Medical ArticlesDiabetes A Kidney Disease
This disease occurs in two forms--diabetes insipidus and diab...
After the bath, the patient is rubbed dry, and either taken t...
1. "Nervous headache." Take the B D current--moderate force. ...
Accidents And Emergencies
Ordinarily, Accidents are not Serious. Accidents will happe...
The remedy which has attracted and still attracts in a very h...
The Circumstances Of Life
IT is not the circumstances of life that trouble or w...
Deviation Of The Esophagus
Deviation of the esophagus may be marked in the presence of a...
is a specific when locally used for _Sycosis_, also for fungo...
See Child-bearing. ...
Foods For Monodiet, Juice Or Broth Fasting
zucchini, garlic, onion, green beans, kale, celery, beet gree...
Inflammation Of The Bowels - Enteritis
This consists in inflammation of the muscular and peritoneal ...
Anchoring The Foreign Body Against The Tube Mouth
If withdrawal be made a bimanual procedure it is almost cert...
This is neuralgia in an ischiatic nerve, commonly the great i...
Hepatization Of Lungs
Take A D current, pretty strong force. Treat in front, over t...
The Blue-glass Mania
As illustrative of the power of the imagination, the so-cal...
WATCH the faces as you walk along the street! If you ...
A most common trouble is anaemia, a lack of good red blood, sh...
Pain Severe In Limbs
This is often not due to any trouble in the joint itself, but ...
The immediate conditions to meet are the rapid fluttering hea...
Bruises Case Xx
It frequently occurs to surgeons to receive slight wounds upo...
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