Surgical emergencies, together with the emergencies attendant on parturition and the treatment of poisoning : a manual for the use of general practitioners / by Paul Swain.

  • Swain, William Paul, 1834-1916.
Date:
1896
Catalogue details

Licence: Public Domain Mark

Credit: Surgical emergencies, together with the emergencies attendant on parturition and the treatment of poisoning : a manual for the use of general practitioners / by Paul Swain. Source: Wellcome Collection.

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    If the trachea is entirely divided, the divided edges may be kept together by some catgut sutures. If there is considerable venous haemorrhage, a silver tube should be inserted through the wound in the trachea, and the sur- rounding parts plugged with iodoform gauze. Place the patient in bed, with the shoulders well raised, and the head thrown forward on the chest, and secured there by tapes passing from a nightcap to a roller round the chest. The temperature of the room should be raised to 80° if possible, or at any rate the bed should be placed near the fire and surrounded with a screen. Steam should then be conveyed for the patient to breathe by a piece of india- rubber tubing, placed on the spout of a kettle boiling on the fire. If the pharynx or oesophagus is wounded, the patient must be fed artificially. The best way to accom- plish this is by passing a soft rubber catheter through the nostril well down the oesophagus. This catheter must be attached to a bit of rubber tubing about four feet long, with a flap funnel at the end. By this means beef tea and brandy or milk and brandy may be easily adminis- tered. If the passage of the catheter through the nostril causes distress, it may be much diminished by painting the parts with a 10 per cent, solution of cocaine. It is better to resort early to this feeding, as the patient is generally much depressed by shock and loss of blood. In great collapse from loss of blood intra-venous injection of saline solution should be had recourse to (see Chap. XII). In stabs and punctured wounds of the throat the general treatment is the same as for cut throat. If the trachea is wounded, emphysema may ensue. A pad of dry lint, firmly applied, will suffice. When any large vessel is wounded, the wound must be enlarged if needful, and the bleeding vessel secured. If this cannot be done, the common carotid must be ligatured, generally below the omo hyoid. For this operation the following instru- ments are required:—1, Scalpel; 2, dissecting forceps; 3, blunt hooks and retractors ; 4, grooved director; 5, aneurism needle; 6, ligatures.