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Medical ArticlesPoultice BranSee Bran Poultice. ... Heat Internal There is a usual (normal) temperature in all the blood and tis... Deviation Of The Esophagus Deviation of the esophagus may be marked in the presence of a... Treatment Of The Mild Or Erethic Form Of Scarlatina Anginosa The _mild_ or _erethic form_ of scarlatina anginosa requires ... Inflammatory Outbreaks Sometimes a severe out-break and eruption will occur in and ar... Etiology Pathology If a chronic endocarditis has followed an acute condition, so... Tracheobronchial Diphtheria Urgent dyspnea in diphtheria when no membrane and but slight... Tracheotomy Indications.--Tracheotomy is indicated in dyspnea of laryngot... Extent Of Electric Agency When we have settled upon the position that the electricity o... On The Treatment By Eschar And Poultice In many cases in which it is impossible to adopt either the m... Radiotherapy Radium and the therapeutic roentgenray are today our only ef... The Effect Of Athletics On The Heart We can no longer neglect the seriousness of the effects of c... Lilly WILLIAM LILLY, a famous English astrologer of yeoman ancestry... Rupture The abdomen is formed of a series of rings containing the bowe... Asthma Use the A D current, medium force. Treat with P. P. over the ... Wine And Water If No Reaction Can Be Obtained Should the patient remain cold in his pack for longer than an... Acute Cardiac Symptoms Acute Heart Attack It is not proposed here to describe the condition of sudden... Pleurisy The pleura is the tender double web, or membrane, which lines ... Artistic Considerations ALTHOUGH so much time and care are given to the vario... Bedsores There are cases in which the outer skin has been taken off by ... |
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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