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The essentials of bandaging / cover

The essentials of bandaging /

Chapter 39: TRACHEOTOMY.
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About This Book

This practical manual provides concise, illustrated instructions for applying bandages and surgical apparatus, with chapters on materials, operator technique, bandaging of specific body regions, strapping methods, and management of fractures and dislocations of head, trunk, and limbs. It describes common turns and splints, approaches to immobilisation and extension, and offers procedures for dressing wounds, supporting stumps, and using elastic and plaster appliances. An appendix supplies lists of preparations, instruments, and items recommended for sick-room and operating-room use, presented as checklists to help students and practitioners refresh practical skills.

INSTRUMENTS AND APPLIANCES FOR OPERATIONS ABOUT THE HEAD AND NECK.

Trephining the Skull. Cleft Palate.
Operations on the Eye. Excision of Tonsils.
Hare-Lip. Laryngotomy.
Resection of the Jaw. Tracheotomy.
Excision of the whole Tongue.

TREPHINING THE SKULL.

1. Scalpel. 8. Quill, cut like a tooth-pick, to clear the groove of bone-dust.
2. Trephines—several crowns. 9. Lenticular knife.
3. Hey’s saw. 10. Small polypus forceps.
4. Elevator. 11. Sponges.
5. Stout dissecting forceps. 12. Lint.
6. Brush to clean away the bone-dust. 13. Ice.
7. Probe.

OPERATIONS ON THE EYE.

Strabismus.

1. Chloroform, if used. 5. Strabismus scissors and hooks.
2. Laurence’s, or other head-fixer. 6. Fine curved needles, and finest thread.
3. Specula of different sizes. 7. Lint.
4. Toothed forceps. 8. Ice, or cold water.

Extirpation of the Eyeball.

1. Chloroform. 9. Ice-cold water.
2. Head-fixer. 10. Perchloride of iron.
3. Speculum. 11. Fine curved needles, and finest silk thread.
4. Toothed forceps. 12. Lint.
5. Curved scissors. 13. Pulled lint.
6. Strabismus hook. 14. Basin.
7. Small and large sponges. 15. Bandage.
8. Dissecting forceps.

Cataract (Congenital).

1. Atropine drops. 6. Toothed forceps, to fix eyeball.
2. Chloroform. 7. Lint.
3. Head-fixer. 8. Cold water.
4. Speculum. 9. Gelatine plaster.
5. Lacerating needles.

Cataract (Senile).

1. Atropine drops. 8. Scoop.
2. Chloroform. 9. Platinum spatula, to adjust edges of wound.
3. Head-fixer. 10. Small sponges.
4. Speculum. 11. Basin and water.
5. Lacerating needles. 12. Gelatine plaster.
6. Toothed forceps. 13. Wool and bandage.
7. Cataract knives. 14. Lint.

Iridectomy.

1. Chloroform, if used. 9. Light curved scissors.
2. Head-fixer. 10. Lint.
3. Specula. 11. Gelatine plaster.
4. Toothed forceps. 12. Wool and bandage.
5. Right-angled knives. 13. Atropine drops.
6. Iris forceps. 14. Small sponges and basin.
7. Iris hooks. 15. Hot and cold water.
8. Capsule scissors, if required.

HARE-LIP.

1. Scalpel. 10. Cheek compressor.
2. Artery forceps, or sharp hook. 11. Sponges.
3. Hare-lip pins. 12. Large towel to wrap the child in.
4. Wire nippers. 13. Chloroform and inhaler.
5. Dentist’s silk twist. When the bone has also to be bent back—
6. Strapping plaster. 14. Bone nippers.
7. Silver suture. 15. Sequestrum forceps.
8. Collodion. 16. A knitting needle; and
9. Scissors. 17. Spirit lamp to check deep hæmorrhage by the actual cautery.

RESECTION OF THE JAW, AND TUMOURS CONNECTED WITH IT.

1. Scalpels. 16. Wire nippers.
2. Artery forceps. 17. Actual cautery.
3. Torsion forceps. 18. Perchloride of iron.
4. Ligatures. 19. Ice.
5. Retractors. 20. Sutures, silk and wire.
6. Tooth forceps. 21. Solution of chloride of zinc.
7. Narrow saw. 22. Lint.
8. Hey’s saw. 23. Bandages.
9. Bone-cutting forceps. 24. Plaster.
10. Lion’s-tooth forceps. 25. Collodion.
11. Sequestrum forceps. 26. Mackintosh sheet.
12. Gouges. 27. Small sponges tied on sticks.
13. Chisel. 28. Larger sponges.
14. Gag. 29. Chloroform and inhaler.
15. Hare-lip pins.

EXCISION ON THE WHOLE TONGUE.

1. Scalpel. 17. Needle for passing the chain.
2. Torsion forceps. 18. Sharp and blunt hooks.
3. Artery forceps. 19. Stout silk.
4. Gag. 20. Metallic sutures.
5. Archimedian bone-drill. 21. Ligatures.
6. Cheek retractors. 22. Ice.
7. Incisor tooth forceps. 23. Perchloride of iron.
8. Narrow saw. 24. Cautery iron.
9. Nævus needle, and 25. Solution of chloride of zinc.
10. Half a yard of thick whipcord. 26. Collodion.
11. Stout copper wire. 27. Small sponges mounted on sticks.
12. Key for twisting the wire tight. 28. Brandy.
13. Wire cutters. 29. Chloroform and inhaler.
14. Stout acupressure needle. 30. Lint.
15. Hare-lip pins. 31. Mackintosh sheet.
16. Two ecraseurs.

CLEFT PALATE.

1. Long-handled, narrow-bladed knife, for dividing the palatine muscles. 8. Scissors.
2. Long-handled curved scissors. 9. Ice, ice-cold water.
3. Slender hooked forceps, to seize soft palate. 10. Mackintosh sheet.
4. Long-handled small bistoury, for paring edges of fissure. 11. Sponges set on sticks.
5. Long-handled needles, with the eye at the point for passing sutures. 12. Glass syringe for washing the mouth.
6. Fine blue silk, or catgut. 13. Smith’s gag.
7. Blunt and sharp hooks. 14. Chloroform and inhaler.

EXCISION OF TONSILS.

1. Long vulsellum. 3. Ice, ice-cold water.
2. Tonsil guillotines; or, probe-pointed bistoury, the posterior two-thirds of the blade covered with lint or plaster; or, tonsil excisors of various kinds.

To repress Hæmorrhage from the Tonsils.

1. A small lump of ice held in a long vulsellum against the tonsil. 3. Long straight polypus or gullet forceps with padded ends, to compress the tonsil; one blade being passed within the mouth, the other outside against the neck.
2. Small sponge on the end of a stick, dipped in ice-cold solution of perchloride of iron, or other styptic.

LARYNGOTOMY IN THE CRICO-THYROID SPACE.

1. Scalpel. 5. Tapes.
2. Artery forceps and ligature silk. 6. Sharp and blunt hooks.
3. Torsion forceps. 7. Two hooked forceps.
4. Silver tube, curved on the flat. 8. Sponges.

TRACHEOTOMY.

1. Scalpel. 9. Trachea-dilator, to assist introduction of tube.
2. Dissecting forceps. 10. Sponges.
3. Blunt hooks for veins. 11. Brandy.
4. Sharp hook to draw forward trachea. 12. Ammonia.
5. Double silver tube and tapes. 13. If a foreign body is lodged in the larynx, forceps of various kinds to extract with.
6. Torsion forceps. 14. Strapping plaister.
7. Artery forceps. 15. Silver suture.
8. Ligatures.