. Operative surgery. d passing under the end of the OPERATIONS ON THE NECK. 695 finger (Fig. 874) is tlien piislied downward in the median line, withoutusing force, and pressed into place by the finger and the tube detached (). The joint in the shank of the obturator is for the purpose of facili-tating this part of the operation. As soon as the obturator is removed, andit is ascertained that the tube is in the larynx, the thread is withdrawn, l)utat the same time the finger is kept in contact with tlie tul)e to prevent itsbeing also withdrawn (Fig. 876). It is important that the attempt
. Operative surgery. d passing under the end of the OPERATIONS ON THE NECK. 695 finger (Fig. 874) is tlien piislied downward in the median line, withoutusing force, and pressed into place by the finger and the tube detached (). The joint in the shank of the obturator is for the purpose of facili-tating this part of the operation. As soon as the obturator is removed, andit is ascertained that the tube is in the larynx, the thread is withdrawn, l)utat the same time the finger is kept in contact with tlie tul)e to prevent itsbeing also withdrawn (Fig. 876). It is important that the attempt at introduction l)c made f(uickly, asrespiration is practically suspended from the time that the finger enters thelarynx until the obturator is removed. It istherefore, under tlie circumstances, muchsafer to make several abortive attempts thanone prolonged effort, even if successful. For the purpose of removal, the patientis held in a similar position, except that thehead is not inclined backward, or very i-iiizlil-. B^iG. 872.—The operation of intubation. Method of introducing tlie tube. The respiratorytract of operator protected from infection by mouth shield^ and clothing by a gown. ly SO, and the extractor (Fig. 871, a) is passed cautiously and lightly intothe tube guided by the index finger of the left hand, which also fixes theepiglottis, and is brought in contact with the head of the tnl^e. Firmpressure with the thumb is then made on the lever, above the handle, whilethe tube is being withdrawn. If secondary dyspnoea supervenes at any time,the tube should be removed and a larger one substituted. 696 OPERATIVE SURGERY.
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Keywords: ., bookauthorbryantjosephdjosephde, bookcentury1900, bookdecade1900
