Preparatory and after treatment in operative cases . nstructed on the principle of the chemists wash bottle, by meansof which oxygen can be made to pass through a tube into the air valve,thence with the anesthetic into the lungs, can be attached. Thisdevice, along with that for mingling oxygenwith the inspired air, makes a complete outfitfor the purpose. Next to the bellows is the airvalve (b) with which it is arranged to act. Theoperator presses down the piston of the valvea full stroke during three movements of thebellows, thus causing inspiration by permittingthe air saturated with the anes
Preparatory and after treatment in operative cases . nstructed on the principle of the chemists wash bottle, by meansof which oxygen can be made to pass through a tube into the air valve,thence with the anesthetic into the lungs, can be attached. Thisdevice, along with that for mingling oxygenwith the inspired air, makes a complete outfitfor the purpose. Next to the bellows is the airvalve (b) with which it is arranged to act. Theoperator presses down the piston of the valvea full stroke during three movements of thebellows, thus causing inspiration by permittingthe air saturated with the anesthetic to enterthe lungs through any one of the selectedchannels, , the face mask (c), the intuba-tion cone (Fig. 275), or the tracheotomy tube(Fig. 277). The piston is then released untilthree movements of the bellows are made,which permits expiration to occur. Before theoperation is begun the mask should be snugly fitted to the face to prevent any uncertainty in this respect. If,during inspiration, it does not fit so that the cheeks may bulge. Fig. 277.— The Tra-cheotomy Tube andRings Used inForced Artificial,Respiration, FellsMethod. (Bryant.) 412 OPERATIONS ON THE THORAX without air escaping by the side of the mask, its action cannot beattained. Frequently a pad or folded handkerchief placed over thebridge of the nose will secure a tight fit. If an intubation tube beemployed, a rubber tube from the air valve can be connected with theformer and good inflation can be secured, provided that the end ofthe tube is of proper size to fit the trachea. My best results in long-continued respiration have been secured by means of tracheotomy andthe occluding of the trachea with a suitably sized ring screwed to theend of the tracheotomy tube (Fig. 277). But for operative work onthe thorax, the other methods appear to be better suited. The sizeof the bellows and the manner of its operation should be suited to therequirements of individual cases, i. e., one movement for inspirationa
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