Diseases of infants and children / by Henry Dwight Chapin and Godfrey Roger Pisek.

  • Chapin, Henry Dwight, 1857-1942.
Date:
[1909], ©1909
Catalogue details

Licence: Public Domain Mark

Credit: Diseases of infants and children / by Henry Dwight Chapin and Godfrey Roger Pisek. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

    31/658 (page 11)
    blueness of the mucous membranes, full pulse, and moderate action of the reflexes. As the symptoms of carbon-dioxid poisoning become more marked, the pulse grows feebler, the skin paler, and the mucous membranes assume a grayish-blue color. The reflexes are likewise lost. The prognosis in the latter condition is exceedingly bad. In the milder degrees of birth-asphyxia recovery usually ensues. The Preventive Treatment consists in measures addressed to the acceleration of tedious labors and the prevention of prolonged pressure upon the fetal parts, especially the head. During descent of the head malpositions of the cord, especially prolapse, or winding tightly around the neck, must be looked for and, if possible, corrected. One of the possible causes of asphyxia will be removed if as soon as the head is born it is so turned that the face shall not lie in a pool of blood and liquor amnii. At the same time the mouth and fauces can hastily be cleaned of mucus with a moist rag drawn over the finger or by means of a soft rubber tube with a rubber bulb attached. In moderate degrees of asphyxia the stimulus of the cool external air and allowing a dram or two of blood to escape by the cord will be sufficient. Should this not suffice the chest may be sprinkled with cold water to stimulate the reflexes, while the infant is held suspended by the feet for the purpose of allowing mucus to gravitate from the air-passages. The child may be plunged alternately into hot and cold water. The hot water should have a temperature not exceeding 105° F. When these external stimuli fail to excite respiratory movements, resort must be had to artificial respiration. The child's pharynx should first be cleared of mucus and other liquid material that may have been drawn into it by premature efforts at respiration. The simplest and most effectual method of inflating the lungs is by direct insufflation—the mouth-to-mouth method. Direct Insufflation.—The child is placed upon its back with the head extended by means of a small pillow or roll of clothing placed under its neck; the mouth is well cleansed and a towel or hand- kerchief is spread over the face. With one hand closing the nose, and with the other making pressure upon the epigastrium, to prevent the inflation of the stomach, the physician forces air from his own gently into the child's mouth and inflates the lungs. The air is expelled by gentle pressure upon its chest, and the process then repeated. When properly performed, this method is safer than passing a catheter or other instrument into the trachea, as is sometimes practised. Care should be taken lest injury be done to the air-cells by too forcible expansion.