One of the most common causes of hypertension is clue to exce...
Physics Of Mitral Stenosis
Mitral stenosis, though less common than mitral regurgitation...
Foreign Bodies In The Insane
Foreign bodies may be introduced voluntarily and in great nu...
Papillomata do not infiltrate; but superficial repullulation...
Punctures Case Ix
James Joynes, aged 12, was bitten by an ass, on each side of ...
Rubbing Sheet Substitute For The Half-bath
It cannot be difficult to procure a wash-tub. Should you be s...
TO be truly at peace with one's self means rest indeed. Th...
3 Treatment Of Torpid Forms Of Scarlatina Difference In The
TREATMENT POINTED OUT. When the _reaction_ is _torpid_, the ...
THERE was once a family who had a guest staying with ...
The Curative Influence Of The Imagination
At the present day the remarkable benefit which often resul...
Relaxation Of Treatment Towards The End Of The Third Period Continuation Of Packs During And After Desquamation
When the patient is through the first part of the period of ...
See Hay Fever. ...
From the preceding observations it would naturally be conclud...
Angioneurotic edema manifests itself by a pale or red swolle...
ROBERT FLUDD, surnamed "the Searcher," an English physician, ...
The Triviality Of Trivialities
LIFE is clearer, happier, and easier for us as things assume ...
Use the A D current always in rheumatic affections. If there ...
Though not often fatal, this illness gives serious trouble. It...
Hepatization Of Lungs
Take A D current, pretty strong force. Treat in front, over t...
Removal Of Double Pointed Tacks
If the tack or staple be small, and lodged in a relatively l...
Source: A Manual Of Peroral Endoscopy And Laryngeal Surgery
While the usually thin, watery esophageal and
gastric secretions, if free from food, are readily aspirated through a
drainage canal, the secretions of the bronchi are often thick and
mucilaginous and aspirated with difficulty. Further-more, bronchial
secretions as a rule are not collected in pools, but are distributed
over the walls of the larger bronchi and continuously well up from
smaller bronchi during cough. The aspirating bronchoscopes should be
used whenever their very slight additional area of cross-section is
unobjectionable. In most cases, however, the most advantageous way to
remove bronchial secretion has been found to be by introducing a gauze
swab on a long sponge carrier (Fig. 14), so that the sponge extends
beyond the distal end of the bronchoscope, causing cough. Then
withdrawal of the sponge carrier will remove all of the secretion in
the tube just as the plunger in a pump will lift all of the water
above it. By this maneuver the walls of the bronchus are wiped free
from secretions, and the lamp itself is cleansed.
[FIG. 14.--Sponge carrier with long collar for carrying the small
sponges shown in Fig. 15. The collar screws down as in the Coolidge
cotton carrier. About a dozen of these are needed and they should all
be small enough to go through the 4 mm. (diameter) bronchoscope and
long enough to reach through the 53 cm. (length) esophagoscope, so
that one set will do for all tubes. The schema shows method of
sponging. The carrier C, armed with the sponge, S, when rotated as
shown by the dart, D, wipes the field, P, at the same time wiping the
lamp, L. The lamp does not need ever to be withdrawn for cleaning
during bronchoscopy. It is protected in a recess so that it does not
catch in the sponges.]
[FIG 15.--Exact size to which the bandage-gauze is cut to make
endoscopic sponges. Each rectangle is the size for the tubal diameter
given. The dimensions of the respective rectangles are not given
because it is easier for the nurse or any one to cut a cardboard
pattern of each size directly from this drawing. The gauze rectangles
are folded up endwise as shown at A, then once in the middle as at B,
then strung one dozen on a safety pin. In America gauze bandages run
about 16 threads to the centimeter. Different material might require a
slightly different size and the pattern could be made to suit.]
 The gauze sponges are made by the instrument nurse as directed in
Fig. 15, and are strung on safety pins, wrapped in paper, the size
indicated by a figure on the wrapper, and then sterilized in an
autoclave. The sterile packages are opened only as needed. These
bronchoscopic sponges are also made by Johnston and Johnston, of New
Brunswick, N. J. and are sold in the shops.
Previous: Aspirating Tubes