A practical guide to the administration of anaesthetics / by R.J. Probyn-Williams.

  • Probyn-Williams, R. J.
Date:
1901
Catalogue details

Licence: Public Domain Mark

Credit: A practical guide to the administration of anaesthetics / by R.J. Probyn-Williams. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

    30/228 (page 18)
    sufficiently deep for the operation to be performed. To do this he must observe the following : 1. Respiration. 5. The presence of the corneal 2. Pulse. reflex. 3. Colour of the face. 6. Muscular movements. 4. Size of the pupil. 1. Respiration. The character of the breathing is one of the most important guides in maintaining the condition of anaesthesia. When the patient has once passed into the third stage of anaesthesia, the breathing becomes deep and regular, and the anaesthetist must endeavour to keep up this rhythm without any inter- mission. He must listen carefully when the first incision is made, and if the breath is not held, he will know that the patient is sufficiently under the influence of the drug; but if it is held, more of the anaesthetic will probably be required, and some stimulation of the respiration, by rubbing the lips with a towel, may be necessary to re-start the rhythm which has been interrupted. For this purpose the inhalation of a few breaths of strong ammonia has been recommended. The more perfect a watch the administrator keeps on the respiration, the sooner will he learn to detect, by changes in it so slight that they might escape an ordinary observer, that all is not going well, and valuable time may sometimes be saved and accidents prevented. The breathing with ether is so loud that there is no difficulty in hearing it, but with chloroform it sometimes becomes inaudible, and then it must be felt by a finger or two held close to the mouth of the patient. In order to make this quiet breathing of chloroform anaesthesia audible, some administrators allow the jaw to slip back till there is just sufficient sound made by the soft parts to allow of each res- piration being heard. Care, of course, must be taken that the jaw is not allowed to slip too far back.