The Use of the Breathing Tube.
The breathing tube is a soft rubber tube 5/16” in calibre and 7¼” in length. The end is smooth and beveled and has an opening, there being a second opening on the side, about a quarter of an inch distant. To introduce it, the tip of the nose is lifted and the rounded end of the catheter directed into the larger nostril perpendicularly to the face. The use of a little white vaseline obviates friction and unnecessary traumatism. The tube is pushed gently back into the pharynx behind the receded base of the tongue until the respiratory air streams freely through it. Very rarely, it is necessary to pull the tongue forward until the tube is in position. At times it is of advantage to support the angle of the jaw lightly, in order to get the full benefit of the tube breathing. Oxygen, it is true, improves the color when the tongue has receded and there is partial asphyxia, but no one will argue that it eliminates the cause of the obstruction, viz., that the base of the tongue has dropped back into the pharynx and occludes the way to the air passages.
Sometimes, when the recession of the tongue is slight, supporting the angle of the jaw helps, because the base of the tongue is carried forward with it. Frequently, this is insufficient. The tongue may be drawn forward by means of forceps or suture, but this method is crude and necessitates also the use of a wedge and mouth gag. The same accessories are imperative, when an attempt is made to introduce a breathing tube through the mouth into the pharynx. It is for these reasons that the nasal route is preferred. The method outlined is uncomplicated—its efficacy is often striking. It seems to be the simplest solution of the problem to re-establish the respiratory air channel, which has been occluded by the recession of the tongue.