Direct Laryngoscopy In Children
Categories: DIRECT LARYNGOSCOPYSources: A Manual Of Peroral Endoscopy And Laryngeal Surgery
The epiglottis in children is
usually strongly curled, often omega shaped, and is very elusive and
slippery. The larynx of a child is very freely movable in the neck
during respiration and deglutition, and has a strong tendency to
retreat downward during examination, and thus withdraw the epiglottis
after the arytenoids have been exposed. In following down with the
laryngoscope the speculum is prone to enter the hypoph
in this location will expose the mouth of the esophagus and shut off
the larynx, and may cause respiratory arrest. Practice, however, will
soon develop a technic and ability to recognize the landmarks in state
of spasm, so that on exposing the approximated arytenoid eminences the
endoscopist will maintain his position and wait for the larynx to
open. The procedure should be done without any form of anesthesia for
the following reasons:
1. Anesthesia is unnecessary.
2. It is extremely dangerous in a dyspneic patient.
3. It is inadmissable in a patient with diphtheria.
4. If anesthesia is to be used, direct laryngoscopy will never reach
its full degree of usefulness, because anesthesia makes a major
procedure out of a minor one.
5. Cocain in children is dangerous, and its application more
annoying than the examination.
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Diagnosis
After what has been said about the symptoms of scarlatina, it cannot be difficult to distinguish it from similar eruptive diseases. However, as there is much resemblance between _scarlatina_ and _measles_, at least in the milder form of the former, ... Diagnosis From Measles
In scarlatina the heat is much greater, and the pulse is much quicker than in measles.--In scarlatina the throat is inflamed, usually the brain affected, and the patient smells like salt-fish, old cheese or the cages of a menagerie; in measles, the ... Diagnosis Of Foreign Body In The Air Or Food Passages
The questions arising are: I. Is a foreign body present? 2. Where is it located? 3. Is a peroral endoscopic procedure indicated? 4. Are there any contraindications to endoscopy? In order to answer these questions the definite routine giv... Diarrhoea
This disease consists in a looseness of the bowels, generally accompanied with pain in the abdomen, more or less severe. It sometimes occurs without pain, but is _then_ attended with a sense of weakness, and a general feeling of uneasiness. It preva... Diet
As intimated in the preceding paragraph, the diet during endocarditis must be carefully regulated. It must be sufficient, and appropriate for the disease in which the complication occurs, but it must be in such dosage and administered with such freq... Diet
The diet of the sick should he nutricious, but at all times simple, free from greasy substances, and from all stimulating condiments whatsoever, as well as from vinegar, or food in which vinegar is used. In short, let the food be nutritious, easil... Diet
I have little to say with regard to _diet_, at least to physicians. During great heat and high fever, the patient should eat little or nothing; but he should drink a good deal. Substantial food must be avoided entirely. When the fever abates, he can... Diet And Baths In Heart Disease
The diet in cardiac diseases has already incidentally been referred to. The decision as to what a patient ought to eat or drink must often be modified by just what the patient will do, and, as we all know, it is absolutely necessary to make some c... Diet For A Healthy Person
I doubt that it is possible to be totally healthy in the twentieth century. Doctors Alsleben and Shute in their book How to Survive the New Health Catastrophes state that in-depth laboratory testing of the population at large demonstrated four unive... Diet For A Long, Long Life
Some people not only want to be healthy, but they want to live in good health long past the normal life span projected by statistical tables for Homo Sapiens. Dr. Roy Walford, a well-respected medical research gerontologist who has been actively stu... Diet For The Acutely Ill
The acutely ill person experiences occasional attacks of distressing symptoms, usually after indiscretions in living or emotional upsets. They have a cold, or a flu, or sinusitis, or a first bout of pneumonia, or a spring allergy attack. The intense... Diet For The Chronically Ill
The chronically ill person has a long-term degenerative condition that is not immediately life threatening. This condition usually causes more-or-less continuous symptoms that are painful, perhaps unsightly, and ultimately will be disabling or eve... Diet Is Not Enough
Those isolated, long-lived peoples discovered by Weston A. Price had to do hard physical labor to eat, had to walk briskly up and down steep terrain to get anywhere. But today, few North Americans output very much physical energy in process of daily... Diets To Heal The Critically Ill
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Determination of the nature of the lesion in these cases usually consists in the diagnosis by exclusion of the possibilities, namely, 1. Lues. 2. Tuberculosis, including lupus. 3. Scleroma. 4. Malignant neoplasm. In the Bronchoscopic C... Differential Diagnosis Of Ulcer Of The Esophagus
Simple ulcer requires the exclusion of lues, tuberculosis, epithelioma, endothelioma, sarcoma, and actinomycosis. Simple ulcer of the esophagus is usually associated with stenosis, spastic or organic. Luetic ulcers commonly show a surrounding infl... Difficulties In The Introduction Of The Bronchoscope
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The larynx can be directly exposed in any patient whose mouth can be opened, although the ease varies greatly with the type of patient. Failure to expose the epiglottis is usually due to too great haste to enter the speculum all the way down. The s... Difficulties Of Esophagoscopy
The beginner may find the esophagoscope seemingly rigidly fixed, so that it can be neither introduced nor withdrawn. This usually results from a wedging of the tube in the dental angle, and is overcome by a wider opening of the jaws, or perhaps by ... Diffuse Dilatation Of The Esophagus
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It will be noted that the bronchi divide monopodially, not dichotomously. While the lumina of the individual bronchi diminish as the bronchi divide, the sum of the areas shows a progressive increase in total tubular area of cross-section. Thus, the... Diphtheria
Chronic postdiphtheritic stenosis may be of the panic, spasmodic or, rarely, the paralytic types; but more often it is of either the hypertrophic or cicatricial forms. Only too frequently the stenosis should be called posttracheotomic rather than p... Diphtheria
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Before starting, every detail in regard to instrumental equipment and operating room assistants, (including an assistant to hold the arms and legs of the patient) must be complete. Preparation of the patient and the technic of local anesthesia have... Direct Laryngoscopy In Children
The epiglottis in children is usually strongly curled, often omega shaped, and is very elusive and slippery. The larynx of a child is very freely movable in the neck during respiration and deglutition, and has a strong tendency to retreat downward ... Direct Laryngoscopy In Diseases Of The Larynx
The diagnosis of laryngeal disease in young children, impossible with the mirror, has been made easy and precise by the development of direct laryngoscopy. No anesthetic, local or general, should be used, for the practised endoscopist can complete t... Direction Of The Esophagus
The esophagus enters the chest in a decidedly backward as well as downward direction, parallel to that of the trachea, following the curves of the cervical and upper dorsal spine. Below the left bronchus the esophagus turns forward, passing through... Diseases And Disturbances Of The Skin
Their Chief Causes. Skin troubles are of two main kinds according to their cause: internal, due to the irritation of waste-poisons, or toxins, in the blood; and external, from direct injury or irritation of the skin from without. The latter are o... Diseases Of The Esophagus
The more frequent causes of the one common symptom of esophageal disease, dysphagia, are included in the list given below. To avoid elaboration and to obtain maximum usefulness as a reminder, overlapping has not been eliminated. 1. Anomalies. ... Disorders Of Muscles And Bones
The Muscles and Bones Have Few Diseases. Considering how complex it is, and the never-ceasing strain upon it, this moving apparatus of ours, the nerve-bone-muscle-machine, is surprisingly free from disease. The muscles, though they form nearly half ... Distinctive Use Of Each Pole
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Its course is commonly divided into four distinct periods, viz.: the period of incubation, the period of eruption, the period of efflorescence, and the period of desquamation; to which may be added: the period of convalescence. ... Do Not Hurry
HOW can any one do anything well while in a constant state of rush? How can any one see anything clearly while in a constant state of rush? How can any one expect to keep healthy and strong while in a constant state of rush? But most of m... Don't Talk
THERE is more nervous energy wasted, more nervous strain generated, more real physical harm done by superfluous talking than any one knows, or than any one could possibly believe who had not studied it. I am not considering the harm done by ... Dr Jerome Kidder's Electro-magnetic Machine
On opening the machine-box, as it comes from the manufacturer, there will be found a glass bottle, intended to hold the battery fluid when not in use; a glass cup or jar, to serve as the battery cell; a pair of insulated metallic conducting cords; t... Dripping Sheet Substitute For The Half-bath
To apply the _dripping sheet_, a tin bathing hat or a large wash-tub is placed near the patient's bed, and a pail of water on the brim of the hat, or close by the tub. Dip a linen sheet into it, and leave it there till you wish to take the patient o... Dropsy
Use the A D current, moderate force. Give general tonic treatment; then place P. P. with the feet, in a vessel of warm water, or place the sponge-roll P. P. at the soles of the feet, and treat the affected parts a few minutes with N. P., to quicken ... Drugs In Hypertension
The drugs that are mostly used to lower blood pressure are nitrites or drugs which are like nitrites, and these are nitroglycerin, sodium nitrite, erythroltetra nitrate and amyl nitrite, and the frequency of their use is in the order named. Other dr... During And After Desquamation The Treatment Should Be Continued As
indicated in milder cases, except the throat continue troublesome, when more packs should be used. If the throat is well, the patient may leave his room by the sixteenth day, under the precautions given above. ... Dysentery
Treat exactly as in acute diarrh[oe]a, except that P. P. should be moved more over the colon and rectum than in diarrh[oe]a. ... Dysentery
This disease is caused by inflammation of the mucous membrane of the colon and rectum, (the large intestine) generally confined to the lower part of the bowel. It is always painful. There is griping and straining in the lower part of the abdomen, an... Dysmenorrhea Painful Menstruation
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For this disorder, I know of no one remedy so valuable as the _Caulophyllin_, but _Pulsatilla_ in many cases is efficacious, and as they do not prevent each other's action, I prescribe them in alternation, giving a dose every half hour, for a short ... Dyspepsia
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