The essentials of bandaging: $b including the management of fractures and dislocations, with directions for using other surgical apparatusHill, Berkeley
Science
The essentials of bandaging: $b including the management of fractures and dislocations, with directions for using other surgical apparatus
Hill, Berkeley
Bandages and bandaging; Dislocations -- Treatment; Fractures -- Treatment; Surgery, Minor
_Bulbous-ended or probe-ended Catheters and Bougies_ (_Bougies à
boule_) are always straight; their suppleness, their tapering
ends, and their smooth rounded point enable them to glide along the
urethra, and to accommodate themselves readily to the windings of the
passage; for which reason they are the easiest to pass both for the
patient and the surgeon. In passing them they are slightly warmed, if
the weather is cold, to restore their flexibility, and gently pushed
along the canal till the bladder is reached.
_Vulcanised India-Rubber Catheters_ (fig. 87) are used when the
bladder is to be kept empty; their suppleness renders them very
unirritating, and as phosphates crust on them very slowly, they may
be worn for a week without being changed.
They are easily passed by threading them on a stylet with the
appropriate curve, and lubricating them with white of egg or water,
not with grease, which injures them. The stylet is withdrawn after
they are passed.
=To pass a Catheter in the Female.=—The patient may lie on one
side or on her back; if on her side the knees should be well drawn
up; if on her back, the thighs must be somewhat separated. Before
introducing the catheter, a wine bottle or narrow-necked bed urinal
should be placed in the bed ready to receive the urine. If the
ordinary slightly curved female catheter be not at hand, a No. 7 or 8
flexible one does just as well.
Having oiled the instrument, go to the patient’s back, and take the
catheter in the right hand if the patient lies on her right side, and
in the left hand if she lies on her left side; if she lies on her
back, go to either side and take the catheter in the hand nearest her
feet. Hold the stem of the catheter in the palm, so that the beak
lies against the tip of the forefinger, while the thumb and second
and third fingers grasp the stem. Then passing the hand under the
bed-clothes, seek the buttock; from that pass the forefinger to the
perinæum, and let it enter the vulva, keeping the back of the finger
against the posterior part, then pass it between the nymphæ to the
entry of the vagina. This is known by the tip of the forefinger being
lightly grasped, unless the vagina is very wide. Keeping the finger
just within the entry, feel for the arch of the pubes in front;
having found this, withdraw the tip of the finger slightly from the
vagina: in doing this, it will strike a small projection of mucous
membrane hanging just at the anterior margin of the entry. Keep the
finger steady against this, while the other hand pushes the catheter
gently onwards, which then rarely fails to enter the urethral opening
close above the projection of mucous membrane. Having penetrated the
urethra, arrange the catheter in the receptacle for the urine, and
push the instrument into the bladder.
=To Wash out the Bladder.=
_Apparatus._—1. A flexible catheter; Nos. 8 or 9 are convenient
sizes; but a smaller one can be employed.
Public-domain text, read in full here on John Shaqi.
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