Except in emergency cases every patient should be gone over
by an internist for organic disease in any form. If an endolaryngeal
operation is needed by a nephritic, preparatory treatment may prevent
laryngeal edema or other complications. Hemophilia should be thought
of. It is quite common for the first symptom of an aortic aneurysm to
be an impaired power to swallow, or the lodgment of a bolus of meat or
other foreign body. If aneurysm is present and esophagoscopy is
necessary, as it always is in foreign body cases, to be fore-warned
is to be forearmed. Pulmonary tuberculosis is often unsuspected in
very young children. There is great danger from tracheal pressure by
an esophageal diverticulum or dilatation distended with food; or the
food maybe regurgitated and aspirated into the larynx and trachea.
Therefore, in all esophageal cases the esophagus should be emptied by
regurgitation induced by titillating the fauces with the finger after
swallowing a tumblerful of water, pressure on the neck, etc. Aspiration
will succeed in some cases. In others it is absolutely necessary to
remove food with the esophagoscope. If the aspirating tube becomes
clogged by solid food, the method of swab aspiration mentioned under
bronchoscopy will succeed. Of course there is usually no cough to aid,
but the involuntary abdominal and thoracic compression helps. Should a
patient arrive in a serious state of water-hunger, as part of the
preparation the patient must be given water by hypodermoclysis and
enteroclysis, and if necessary the endoscopy, except in dyspneic
cases, must be delayed until the danger of water-starvation is past.
As pointed out by Ellen J. Patterson the size of the thymus gland
should be studied before an esophagoscopy is done on a child.
Every patient should be examined by indirect, mirror laryngoscopy as a
preliminary to peroral endoscopy for any purpose whatsoever. This
becomes doubly necessary in cases that are to be anesthetized.
Next: Anesthesia For Peroral Endoscopy
Previous: Direction Of The Esophagus