Notes On Nursing Tracheotomized Patients
Categories: CHRONIC STENOSIS OF THE LARYNX AND TRACHEASources: A Manual Of Peroral Endoscopy And Laryngeal Surgery
Bedside tray should contain:
Duplicate cannula
Scalpel
Trousseau dilator
Hemostat
Dressing forceps
Sterile vaseline
Scissors
Tape
Probe
Gauze sponges
Gauze squares
Probe-pointed curved bistoury.
1. Room should be abundantly ventilated, as free from dust and lint
as possible, an
2. Keep mouth clean. Tooth brush. Rinse alcohol 1:10.
3. Sponge away secretion after the cough before drawn in.
4. Remove inner cannula (not outer) as often as needed. Not less
often than every hour. Replace immediately. Never boil a cannula until
you have thoroughly cleaned it.
5. Obstruction of cannula calling for cleaning indicated by:
Blue or ashy color.
Indrawing at clavicles, sternal notch, epigastrium.
Noisy breathing. (Learn sound.)
6. Surgeon (in our cases) will change outer cannula once daily or
oftener.
7. Duplicate cannulae.
8. Be careful in cleaning cannulae not to damage.
9. Watch for loose parts on cannula.
10. Change dressing (in our cases) as often as soiled. Not less
often than every hour. Large squares. Never narrow strips.
11. Watch color of lips and ears and face.
[299] 12. Report at once if food or water leaks through wound.
(Coughing and choking).
13. Never leave a tracheotomized patient unwatched during the first
days or weeks, according to case.
14. Remember Trousseau dilator or hemostat will spread the tracheal
wound or fistula when cannula is out.
15. Remember life depends on a clear cannula if the patient gets no
air through the mouth.
16. Remember it takes very little to clog the small cannula of a
child.
17. Remember a tracheotomized patient cannot call for help.
18. Decannulation. Testing by corking partially. Watch corks
not too small, or broken. Attach them by braided silk
thread. Pure rubber cord ground down makes best cork.
More
-
Mitral Stenosis: Mitral Narrowing
This particular valvular defect occurs more frequently in women than in men, and between the ages of 10 and 30, and is generally the result of rheumatic endocarditis or chorea, perhaps 60 percent of mitral stenosis having this origin. Other causes a... Modifications Of Electricity
In the present stage of electric science, the conviction has become very general among experimenters that galvanism, magnetism, faradism, frictional electricity and the electricity of the storm-cloud are, in their essential nature, one and the same;... Moods
RELIEF from the mastery of an evil mood is like fresh air after having been several hours in a close room. If one should go to work deliberately to break up another's nervous system, and if one were perfectly free in methods of procedure, the bes... More Facts!
I have been treating several hundred cases of eruptive fevers during twenty-one years, and except the one mentioned above (111.) never lost a patient. I have known similar results, in the practice of other hydriatic physicians who employed a similar... Morning Sickness Of Pregnant Females
The most efficient and certain remedy for this symptom is _Macrotin_. It should be taken at the first attenuation, a dose before rising in the morning, and one every six hours during the day, as long as the sickness is troublesome. It will generally... Most Diseases Cure Themselves
If you ask any honest medical doctor how they cure diseases, they will tell you that most acute disease conditions and a smaller, though significant percentage (probably a majority) of chronic disease conditions are self-limiting and will, given tim... Mouth-gag
Wide gagging prevents proper exposure of the larynx by forcing the mandible down on the hyoid bone. The mouth should be gently opened and a bite block (Fig. 16) inserted between the teeth on the left side of the patient's mouth, to prevent closing o... Mumps
This is a contagious disease, consisting in an inflammation of the Parotid gland. There is, at first, a sense of stiffness and soreness on moving the jaw, soon after the gland begins to swell, and continues to be sore and painful, with more or less ... My Beginning
_Tis a gift to be simple Tis a gift to be free, Tis a gift to come down Where we ought to be. And when we find ourselves In a place just right, It will be in the valley Of love and delight._ Old Shaker Hymn Favorite of Dr. Isabelle Moser ... My Own 56 Day Long Fast
Fasters go through a lot of different emotional states, these can get intense and do change quite rapidly. The physical body, too, will manifest transitory conditions. Some can be quite uncomfortable. But, I don't want to leave the reader with the ... Myocardial Disturbances
While the myocardium is the most important muscle structure of the body, it has but recently been studied carefully or well understood clinically or pathologically. A heart was "hypertrophied" or "dilated" or perhaps "fatty." It suffered from "pai... Myocarditis Fibrous Management
The advice he should receive is well understood: to avoid physical efforts; to avoid mental tire; to avoid overeating or overdrinking of any foods or liquids; to reduce or abstain from alcohol, coffee, tea and tobacco, depending on what seems advisa... Myocarditis Fibrous Symptoms And Signs
The symptoms of chronic myocardial degeneration are progressive weakness, slight at first, noticeable on exertion (and what was not considered exertion becomes such), as evidenced by slight palpitation, slight shortness of breath, leg weariness and ... Natural Polarization Of Man's Physical Organism
The electro-vital fluid, in the animal economy, is subject to the same principles of polarization as the magnetic current from the artificial machine, or the magnetism of the bar-magnet. In the material organism of man, the great nerve-centers--the ... Nature's Teaching
NATURE is not only our one guide in the matter of physical training, she is the chief engineer who will keep us in order and control the machine, if we aim to fulfil her conditions and shun every personal interference with the wholesome work... Nauheim Baths
At Nauheim, under the direction of Dr. Theodore Schott, baths form an important part of the treatment. These baths are of two kinds, the saline and the carbonic acid. The medicinal constituents of the saline bath are sodium chlorid and calcium chlor... Necessity Of Allaying The Heat
The packs and baths should be continued, even when the patient cannot be prevailed upon to stay long enough in the packs to perspire. The heat of the skin and the general inflammatory condition of the whole organism _must_ be allayed, especially, wh... Necessity Of Ventilation Means Of Heating The Sick-room Relative Merits Of Open Fires Stoves And Furnaces
Next to its intrinsic value, our method gives the patient the great advantage of enjoying _pure fresh air_, either in or out of bed, as it keeps the skin and the whole system in such order as to resist the effects of atmospheric influences better th... Neoplasms
Decannulation in neoplastic cases depends upon the nature of the growth, and its curability. Cicatricial contraction following operative removal of malignant growths is best treated by intubational dilatation, provided recurrence has been ruled out.... Nephritis Inflammation Of Kidneys
1. Acute. If the urinary secretion be reddish and scant, with or without sedimentary deposit, let the inflammation be regarded as acute; and use upon it the B D current of good medium strength, or a little more, if the patient can bear it. The pain ... Nervous Fears
TO argue with nervous anxiety, either in ourselves or in others, is never helpful. Indeed it is never helpful to argue with "nerves" at all. Arguing with nervous excitement of any kind is like rubbing a sore. It only irritates it. It does no... Nervous Strain In Pain And Sickness
THERE is no way in which superfluous and dangerous tension is so rapidly increased as in the bearing of pain. The general impression seems to be that one should brace up to a pain; and very great strength of will is often shown in the effort... Nervous Strain In The Emotions
THE most intense suffering which follows a misuse of the nervous power comes from exaggerated, unnecessary, or sham emotions. We each have our own emotional microscope, and the strength of its lens increases in proportion to the supersensiti... Neuralgia
If the disease be general in the system, moving from place to place, or causing transient acute pains here and there, give general tonic treatment, three times a week, for several weeks--perhaps a month or two, provided the case be an old one. This ... Neuralgia
_Aconite_ and _Bell._ are two important remedies in this affection. If given low, and applied directly along the course of the affected nerves, at full strength of the tincture, they will almost always effect a cure. The proper way to use them is to... Neuralgia And Rheumatism Of The Heart
If neuralgia, use B D current; if rheumatism, use A D. In either case, treat the heart with P. P., moderate force, placing N. P. at lower dorsal or upper lumbar vertebrae. Treat five to eight minutes, daily, until relief is gained. Rheumatism of ... No Cutting Short Of The Process Of Scarlatina The Morbid Poison Must Be Drawn To The Skin As Soon As Possible
Scarlet-fever is a disease, which cannot be cut short. Any attempt to stop the process of incubation, after the contagion has once been received within the body, or to prevent its being thrown out upon the surface, would destroy the patient's life: ... Normal Blood Pressure For Adults
Woley [Footnote: Woley, II. P.: The Normal Variation of the Systolic Blood Pressure, THE JOURNAL A. M. A., July 9, 1910, p. 121.] after studying, the blood pressure in a thousand persons, found that the systolic average for males at all ages was 127... Nose Bleed - Epistaxis
If it arises from fullness of the vessels of the head, with throbbing of the temples, redness of the face and eyes, _Belladonna_ is the remedy. If fever is present, _Aconite_ must be alternated with _Bell._ In females or children who have habitual... Nostradamus
MICHEL DE NOTREDAME, or NOSTRADAMUS, a celebrated French physician and astrologer, of Jewish ancestry, was born at Saint-Remi, a small town in Provence, December 14, 1503. Both of his grandfathers were practitioners of medicine, and his father, Jacq... Notes On Nursing Tracheotomized Patients
Bedside tray should contain: Duplicate cannula Scalpel Trousseau dilator Hemostat Dressing forceps Sterile vaseline Scissors Tape Probe Gauze sponges Gauze squares Probe-pointed curved bistoury. 1. Room should b... Nstrumentarium
Direct laryngoscopy, bronchoscopy, esophagoscopy and gastroscopy are procedures in which the lower air and food passages are inspected and treated by the aid of electrically lighted tubes which serve as specula to manipulate obstructing tissues out ... Nursing Sore Mouth
Sore mouth of nursing women, as the name of the disease indicates, is peculiar to women who are suckling children. It is an inflammation of the mouth, tongue and fauces, which sometimes comes on during pregnancy, several months or but a few days bef... Nuts
How Nuts should be Used. Another form of fat is the meat of different nuts--walnuts, pecans, almonds, etc. These are quite rich in fats, and also contain a fair amount of proteins, and are, in small quantities, like other fats, appetizing and useful... Of Burns
The application of the lunar caustic in recent burns or scalds, has always appeared to me to increase the inflammation and vesication, even inducing blisters where there were none before. The caustic must not, therefore, be applied in these cases, u... Of Fungous Ulcer Of The Navel In Infants
It sometimes occurs that a little fungous sore exists upon the navel in infants which is difficult of cure in the ordinary way. I had one case which had subsisted for two years, and another, which had continued for two months, and were, during those... Of Inflammation Of The Knee
Servant women, I suspect from much kneeling in scouring stairs, &c. are subject to a species of inflammation of the knee which is frequently extremely troublesome. In one case suppuration of the integuments took place in the forepart of the knee,... Of Punctures Etc
In cases of recent punctured wounds the orifice and surrounding skin should be moistened with a drop of water; the caustic should then be applied within the puncture until a little pain be felt, and then over the surrounding skin, and the eschar mus... Of Whitlow
The lunar caustic is very useful in the treatment of this painful affection. Patients seldom apply to the surgeon before suppuration has taken place. It is then, I think, the best plan to open the abscess freely, to apply the caustic well within the... Old Ulcers
Take the A D current. If torpid, treat with mild force. Treat the sore with N. P., while P. P. is held upon some healthy part, and usually at a higher point. Treat five to ten minutes, three or four times a week. If high inflammation be present, thi... On The Adherent Eschar
It appears scarcely necessary to describe the immediate and well known effects of the application of the lunar caustic to the surface of a wound or ulcer. It may, however, be shortly observed that the contact of the caustic induces, at first, a whit... On The Treatment By Eschar And Poultice
In many cases in which it is impossible to adopt either the mode of treatment by the adherent or the unadherent eschar, it is of great utility to apply the caustic first and then a cold poultice made without lard or oil: this plan is particularly us... On The Unadherent Eschar
The eschar is generally adherent in cases of recent injuries, and in small ulcers, when they are nearly even with the skin and attended by little inflammation. In other cases the eschar is too apt to be unadherent, and this arises from the formation... On Ulcers
From the preceding observations it would naturally be concluded that the lunar caustic would afford a remedy for the treatment of ulcers. This conclusion is perfectly just. Yet there are many circumstances which render the mode of treating ulcers by... One's Self
TO be truly at peace with one's self means rest indeed. There is a quiet complacency, though, which passes for peace, and is like the remarkably clear red-and-white complexion which indicates disease. It will be noticed that the sufferers from thi... Onion Cases
All too many of my cases are what I privately refer to as onion cases. By this I mean the opposite of a simple case. There are multiple complaints. I call them onion cases because these people get better in layers, like pealing an onion. As each ski... Operating Room
All endoscopic procedures should be performed in a somewhat darkened operating room where all the desired materials are at hand. An endoscopic team consists of three persons: the operator, the assistant who holds the head, and the instrument assista... Opium
As so many times repeated, real pain must be stopped, and morphin, either by the mouth or hypodermically, should be used to the point of stopping such pain. If the patient is a young child, codein sulphate or the deodorized tincture of opium may be ... Other Bad Symptoms
These symptoms may present themselves with the rash standing out; but most frequently they occur when there is little or no eruption, or when it fades, becomes livid, or disappears altogether. A sudden disappearance of the rash, before the sixth day... Other Forms Of Rest
DO you hold yourself on the chair, or does the chair hold you? When you are subject to the laws of gravitation give up to them, and feel their strength. Do not resist these laws, as a thousand and one of us do when instead of yielding gently... Other Kinds Of Cancer
There seem to be many other kinds of cancer, at least if you believe the medical doctors. They divide up cancers and their treatments by their location in the body and by the type of cancer cells present. I do not see it that way. To me, a cancer is... Other Lesions
Tricuspid insufficiency, except as rarely found in the fetus, is generally due to a relative insufficiency rather than to an actual disease of the tricuspid valve. In other words, if the right ventricle dilates the valve may be insufficient. Tricusp... Other People_
HOWEVER disagreeable other people may be,--however unjust they may be, however true it may be that the wrong is all on their side and not at all on ours,--whatever we may suffer at their hands,--we can only remedy the difficulty by looking f... Other Sequels Dropsy &c
Beside the ulceration of glands and deafness, some of the sequels of scarlatina are white swelling of one or more of the joints, usually the knee, chronic inflammation of the eyes and eyelids, and partial paralysis. These chiefly occur in scrofulous... Others
HOW to live at peace with others is a problem which, if practically solved, would relieve the nervous system of a great weight, and give to living a lightness and ease that might for a time seem weirdly unnatural. It would certainly decrease the inc... Our Feet
The Living Arches of the Foot. One of the most important things to look after, if we wish to have an erect carriage and a swift, graceful gait, is the shape and vigor of the feet. Each foot consists of two springy, living arches of bone and sinew, w... Our Relations With Others
EVERY one will admit that our relations to others should be quiet and clear, in order to give us freedom for our work. Indeed, to make these relations quiet and happy is the special work that some of us have to do. There are laws for health,... Our Spirit-levels
The Sixth Sense. Though we usually speak of having five senses,--sight, smell, hearing, touch, and taste,--we really have also a sixth--the sense of direction, or of balance. The machine of this sense is comparatively simple, being made up of three ... Our Telephone Exchange And Its Cables
The Brain. We are exceedingly proud of our brain and inclined to regard it as the most important part of our body. So it is, in a sense; for it is the part which, through its connecting wires, called the nerves, ties together all the widely separate... Our Wonderful Coat
What the Skin Is. The skin is the most wonderful and one of the most important structures in the body. We are prone to think lightly of it because it lies on the surface, and to speak of it as a mere coating, or covering--a sort of body husk; but it...