|VIEW THE MOBILE VERSION of www.homemedicine.ca|| Informational|
Medical ArticlesOn The Adherent Eschar
It appears scarcely necessary to describe the immediate and w...
Milk, Meat, And Other Protein Foods
Speaking of butter, how about milk? The dairy lobby is very p...
It is not uncommon to find a stricture of the bronchus super...
WHEN we are tolerant as a matter of course, the nervous syste...
The Relative Position Of The Cranial Nasal Oral And Pharyngeal Cavities
On making a section (vertically through the median line) of t...
Rapid Relief From Colon Cleansing
During fasting the liver is hard at work processing toxins re...
Conditions Causing Change In Blood Pressure
Woolley [Footnote: Woolley, P. G.: Factors Governing Vascular...
The Relative Position Of The Superficial Organs Of The Thorax And Abdomen
In the osseous skeleton, the thorax and abdomen constitute a ...
The treatment of shock will probably always be unsatisfactory...
Cold baths, while greatly to be recommended to those who are s...
_This is preaching rebellion!_ I know it is, and it is wit...
Length Of Pack Perspiration
To make quite sure of the reaction, the single sheet may be t...
Accidents And Emergencies
Ordinarily, Accidents are not Serious. Accidents will happe...
Mitral Insufficiency: Mitral Regurgitation
This is the most frequent form of valvular disease of the hea...
The Surgical Form Of The Superficial Cervical And Facial Regions And The Relative Position Of The Principal Blood-vessels And Nerves
When the neck is extended in surgical position, as seen in Pl...
Essentials Of A Successful, Safe Fast
1. Fast in a bright airy room, with exceptionally good ventil...
How To Be Ill And Get Well
ILLNESS seems to be one of the hardest things to happ...
The fundamental principles of peroral endoscopy are best tau...
Towards The End Of The Period Of Efflorescence When The Rash
declines, fades, disappears, and the skin begins to peal off, a...
Anesthesia For Peroral Endoscopy
A dyspneic patient should never be given a general anesthetic...
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