. Diseases of infancy and childhood . b and lingers o\ the right band, the thumb restingou tlu^ uppiM- surfaci^ o\ i\\c liandle, jusi behind the kiu^b that serves to(h^iacb Mi(> {[\\)(\ and lh(^ indc^x linger in front of the trigger support under-iu>alh. Held in this manner i( is impossible to use force eiunigh to make 550 THE INFECTIOUS DISEASES. a false passage, while if firmly grasped in the hand the beginner may, nncon-sciously, exert sufficient force to lacerate the tissues. The index finger of the left hand is carried well down in the pharynxor beginning of oesophagus and then brou
. Diseases of infancy and childhood . b and lingers o\ the right band, the thumb restingou tlu^ uppiM- surfaci^ o\ i\\c liandle, jusi behind the kiu^b that serves to(h^iacb Mi(> {[\\)(\ and lh(^ indc^x linger in front of the trigger support under-iu>alh. Held in this manner i( is impossible to use force eiunigh to make 550 THE INFECTIOUS DISEASES. a false passage, while if firmly grasped in the hand the beginner may, nncon-sciously, exert sufficient force to lacerate the tissues. The index finger of the left hand is carried well down in the pharynxor beginning of oesophagus and then brought forward in the median line,raising and fixing the epiglottis, while the tube is guided along beside it intothe larynx. If any difficulty is experienced in locating the epiglottis, it isbetter to search for the cavity of the larynx, a cul-de-sac into which the tipof the finger readily enters, and which cannot be mistaken for anything in this cavity, the epiglottis must be in front of the finger and the latter VOCAL CORDS. Fig. 179.—Tube, resting on vocal cords, in the larynx. (Original.) is then raised and pressed toward the patients right to leave room for thetube to pass beside it. The distal extremity of the tube should be kept incontact with the finger, and even directing it a little obliquely toward theright side of the larynx if necessary to get inside the left aryepiglottic fold,especially in very young children. The handle of the introducer is heldclose to the patients chest in the beginning of the operation, and rapidlyraised as soon as the end of the tube has passed behind the epiglottis; other-wise it will slip over the larynx into the oesophagus. Some operators hold the introducing instrument in the horizontalposition until the tube is well back in the fauces, and then swing it aroundto the middle line and complete the operation in the usual manner. Thebeginner is liable to forget the latter movement, which is the only objectionto this plan. PLATE XXY
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Keywords: ., bookcentury1900, bookdecade1910, bookpublish, booksubjectchildren
