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Medical ArticlesIndications For Esophagoscopy In DiseaseAny persistent abnormal sensation or disturbance of function... Hope And Healing The mind has always an influence on the body. Life rises and f... Sprains Or Racks A sprain is usually the result of some involuntary stress comi... Opium See Narcotics. ... Polarization Of The Circuit I have said, in effect, a little above, that, while the curre... Children's Nerves The nervous system of children is often damaged by shock or fr... The Use Of The Will IT is not generally recognized that the will can be t... The Child As An Ideal WHILE the path of progress in the gaining of repose c... Sponge-pumping While the usually thin, watery esophageal and gastric secret... Copy Of Certificate These may Inform all whom it might Concern, that Mr. J... How And Why We Breathe Life is Shown by Breathing. If you wanted to find out whether... Tempering Treatment Much, if not all, of the success in any case of treatment depe... Clothing Clothes should be Loose and Comfortable. Man is the only anim... 1 Is Water Applicable In All Typhoid Cases? The question has been raised, whether in typhoid cases, and i... Of Fungous Ulcer Of The Navel In Infants It sometimes occurs that a little fungous sore exists upon th... Heat Internal There is a usual (normal) temperature in all the blood and tis... Climate And Soil The soil on which one lives is a matter of primary importance;... Hip-joint Disease Thorough heating, with moist heat is the best treatment for th... Artistic Considerations ALTHOUGH so much time and care are given to the vario... Diagnosis After what has been said about the symptoms of scarlatina, it... |
Preparation Of The Patient For Peroral EndoscopyCategory: 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
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