Resume Of Emergency Tracheotomy
Categories: TRACHEOTOMYSources: A Manual Of Peroral Endoscopy And Laryngeal Surgery
The following notes should be memorized.
1. Essentials: Knife and pair of hands (but full equipment better).
[295] 2. Don't do a laryngotomy, or stabbing.
3. Two stage, finger guided operation better.
4. Sand bag or substitute.
5. Press back danger lines with left thumb and middle finger, making
safety line and trachea prominent.
6. Memorize Jackson's tracheotomic triangle.
7. In
8. Feel for tracheal corrugations with left index in pool of blood,
following trachea with finger downward from superficial Adam's apple.
9. Pass knife along index and incise trachea (not too deeply, may
cut posterior wall).
10. Don't mind bleeding; but keep middle line and keep head
straight; keep head low; don't bother about thyroid gland.
11. Don't expect hiss when trachea is cut if patient has stopped
breathing.
12. Start artificial respiration.
13. Amyl nitrite. Oxygen.
14. Practice palpation of the neck until the tracheal landmarks are
familiar.
15. Practice above technic, up to point of incision, at every
opportunity.
16. Jackson's tracheotomic triangle: A triangulation of the front
of the neck intended to facilitate a proper emergency tracheotomy.
Apex at suprasternal notch.
Sides anterior edge sternomastoids.
Base horizontal line lower edge cricoid.
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Punctures Case Xi
Mrs. G. was bitten by a little dog on forefinger about a fortnight ago. There is now a very irritable, inflamed, fungous sore. I removed the fungous by a pair of scissors and applied the lunar caustic to form an eschar. On the succeeding day, I f... Punctures Case Xii
A servant maid was bitten by a dog in four places--severely on the forearm--three days ago. Adhesive plaster had been applied. There is a wound across the arm two inches in length and three-fourths of an inch in breadth, attended by dull pain, and s... Punctures Case Xiii
Am old man applied leeches to the instep for inflammation occasioned by a bruise. Several very irritable sores were produced with some swelling. I applied the lunar caustic to form an eschar. On the following day, the eschars were adherent, the sw... Putrid Symptoms
Next to those most dangerous forms--most dangerous, because the organic power (the _vis medicatrix naturae_), from which the restoration of health must be expected, and without which no physician can remove the slightest symptom of disease, becomes ... Putrid Symptoms Gargle Solution Of Chloride Of Soda Drink: Chlorate Of Potass Liquor Calcii-chloridi
Should _putrid symptoms_ make their appearance (21), I would strongly advise the acid in full and repeated doses, as well as the frequent repetition of the packs. In putrid cases, not only the syrup, but also the gargle will do good service. Garglin... Quacks And Quackery
Quackery and the love of being quacked, are in human nature as weeds are in our fields. DR. J. BROWN, Spare Hours. They are Quack-salvers, Fellowes that live by senting oyles and drugs. ... Quacks And Quackery Continued
An English physician, who practised during the early part of the reign of King James I, described the charlatan of that period as shameless, a mortal hater of all good men, an adept in cozening, legerdemain, conycatching, and all other shifts and ... Quiet Vs Chronic Excitement
SOME women live in a chronic state of excitement all the time and they do not find it out until they get ill. Even then they do not always find it out, and then they get more ill. It is really much the same with excitable women as with a m... Radiotherapy
Radium and the therapeutic roentgenray are today our only effective means of retarding the progress of esophageal malignant neoplasms. No permanent cures have been reported, but marked temporary improvement in the swallowing function and prolongatio... Rapid Relief From Colon Cleansing
During fasting the liver is hard at work processing toxins released from fat and other body deposits. The liver still dumps its wastes into the intestines through the bile duct. While eating normally, bile, which contains highly toxic substances, is... Raw Food Healing Diets
Next in declining order of healing effectiveness is what I call a raw food healing diet or cleansing diet. It consists of those very same watery fruits and nonstarchy vegetables one juices or makes into vegetable broths, but eaten whole and raw. Hea... Rebellion!
_This is preaching rebellion!_ I know it is, and it is with great reluctance that I preach it, as I am by no means in favor of taking medical matters out of the hands where they belong, to place them into the hands of such as have had no medical ... Recent Wounds Contusions And Burns
Use the B D current, strong force as can be borne. Bring the lesion under P. P., and place N. P. at discretion, in view of the location of the injury. Treat five to eight minutes, twice or thrice on the same day. Unless the injury is very severe, no... 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 efflorescence the symptoms decrease, and he will be easier. Under the treatment prescribed, the time when the excitement is highest, is much abridged, and usually the treatment can be relax... Relaxed And Atrophied Conditions
I alluded, above, to a distinction between a relaxed and an atrophied condition of an organ. There is such a distinction, which should be carefully observed while treating parts so affected. An atrophied muscle or organ becomes soft and flabby from ... Remedial Virtues Ascribed To Relics
A relic has been defined as an object held in reverence or affection, because connected with some sacred or beloved person deceased. And specifically, in the Roman Catholic and Greek churches, a saint's body or portions of it, or an object suppose... Removal Of Double Pointed Tacks
If the tack or staple be small, and lodged in a relatively large trachea a version may be done. That is, the staple may be turned over with the hook or rotation forceps and brought out with the points trailing. With a long staple in a child's trach... Removal Of Foreign Bodies From The Larynx
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 pre... Removal Of Growth From The Laryngeal Ventricle
After exposing the larynx in the usual manner, if the head is turned strongly to the right, the tip of the laryngoscope, directed from the right side of the mouth, may be used to lift the left ventricular hand and thus expose the ventricle, from wh... Removal Of Open Safety Pins From The Trachea And Bronchi
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 ... Renal Calculi Gravel In The Kidneys
Take the A C current, of considerable force. Place N. P. low upon the bladder, and treat with P. P. upon the inflamed and painful point five to eight minutes, once or twice a day. If treating twice a day, continue not more than five minutes at a tim... Resistance
A MAN once grasped a very hot poker with his hand, and although he cried out with pain, held on to the poker. His friend called out to him to drop it, whereupon the man indignantly cried out the more. "Drop it? How can you expect me to th... Rest In Sleep
HOW do we misuse our nervous force? First, let us consider, When should the body be completely at rest? The longest and most perfect rest should be during sleep at night. In sleep we can accomplish nothing in the way of voluntary activity ei... Resume Of After-care Of A Tracheotomic Case
1. Always bear in mind that tracheotomy is not an ultimate object. The ultimate object is to pipe air down into the lungs. Tracheotomy is only a means to that end. 2. Sterile tray beside bed should contain duplicate (exact) tracheotomy tube, Tr... Resume Of Emergency Tracheotomy
The following notes should be memorized. 1. Essentials: Knife and pair of hands (but full equipment better). [295] 2. Don't do a laryngotomy, or stabbing. 3. Two stage, finger guided operation better. 4. Sand bag or substitute. 5. Press ... Resume Of Tracheotomy
Instruments. Headlight Sandbag Scalpel Hemostats Small retractors Tenaculum Tracheotomic cannulae (proper kind) Long. Half area cross-section trachea. Proper curve: Radius too short will press ant. tracheal wall; too... Retrograde Esophagoscopy
The first step is to get rid of the gastric secretions. There is always fluid in the stomach, and this keeps pouring out of the tube in a steady stream. Fold after fold is emptied of fluid. Once the stomach is empty, the search begins for the cardi... Rheumatism Acute Inflammatory
First ascertain if the kidneys be morbidly positive--urine scant and too highly colored. If so, as is commonly the case, begin with the B D current, good medium force. Place N. P. at the pelvis, and treat over the kidneys with P. P. some three or fo... Rheumatism Chronic
Use the A D current always in rheumatic affections. If there be no visible inflammation or swelling in the diseased parts, approach such parts in the same manner as in acute inflammatory rheumatism, except with reversed poles. The parts affected req... Rhus Tox
applied, with water at the strength of thirty drops of the _tr._ to a gill, to parts affected with _Rheumatism_, acts very beneficially. It is also a most valuable application at half the above strength upon parts affected with Erysipelas, when the ... Roentgenray Study In Foreign Body Cases
Roentgenography.--All cases of chest disease should have the benefit of a roentgenologic study to exclude bronchial foreign body as an etiological factor. Negative opinions should never be based upon any plates except the best that the wonderful mod... Rotation Forceps
It is sometimes desired to make traction on an irregularly shaped foreign body, and yet to allow the object to turn into the line of least resistance while traction is being made. This can be accomplished by the use of the rotation forceps (Fig. 20)... Rubbing Sheet Substitute For The Half-bath
It cannot be difficult to procure a wash-tub. Should you be so situated, however, as not to be able to procure even this, you will be compelled to make shift with a _rubbing sheet_. For that purpose, a sheet and a pail of water are all you need. The... Rules For Direct Laryngoscopy
1. The laryngoscope must always be held in the left hand, never in the right. 2. The operator's right index finger (never the left) should be used to retract the patient's upper lip so that there is no danger of pinching the lip between the instr... Rules For Endoscopic Foreign Body Extraction
1. Never endoscope a foreign body case unprepared, with the idea of taking a preliminary look. 2. Approach carefully the suspected location of a foreign body, so as not to override any portion of it. [175] 3. Avoid grasping a foreign body has... Rules For Insertion Of The Catheter For Insufflation Anesthesia
1. The patient should be fully under the anesthetic by the open method so as to get full relaxation of the muscles of the neck. 2. The patient's head must be in full extension with the vertex firmly pushed down toward the feet of the patient, so... Rules For The Application Of Water In Typhoid Cases
As a general rule, in typhoid cases, bathing should form one of the principal features of the treatment; i. e. the patient should have more baths than packs in proportion to the treatment of other cases. The temperature of the baths should be in... Running The Human Automobile
The Body-Automobile. If you were to start to-morrow morning on a long-distance ride in an automobile, the first thing that you would do would be to find out just how that automobile was built; how often it must have fresh gasoline; how its differe... Rupture And Trauma Of The Esophagus
These may be spontaneous or may ensue from the passage of an instrument, or foreign body, or of both combined, as exemplified in the blind attempts to remove a foreign body or to push it downwards. Digestion of the esophagus and perforation may resu... Safety-pin Closer
There are a number of methods for the endoscopic removal of open safety-pins when the point is up, one of which is by closing the pin with the instrument shown in Fig. 37 in the following manner. The oval ring is passed through the endoscope until i... Scald Head
of children, where there is a discharge of yellow and watery pus from the sores, and the eruption extends to the ears or face, like the disease called the _crusta lactea_ (milk crust), the same washes as for itch, are the most effectual, while at th... Scarlatina Anginosa Or Sore-throat Scarlet-fever
Wherever the _throat_ is affected, which is almost always the case, the disease is called _scarlatina anginosa_, or _sore-throat scarlet-fever_. This is the form described at the commencement of this article. There are several varieties, however, of... Scarlatina Miliaris
Sometimes the red patches of the rash are covered with small vesicles of the size of mustard-seed, which either dry up or discharge a watery liquid, leaving thin white scurfs, that come away with the cuticle during desquamation. Although this form, ... Scarlatina Simplex Or Simple Scarlet-fever
In the _mildest form_ of the disease, called _scarlatina simplex_, or _simple scarlet-fever_, there is no inflammation of the throat, the fever is moderate, and the patient suffers very little. Unfortunately this form is so rare, that many experienc... Scarlatina Sine Exanthemate
There are also mild cases of scarlet-fever, when little or no rash appears, and the throat is very little affected. These are the result of a particularly mild character of the epidemy, together with a peculiar condition of the skin, the desquamatio... Scarlet Fever
This fever assumes two principal forms: Simple or mild, and Malignant. In the _Simple form_, there is great heat of the surface, extremely quick and frequent pulse, headache, and some sense of pain and soreness in the throat. After a day or two, the... Scarlet-fever Or Scarlatina
is an eruptive fever, produced by a peculiar contagious poison, and distinguished by extreme heat, a rapid pulse, a severe affection of the mucous membranes, especially those of the mouth and throat, and by a burning scarlet eruption on the skin. ... Sciatica
This is neuralgia in an ischiatic nerve, commonly the great ischiatic. Use the B D current, strong as the patient can well bear. Place the foot in warm water with N. P., or place the sponge-roll N. P. at the sole of the foot, (the former is the be...