Preparatory and after treatment in operative cases . Fig. 258.—Liters Double Tracheal, Can-nula, (von Bergmann.) OPERATIONS ON THE LARYNX AND TRACHEA 381 When evidence of obstruction occurs the inner cannula is im-mediately removed and cleansed by means of wet sterile gauze,pushed through it with a bent probe. If the dyspnea is not re-lieved by this means, the outer tube must be removed, cleansed,and reinserted. The latter measure is rarely necessary. How-. Fig. 259.—Tracheotomy Tube in Place, and Position of Patientafter Tracheotomy, (von Bergmann.) ever, it does at times occur that dried sec
Preparatory and after treatment in operative cases . Fig. 258.—Liters Double Tracheal, Can-nula, (von Bergmann.) OPERATIONS ON THE LARYNX AND TRACHEA 381 When evidence of obstruction occurs the inner cannula is im-mediately removed and cleansed by means of wet sterile gauze,pushed through it with a bent probe. If the dyspnea is not re-lieved by this means, the outer tube must be removed, cleansed,and reinserted. The latter measure is rarely necessary. How-. Fig. 259.—Tracheotomy Tube in Place, and Position of Patientafter Tracheotomy, (von Bergmann.) ever, it does at times occur that dried secretions accumulate overthe end of the outer tube, and these must be removed to free thecannula. One of the causes of unfavorable outcome following trache-otomy is due to the absence of the normal amount of moisturecontributed to the inspired air in its passage over the mucosa ofnose, mouth, and pharynx. Moist air is an important means ofpreventing the drying of secretions in the cannula. For the pur-pose, the bed is covered with a hood and the bedclothes coveredwith waterproof material. A croup kettle is located near thebed with the nozzle led beneath the hood. Various medicinalagents have been added to the water, which become vaporizedwhen the mixture boils and are supposed to contribute to thebeneficial effect of the moist air. It is probable that the latteris the important consideration, though there is no objection to 382 OPERATIONS ON THE NEC
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