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| David was now King. He had great riches and honour, and a palace had been built for him. He had brought the ark from Kirjath-jearim, and placed it in the tabernacle prepared for it at Jerusalem, and he now reigned over all the people of Israe... Read more of NATHAN REPROVING THE KING. at Children Stories.ca | Informational Privacy |
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Medical ArticlesLength Of BathAlthough the temperature, in sthenic cases, should be a littl... Scarlatina Simplex Or Simple Scarlet-fever In the _mildest form_ of the disease, called _scarlatina simp... In Excessive Heat And Continuous Delirium A Half-bath May Be Given also, every time the packing sheet is changed. The rule is that... Diagnosis After what has been said about the symptoms of scarlatina, it... Bruises Case Xviii Mrs. C. aged 40, was detained on a journey by a bruised wound... Length Of Pack Perspiration To make quite sure of the reaction, the single sheet may be t... Heartburn This peculiar burning and distressed feeling at the stomach d... Acute Dilatation Of The Heart In Acute Disease It has for a long time been recognized that in all acute prol... General Principles Of Position As will be seen in Fig. 47 the trachea and esophagus are not... Gastroscopes The gastroscope is of the same construction as the esophagos... Arsenic Emetic, followed by white of egg. Keep very warm. ... Tobacco In spite of the fact that a large number of men today do not ... Teething At the outset, it must ever be remembered that this is not a d... Rich Foods Brandy Beef-tea Etc must be avoided. Involuntary starting, and the manifestation... Weariness Where persistent weariness is felt, and the least exertion bri... Cauliflower Growths These begin like warts, and in the earlier stages poulticing a... Hay Fever A most effective preventive and cure for this is the inhaling ... Brain Impressions THE mere idea of a brain clear from false impressions gives a... Retrograde Esophagoscopy The first step is to get rid of the gastric secretions. Ther... Practice On The Dog Having mastered the technic of introduction on the cadaver a... |
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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