Practical Points in AnesthesiaNeef, Frederick-Emil
Science
Practical Points in Anesthesia
Neef, Frederick-Emil
Anesthetics
The breathing tube is a soft rubber tube 5/16” in calibre and 7¼” in
length. The end is smooth and beveled and has an opening, there being a
second opening on the side, about a quarter of an inch distant. To
introduce it, the tip of the nose is lifted and the rounded end of the
catheter directed into the larger nostril perpendicularly to the face.
The use of a little white vaseline obviates friction and unnecessary
traumatism. The tube is pushed gently back into the pharynx behind the
receded base of the tongue until the respiratory air streams freely
through it. Very rarely, it is necessary to pull the tongue forward
until the tube is in position. At times it is of advantage to support
the angle of the jaw lightly, in order to get the full benefit of the
tube breathing. Oxygen, it is true, improves the color when the tongue
has receded and there is partial asphyxia, but no one will argue that it
_eliminates the cause of the obstruction_, viz., that the base of the
tongue has dropped back into the pharynx and occludes the way to the air
passages.
Sometimes, when the recession of the tongue is slight, supporting the
angle of the jaw helps, because the base of the tongue is carried
forward with it. Frequently, this is insufficient. The tongue may be
drawn forward by means of forceps or suture, but this method is crude
and necessitates also the use of a wedge and mouth gag. The same
accessories are imperative, when an attempt is made to introduce a
breathing tube _through the mouth_ into the pharynx. It is for these
reasons that the nasal route is preferred. The method outlined is
uncomplicated—its efficacy is often striking. It seems to be the
simplest solution of the problem to re-establish the respiratory air
channel, which has been occluded by the recession of the tongue.
INDICATIONS FOR STIMULATION DURING
NARCOSIS.
[Sidenote: Volume of the Pulse]
[Sidenote: Camphor-Ether]
[Sidenote: Strychnine]
[Sidenote: Venous Infusion]
Public-domain text, read in full here on John Shaqi.
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