. Manual of operative surgery. e mediancephalic) and sterilize the skin over it with Tr. iodine or with alcohol. Punc-ture the vein with a cannula of fairly large caliber. Watson faciUtates theinsertion of the needle by transfixing the skin and the superficial segment ofthe vein with an ordinary seamstress needle, Fig. 1017. Collect the blood ina graduated glass jar which contains some two per cent. (2 per cent.) sodiumcitrate solution. If it is expected to use 450 of blood there should be HL(JUU TRANSFUSION 865 50 of the 2 per cent, citrate in the jar thus giving a per cent, sol
. Manual of operative surgery. e mediancephalic) and sterilize the skin over it with Tr. iodine or with alcohol. Punc-ture the vein with a cannula of fairly large caliber. Watson faciUtates theinsertion of the needle by transfixing the skin and the superficial segment ofthe vein with an ordinary seamstress needle, Fig. 1017. Collect the blood ina graduated glass jar which contains some two per cent. (2 per cent.) sodiumcitrate solution. If it is expected to use 450 of blood there should be HL(JUU TRANSFUSION 865 50 of the 2 per cent, citrate in the jar thus giving a per cent, solutionwhen the blood is added. Lewisohn advises the use of a few cubic centimetersof the citrate solution lest the resultant blood mixture should contain less thanthe minimum percentage of citrate. (2) Infusion of the Blood into Recipient.—As the recipient is usually exceed-ingly anemic, the vein must l)c exposed by incision in about 80 per cent, of thecases. Insert the cannrla into the vein. Attach to the cannula a salvarsan. Fig. 1017.—A, Cross-section of vein transfixed in its upper se<^ment to skin bv astraight intestinal needle. B, Introducing Kaliski cannula into the cephalic vein of thedonor. The vein is steadied and prevented from rolling from under the cannula by meansof slight traction exerted upon the transfixing needle. C, Cannula introduced in vein ofrecipient. {Pemberton in Surgery, Gynecolog} and Obstetrics.) apparatus which contains 20 or 30 of normal salt solution. Pour the citratedblood into this apparatus and let it flow into the vein exactly like an ordinarysaline infusion. Rarely more than 1000 of blood requires to be used andthus only contains two grams of sodium citrate, a perfectly safe dose. Infective Phlebitis.—For many years it has been customary to ligate theinternal jugular vein to prevent dissemination of infection in cases of sigmoidsinus thrombosis. The same treatment is applicable in acute thrombophlebitis 866 OPERATIONS ON VEI
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