A few remarks on tracheotomy : with cases / by T.R. Jessop.

  • Jessop, Thomas Richard, 1837-1903.
Date:
1869
Catalogue details

Licence: Public Domain Mark

Credit: A few remarks on tracheotomy : with cases / by T.R. Jessop. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    In conclusion, I have Iwo suggestions to offer for the ini- jirovement of tracheotomy tuV)0s aa ordinarily constructed. A remark commonly made after pei’forming the oj)eration is, “ How much deeper the trachea is than it seems to he ! ” We may go further with our reflections, and add, “How much deeper the trachea is in the living than in the dead !” In private practice, where the patient resides at a distance from the surgeon, it is no unusual circumstance to be told, on making the morning visit, that the patient, especially if it be a child, has died after a violent fit of coughing during the night. And if the throat be examined, it will not un- frequently be found that the tube has been forced out of the trachea, and is lying irregularly in the wound; that, in fact the child has died suffocated, because the tube was only just long enough to reach the trachea, and has therefore become readily displaced during the act of coughing, or in swallowing. The ordinary tracheotomy tubes would seem to be made to correspond with the apparent, and not with the actual dej)th of the trachea—to reach the trachea of the dead and not of the living. Those I am in the habit of using are neaily half as long again as the ordinary tubes, and I find them very advantageous. I had them made after losing two children in the way I have described above. My second suggestion—the principle of which is, I believe recognised, but is not sufficiently appreciated by instrument makers—is, that the two blades of the outer canula should be made so that they lie in close apposition at their distal extremities, and are separated only by the introduction between them of the inner canula. By the adoption of this means the most difficult step in the operation of tracheotomy—viz., the introduction of the canula through the slit in the trachea—will be much facilitated. Leeds, 1869. EDWAED BAINES AND SONS, PRINTERS, LEEDS.