|The material used for all connecting rods on the Liberty engine was selected at the option of the manufacturer from one of two standard S. A. E. steels, the composition of which are given in Table 13. TABLE 13.--COMPOSITION OF STEELS NOS. X-... Read more of Connecting Rods at Steel Making.ca|| Informational|
This frequent and distressing trouble is to be traced to a sta...
The Use Of Forceps In Endoscopic Foreign Body Extraction
Two different strengths of forceps are supplied, as will be s...
See Bleeding; Wounds. ...
is valuable as a _palliative_ upon cancerous tumors. As a _cu...
Version Of A Safety Pin
A safety pin of very small size may be turned over in a dire...
Punctures Case Vii
Mr. Parr, aged 30, of delicate habit, trod upon a needle whic...
As mentioned above the anterior commissure laryngoscope and ...
To Prevent Itch
A dose of _Sulphur_, or rubbing a little flour of sulphur on ...
The Vegetable Kingdom
As to the vegetable kingdom, there is here, so far as we can ...
Purple Spots On Skin
These arise first as small swellings. The swellings fall, and ...
Diagnosis From Measles
In scarlatina the heat is much greater, and the pulse is much...
Ulcers Case Xxix
The peculiarity of the present case arose from neglect in eva...
For slight bruises, such as children frequently get by falling...
Cooling In Heating
Often it is difficult to get a sufficient cooling effect by me...
The Journey Down The Food Tube
The Flow of Saliva and Appetite Juice. We are now ready to st...
Ulcers Case Xxiv
The following case must not be regarded as altogether triflin...
A foreign body lodged in the esophagus may prove quickly fat...
This is a contagious disease, consisting in an inflammation o...
If the patient is weak, the circulation depressed, the blood ...
The Surgical Dissection Of The Deep Structures Of The Male Perinaeum The Lateral Operation Of Lithotomy
The urethra, at its membranous part, M, Fig. 1, Plate 53, whi...
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