A manual of diseases of the nose and throat / by Cornelius Godfrey Coakley.

Date:
1906
Catalogue details

Licence: In copyright

Credit: A manual of diseases of the nose and throat / by Cornelius Godfrey Coakley. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    the right hand should now be held so that its handle is parallel with the child’s chest and the intubation tube opposite the entrance to the mouth. The tube should now be passed into the mouth parallel with the tongue and kept absolutely in the median line. When the distal end of the tube reaches the back part of the tongue the handle of the intubator is to be elevated through an arc of a circle, care being taken that while this is being done the handle is kept continuously in the median line. The elevation of the handle depresses the end of the tube, which should now be in contact with the palmar surface of the forefinger. Continued elevation of the handle will cause the tube to descend along this surface of the forefinger, the tip of which, being at the posterior ])ortion of the entrance to the larynx, the tube is guided thereby into the cavity of the larynx. One of the greatest difficulties that begin- ners experience in performing this operation is that of allowing the right hand, holding the intubator, to devi- ate from the median line of the child’s body. If such deviation takes place, the tube almost invariably passes down the pyriform fossa, alongside of instead of in front of the forefinger of the left hand, and passes into the esophagus. No force whatever should be employed, for none is needed, to insert the tube into the larynx in a case of diphtheria. When the head of the tube has come down to the level of the tip of the forefinger the latter should be moved forward so as to rest upon the head of the tube and push it well down into the cavity of the larynx. The button, C, on the intubator (Fig. 86) should be pressed forward with the thumb of the right hand, thereby releasing the obturator from the tube, and the intubator, with the attached obtura- 23