In many cases of severe illness, the stomach rejects all food,...
Colic Of Whatever Kind
Use A D current, pretty strong force. In severe cases, introd...
THE ability to be easily and heartily amused brings a wholeso...
To Prevent Scarlet Fever
Give Belladonna at the 3d attenuation, three to six pellets, ...
Baths And Bathing
Bathing as a Means of Cleanliness. It has been said that one ...
Sitting (or Sitz) Bath
This bath, in whatever form administered, is essentially a sit...
Like any other muscular tissue, the heart hypertrophies whe...
There is a vast variety of ailments associated with what is ca...
You Have No Idea How I Am Rushed
A WOMAN can feel rushed when she is sitting perfectly...
Dysmenorrhoea - Painful Menstruation
For this disorder, I know of no one remedy so valuable as the...
From The Hygienic Dictionary
Cure.  There is no "cure" for disease; fasting is not a cur...
Removal Of Foreign Bodies From The Larynx
Symptoms and Diagnosis.--The history of a sudden choking atta...
Take the B D current, medium force. If the paralysis be in a ...
See Narcotics. ...
The spatular end of the laryngoscope is introduced in the ri...
WHEN we face the matter squarely and give it careful ...
The pathology of arteriosclerosis is a thickening and diminis...
of children, where there is a discharge of yellow and watery ...
Croup Less Serious Form
The less serious croup proceeds from a nervous closing of the ...
Mineral Acids And Glacial Acetic
If any neutralising agent, such, e.g., as lime, chalk, soda, o...
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