|VIEW THE MOBILE VERSION of www.homemedicine.ca|| Informational|
The use of these to give temporary relief, often degenerating ...
Sometimes the red patches of the rash are covered with small ...
A snake bite is only one of a large class of injuries which ma...
See Headache. ...
Ice-water And Snow-bath In Malignant Cases
If no rash appear during the first pack, which will scarcely ...
The disease called Polypus, affecting the mouth or nostril wit...
The Relative Anatomy Of The Male Pelvic Organs
As the abdomen and pelvis form one general cavity, the organs...
Medicinal Runic Inscriptions
The discovery of the script of the ancient Germans, suppose...
Bronchoscopic And Esophagoscopic Grasping Forceps
are of the tubular type, that is, a stylet carrying the jaws...
Disorders Of Muscles And Bones
The Muscles and Bones Have Few Diseases. Considering how comp...
Chloroform Or Ether (swallowed)
Emetic; enema of hot coffee; keep awake. If necessary, artific...
Children In Fever
Fevered children, whether in any actual fever, as scarlet, typ...
Aortic Stenosis Aortic Obstruction
Valvular disease at the aortic orifice is much less common th...
Sometimes mere internal inflammation is mistaken for this dise...
See Rubbing. ...
Differential Diagnosis Of Ulcer Of The Esophagus
Simple ulcer requires the exclusion of lues, tuberculosis, e...
See Whooping Cough. ...
Why Does Mrs Smith Get On My Nerves?
IF you want to know the true answer to this question ...
Eyes Paralysis Of
The partial paralysis of the muscles of one eye produces doubl...
The esophagoscope, like the bronchoscope, is a hollow brass ...
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