Peroral endoscopy and laryngeal surgery . a is to be found very reailily by the tip ofthe index finger which detects the ridges of the tracheal rings feelinglike a wash board. The left index is moved over a little bil t(i the pa-tients left side in order that the knife shall come precisely in the middleof the trachea, and the trachea is steadied by the left index so that theincision can be made (jtute accurately in the middle line, notwithstanding G04 TRACHEOTOMY. it lies buried at the bottom of a pool of blood. The head of the tableshould he lowered, just as soon as the incision in the trache
Peroral endoscopy and laryngeal surgery . a is to be found very reailily by the tip ofthe index finger which detects the ridges of the tracheal rings feelinglike a wash board. The left index is moved over a little bil t(i the pa-tients left side in order that the knife shall come precisely in the middleof the trachea, and the trachea is steadied by the left index so that theincision can be made (jtute accurately in the middle line, notwithstanding G04 TRACHEOTOMY. it lies buried at the bottom of a pool of blood. The head of the tableshould he lowered, just as soon as the incision in the trachea is com-pleted and a hemostat or the Trousseau dilator, if it be at hand, is usedto spread the lips of the tracheal wound, then the patient is turned overon the side, provided the patient is breathing freely, in order that theblood may run away from the wound and less of it may be cases, however, where respiration has ceased, it is necessary to keepthe patient on the back so that efficient artificial respiration may be kept. Fig. 448.—Illustrating the authors method of quick tracheotomy. Secondstage. The fingers are drawn ungloved for the <;ake of clearness. In operating;the whole wound is full of blood, and the rings of the trachea are felt with the leftindex which is then moved slightly to the operators left, while the knife is sliddown along the left index to exactlv the middle line when the trachea is incised. up. In doing a tracheotomy after respiration has ceased, it must be re-membered there will be no hissing in or out of air. Strange as it mayseem, many an operator has been misled into thinking he has not openedthe trachea by the absence of this sound which is so reliable if the pa-tient is breathing. During artificial respiration, the air should hiss inand out and this is the test of the efficiency of the artificial respiratory TRACIIlOTOMY. 605 movements. Of course, if ilic wduml is [iroperly spread with the Trousseauforceps or a hemostat or the ca
Size: 1471px × 1699px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1910, booksubjectrespira, bookyear1915
