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| Once, while Jesus was journeying about, He passed near a town where a man named Jairus lived. This man was a ruler in the synagogue, and he had just one little daughter about twelve years of age. At the time that Jesus was there the little ... Read more of THE STORY OF JAIRUS'S DAUGHTER at Children Stories.ca | Informational Privacy |
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Medical ArticlesEyes Hazy SightFrequently, after inflammation, and even when that has ceased,... Snake Bites A snake bite is only one of a large class of injuries which ma... Water In The Head In cases where this trouble is suspected, very often there is ... Physical Signs Of Tracheal Foreign Body If fixed in the trachea the only objective sign of foreign bo... Butter, Margarine And Fats In General Recently, enormous propaganda has been generated against eati... Tuberculosis Of The Esophagus Esophageal tuberculosis is not commonly met, but is probably ... Bronchoscopic Oxygen Insufflation Bronchoscopic oxygen insufflation is a life-saving measure eq... Breath And Blood Often difficulty of breathing, especially in close air, mistak... Fever At Night Frequently, in illness, a fever sets in as night approaches, a... Breast Sore Nipples On Take a little warm vinegar or weak acid (see Acetic Acid). Bat... Spine Misshapen Often in the case of delicate infants or children, the bones o... Breath And The Heart Stout people are usually more or less "scant of breath." Accum... Breast Swelling In A blow on the breast, or the drain of nursing a child, along w... Paroxysm Management The immediate conditions to meet are the rapid fluttering hea... Upper-lobe-bronchus Forceps Foreign bodies rarely lodge in an upper-lobe bronchus, yet w... Wet Compress The wet compress on the throat in torpid cases should not be ... Tests Of Heart Strength If both systolic and diastolic blood pressure are taken, and ... Stimulants See Alcohol; Narcotics. ... Difficulties In The Introduction Of The Bronchoscope The beginner may enter the esophagus instead of the trachea:... Medicines The delusion that health can be restored by swallowing drugs i... |
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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