|VIEW THE MOBILE VERSION of www.homemedicine.ca|| Informational|
Medical ArticlesEnemas Cold Water
Prejudice often exists against cold treatment of any kind, but...
Structure of the Ear. Next after sight, hearing is our most i...
Diseases And Disturbances Of The Skin
Their Chief Causes. Skin troubles are of two main kinds accor...
The term "simple dilatation" may be applied to the dilatation...
The Healing Crisis And Retracing
Certain unpleasant somatics that occur while fasting (or whil...
Water On The Chest
Sometimes a large watery swelling appears in one part or anoth...
Practice On The Rubber-tube Manikin
This must be carried out in two ways. 1. General practice...
Diet For The Lean
To a large extent the preceding article will suggest what is s...
The cause of this is a nervous derangement of the internal org...
There is no absolute contraindication to careful esophagosco...
This arises from the undue contraction of some of the muscles ...
Ulcers Case Xxv
The following case illustrates the superior efficacy of the l...
Colds Consumption And Pneumonia
Disease Germs. In all foul air there are scores of different ...
SELF-CONSCIOUSNESS may be truly defined as a person's...
Brow The Weary
Sometimes in the case of a child at school, the result of over...
Urticaria Zoster Rubeola
_Urticaria_, _Zoster_ and _Rubeola_, are treated in the same ...
The Progress Of Disease: Irritation, Enervation, Toxemia
Disease routinely lies at the end of a three-part chain that ...
Scarlatina Anginosa Or Sore-throat Scarlet-fever
Wherever the _throat_ is affected, which is almost always the...
Dripping Sheet Substitute For The Half-bath
To apply the _dripping sheet_, a tin bathing hat or a large w...
The Brain In Its Direction Of The Body
WE come now to the brain and its direction of other p...
Removal Of Foreign Bodies From The Larynx
Category: MECHANICAL PROBLEMS OF BRONCHOSCOPIC FOREIGN BODY EXTRACTION
Source: A Manual Of Peroral Endoscopy And Laryngeal Surgery
Symptoms and Diagnosis.--The history of a sudden choking attack
followed by impairment of voice, wheezing, and more or less dyspnea
can be usually elicited. Laryngeal diphtheria is the condition most
frequently thought of when these symptoms are present, and antitoxin
is rightly given while waiting for a positive diagnosis. Extreme
dyspnea may render tracheotomy urgently demanded before any attempts
at diagnosis are made. Further consideration of the symptomatology and
diagnosis of laryngeal foreign body will be found on pages 128, 133
Preliminary Examination.--In the adult, mirror examination of the
larynx should be done, the patient being placed in the recumbent
position. Whenever time permits roentgenograms, lateral and
anteroposterior, should be made, the lateral one as low in the neck as
possible. One might think this an unnecessary procedure because of the
visibility of the larynx in the mirror; but a child's larynx cannot
usually be indirectly examined, and even in the adult a pin may be so
situated that neither head nor point is visible, only a portion of the
shaft being seen. The roentgenogram will give accurate information as
to the position, and will thus allow a planning of the best method for
removal of the foreign body. A bone in the larynx usually is visible
in a good roentgenogram. Accurate diagnosis in children is made by
direct laryngoscopy without anesthesia, but direct laryngoscopy should
not be done until one is prepared to remove a foreign body if found,
to follow it into the bronchus and remove it if it should be dislodged
and aspirated, and to do tracheotomy if sudden respiratory arrest
 Technic of Removal of Foreign Bodies from the Larynx.--The
patient is to be placed in the author's position, shown in Fig. 53. No
general anesthesia should be given, and the application of local
anesthesia is usually unnecessary and further, is liable to dislodge
and push down the foreign body.* Because of the risk of loss downward
it is best to seize the foreign body as soon as seen; then to
determine how best to disimpact it. The fundamental principles are
that a pointed object must either have its point protected by the
forceps grasp or be brought out point trailing, and that a flat object
must be so rotated that its plane corresponds to the sagittal plane of
the glottic chink. The laryngeal grasping forceps (Fig. 53) will be
found the most useful, although the alligator rotation forceps (Fig.
31) may occasionally be required.
* In adolescents or adults a few drops of a 4 per cent solution of
cocain applied to the laryngopharynx with an atomizer or a dropper
will afford the minimum risk of dislodgement; but the author's
personal preference is for no anesthesia, general or local.
Next: Mechanical Problems Of Bronchoscopic Foreign Body Extraction*
Previous: Complications And After-effects Of Bronchoscopy