. Operative surgery. 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the head of the tnl^e. Firmpressure with the thumb is then made on the lever, above the handle, whilethe tube is being withdrawn.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
. Operative surgery. 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the head of the tnl^e. Firmpressure with the thumb is then made on the lever, above the handle, whilethe tube is being withdrawn.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 Fig. 873.—The operation of intubation. Elevating epi-glottis and drawing tongue forward with finger, direct-ing tube into larynx. String in tube. The late Dr. ODwyer recommended that preliminary practice in theintroduction and removal of the tube, and touching of the j)arts, be had uponthe cadaver when j)ossible. The removal of the tube is more difficult than the introduction, on ac-count of the trouble ofinserting the blades ofthe extractor into theopen upper end of thetube while more or lesscompletely hidden fromview by the natural posi-tion of the surroundingsoft parts. This part ofthe ojDeration becomesespecially troublesomewhen the patient offersany opposition to theattempt, and it maybecome necessary underthese circumstances toadminister an anesthet-ic before the tube canbe safely removed. Theoccurrence of spasm during this time may be met by holding the finger inplace until the irritation subsides. The Precautions.—It is often wise in intubation to prepare for trache-otomy
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