VIEW THE MOBILE VERSION of www.homemedicine.ca Informational Site Network Informational
Privacy


Home


Medical Articles


Mother's Remedies


Household Tips


Medicine History


Forgotten Remedies


Search

Medical Articles

Bradycardia Symptoms

If a person has been long accustomed to a slow-acting heart, ...

Necessity Of Allaying The Heat

The packs and baths should be continued, even when the patien...

Lungs Congestion Of The

Treatment as below. Read preceding and succeeding articles. ...

Varix And Angioma Of The Esophagus

These lesions are sometimes the cause of esophageal hemorrhag...

Throat Sore (clergyman's)

Those who are in the habit of using their voice much should be...

The Relations Of The Principal Bloodvessels To The Viscera Of The Thoracico-abdominal Cavity

The median line of the body is occupied by the centres of the...

Headache Sick

The stomach and head affect each other powerfully, and a disor...

Exercise While Fasting

The issue of how much activity is called for on a fast is co...

Beverages

The Popularity of Beverages. For some curious reason, the h...

My Beginning

_Tis a gift to be simple Tis a gift to be free, Tis a gift ...

The Surgical Dissection Of The Popliteal Space And The Posterior Crural Region

On comparing the bend of the knee with the bend of the elbow,...

Prevention

If the patient is weak, the circulation depressed, the blood ...

The Care Of An Invalid

TO take really good care of one who is ill requires n...

Chest Protectors

These are often piled on the front of the body, while the far ...

Scarlet Fever

This fever assumes two principal forms: Simple or mild, and M...

Fomentation Armchair

This is applied as follows. Over a large armchair spread a fol...

Proteins Or Meats

Proteins, the First Foods. There are proteins, or meats, both...

Asiatic Cholera

I was practicing in Cincinnati during the prevalence of Chole...

Diagnosis

After what has been said about the symptoms of scarlatina, it...

Rules For Direct Laryngoscopy

1. The laryngoscope must always be held in the left hand, nev...



Removal Of Open Safety Pins From The Trachea And Bronchi





Category: MECHANICAL PROBLEMS OF BRONCHOSCOPIC FOREIGN BODY EXTRACTION
Source: A Manual Of Peroral Endoscopy And Laryngeal Surgery

Removal of a closed safety pin presents no difficulty if it is grasped
at one or the other end. A grasp in the middle produces a toggle
and ring action which would prevent extraction. When the
safety pin is open with the point downward care must be exercised
not to override it with the bronchoscope or to push the point through
the wall. The spring or near end is to be grasped with the side-curved
or the rotation forceps (Figs. 19, 20 and 31) and pulled into the
bronchoscope, thus closing the pin. An open safety pin lodged point up
presents an entirely different and a very difficult problem. If
traction is made without closing the pin or protecting the point
severe and probably fatal trauma will be produced. The pin may be
closed with the pin-closer as illustrated in Fig. 37, and then removed
with forceps. Arrowsmith's pin-closer is excellent. Another method
(Fig. 87) consists in bringing the point of the safety pin into the
bronchoscope, after disengaging the point with the side curved
forceps, by the author's inward rotation method. The forceps-jaws
(Fig. 21) devised recently by my assistant, Dr. Gabriel Tucker, are
ideal for this maneuver. As the point is now protected, the spring,
seen just off the tube mouth, is best grasped with the rotation
forceps, which afford the securest hold. The keeper and its shaft are
outside the bronchoscope, but its rounded portion is uppermost and
will glide over the tissues without trauma upon careful withdrawal of
the tube and safety pin. Care must be taken to rotate the pin so that
it lies in the sagittal plane of the glottis with the keeper placed
posteriorly, for the reason that the base of the glottic triangle is
posterior, and that the posterior wall of the larynx is membranous
above the cricoid cartilage, and will yield. A small safety-pin may be
removed by version, the point being turned into a branch bronchial
orifice. No one should think of attempting the extraction of a safety
pin lodged point upward without having practiced for at least a
hundred hours on the rubber tube manikin. This practice should be
carried out by anyone expecting to do endoscopy, because it affords
excellent education of the eye and the fingers in the endoscopic
manipulation of any kind of foreign body. Then, when a safety pin case
is encountered, the bronchoscopist will be prepared to cope with its
difficulties, and he will be able to determine which of the methods
will be best suited to his personal equation in the particular case.

[FIG. 86.--Schema illustrating the upper-lobe-bronchus problem,
combined with the mushroom-anchor problem and the author's method
for their solution. The patient being recumbent, the bronchoscopist
looking down the right main bronchus, M, sees the point of the tack
projecting from the right upper-lobe-bronchus, A. He seizes the point
with the side-curved forceps; then slides down the bronchoscope to the
position shown dotted at B. Next he pushes the bronchoscopic
tube-mouth downward and medianward, simultaneously moving the
patient's head to the right, thus swinging the bronchoscopic level on
its fulcrum, and dragging the tack downward and inward out of its bed,
to the position, 1). Traction, as shown at C, will then safely and
easily withdraw the tack. A very small bronchoscope is essential. The
lip of the bronchoscopic tube-mouth must be used to pry the forceps
down and over, and the lip must be brought close to the tack just
before the prying-pushing movement. S, right stem-bronchus.]

[FIG. 87.--One method of dealing with an open safety pin without
closing it.]





Next: Removal Of Double Pointed Tacks

Previous: Extraction Of Tacks Nails And Large Headed Foreign Bodies From The Tracheobronchial Tree



Add to del.icio.us Add to Reddit Add to Digg Add to Del.icio.us Add to Google Add to Twitter Add to Stumble Upon
Add to Informational Site Network
Report
Privacy
SHAREADD TO EBOOK


Viewed 1290