. A Reference handbook of the medical sciences : embracing the entire range of scientific and practical medicine and allied science. tubing for purposes of insufflation, if it should be neces-sary. A small piece of oiled silk and an ordinary sewingneedle, armed with thread, will be needed to complete thefinal dressing. The Position of the Patient.—Everything beingready, the patient is to be placed in position for theoperation. The most important feature of this positionis that it shall be one in which the neck of the patient isstrongly extended. Upon this point the facility withwhich the after
. A Reference handbook of the medical sciences : embracing the entire range of scientific and practical medicine and allied science. tubing for purposes of insufflation, if it should be neces-sary. A small piece of oiled silk and an ordinary sewingneedle, armed with thread, will be needed to complete thefinal dressing. The Position of the Patient.—Everything beingready, the patient is to be placed in position for theoperation. The most important feature of this positionis that it shall be one in which the neck of the patient isstrongly extended. Upon this point the facility withwhich the after-steps of the operation may be done willgreatly depend. A firm cushion should be placed underthe shoulders—not under the neck—so as to lift them upand cause the head to fall back and thus extend the neckas the patient lies on the back (see Fig. 3975). The desired cushion will usually have to be extempo-rized from articles to be found in the sick-room. A smallpillow made into a firm roll; a bundle of clothing ; abottle with a towel wrapped around it; some books ; afloor-mat rolled up, or other like materials may serve for. Fig. 3975.—Patient in Position ready for Tracheotomy. the purposes of this cushion. The front of the chest aswell as the neck should be made bare, and the field ofoperation and the adjacent skin should be cleansed withsoap and water, if time permits. The Operation.—I shall first describe in detail themethod pursued by myself in opening the trachea belowthe isthmus in children suffering from diphtheritic croup,since these constitute the vast majority of the cases forwhich the operation is demanded, and since the low opera-tion is the one to be chosen, if possible, for reasons alreadygiven. Other operative methods will be described after-ward. Inferior Tracheotomy.—The patient being in positionand anaesthetized, and the instruments and sponges ar-ranged on a table or chair within easy reach of the oper-ator, he places himself on the right of the pati
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Keywords: ., bookcentury1800, bookdecade1880, booksubjectmedicine, bookyear188
