Removal of foreign bodies from the air passages / by De Forest Willard.

  • Willard, De Forest, 1846-1910.
Date:
1901
Catalogue details

Licence: In copyright

Credit: Removal of foreign bodies from the air passages / by De Forest Willard. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    the chest wall, but only to warn him against rash work without proper apparatus, since failure will necessar- ily bring discredit upon the surgeon and disaster to the individual. A somewhat extended but still incomplete examination of the literature on the subject fails to re- veal a recovery after opening of the bronchus. My ob- ject is only to urge that unless an artificial respiration apparatus is at hand, and oxygen obtainable, it will be wiser to cease one’s operative methods, after short man- ipulations through a large tracheal opening. With full appliances, however, and a full knowledge of the dan- gers, one may calmly proceed to enter the chest by a selected route. The conditions are entirely different from those encountered in a diseased lung or pleura, and preliminary injection of air or liquid will avail but little. A small dose of atropia will be helpful. The oft-tried exjiedient of plugging the hole in the ]3leura, or of dragging the lung into the opening, or grasping the base of the lung, is here of no avail, since the search for the bronchus is absolutely prevented by any of these procedures. Air hunger being then the most serious of the complications, some reliable means of artificial respiration must be at hand, or the patient must die in a few moments. Fortunately, the Fell- 0’Dwyer3 apparatus gives us the much-needed help. The apparatus consists of intubation tubes of various sizes attached to a handle, by means of which one of them of proper size can be held permanently within the chink of the glottis, while air is pumped directly into the lungs by bellows,worked by hand or foot pressure. Insufflation is accomplished by moderate pressure about fifteen times in the minute, while expiration is accom- plished by the resiliency of the chest walls. Matas has improved upon this apparatus by using a double pneumatic pump, by means of which the exact a. Northrop: N. Y. Pros. Hasp. Reports, 1896, p. 132.