Identifier: amerbook00star (find matches)
Title: An American text-book of the diseases of children ..
Year: 1895 (1890s)
Authors: Starr, Louis, 1849-1925 Westcott, Thompson Seiser, 1862-
Subjects: Children
Publisher: Philadelphia, W.B. Saunders
Contributing Library: Yale University, Cushing/Whitney Medical Library
Digitizing Sponsor: Open Knowledge Commons and Yale University, Cushing/Whitney Medical Library

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h opera-tion is generally selected in children, because at this point the trachea is mostsuperficial, and for this reason is more readily exposed and opened. In the highoperation the cricoid cartilage is frequently divided with the upper rings of thetrachea. The low operation cannot be executed so rapidly, and is certainlymuch more difficult in its performance, because of the relatively greater depthof the trachea, the large size and number of veins exposed, and the proximityto the large arterial trunks. In young children the extreme shortness ofthe neck sometimes prevents the satisfactory adjustment of the tracheotomy-tube when the low operation is performed. I call to mind the case of a youngchild in whom I did a low operation, where the lower extremity of the tubecame in contact with the bifurcation of the trachea, and it was only afterI had the tube shortened that the child could wear it with comfort. Manyoperators prefer the low operation: Cohen expresses himself decidedly in its
Text Appearing After Image:
TRACHEOTOMY. 297 ftbvor in case the tube is to be worn for a long time or where the operationis done For a foreign body impacted in the bronchus. I am myself decidedly in favor of the high operation in cases of diphtheritic or membranous laryngitiswhen the tube is to be worn only for a short time, and I would thereforerecommend those vho have had little experience with the procedure to employthe high operation, on account of the greater ease and safety of its perform-ance, save in tin1 exceptional conditions referred to by Cohen. Position of the Patient for Tracheotomy.—In the operation of trache-Otomy it is a matter of the first importance that the patient be placed in sucha position that the neck shall be brought into the greatest prominence, torender the trachea more superficial and give the greatest amount of spacebetween the sternum and the chin; and it is surprising with how much moreease the operation will be accomplished if the patient be placed in this posi-tion. The most s

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