66 INTRA-TRACHEAL IRRIGATION. 



be pushed into the pharynx when they will generally be 

 swallowed. Carefully remove any cartilaginous remnants 

 or tissue shreds and control the hemorrhage from any 

 visible vessels. Dust the wounds thoroughly with iodoform 

 and tannin and if the capillary hemorrhage is great pack 

 the larynx with a single strip of iodoform gauze and secure 

 it by sutures through the margin of the skin wound. Re- 

 move this tampon after twelve to twenty-four hours. Wash 

 and disinfect the laryngeal wounds daily. Remove and 

 cleanse the trachea tube and wash the tracheal wound daily 

 and keep the trachea tube in position for five to seven days 

 according to conditions. After about eight days the re- 

 tractors should be placed in the laryngeal wound, the wound 

 dilated and the interior of the larynx examined with the 

 aid of a reflecting lamp and any unhealthy granulations or 

 other untoward conditions given proper attention. 



14. INTRA-TRACHEAL IRRIGATION. 



Objects. The washing of irritant or septic substances 

 from, and the disinfection of, the trachea and bronchi. 



Instruments. Same as for tracheotomy, and a gravity 

 irrigating apparatus fitted with 3 m. of rubber tubing about 

 i cm. in diameter, 5 liters of .6 percent, soda bicarbonate or 

 chloride solution at a temperature of 37 to 39 C. 



Technic. Operate on the standing animal. Perform 

 tracheotomy. Elevate the gravity apparatus containing the 

 irrigating fluid i to 2 m. above the patient, have the animal's 

 head slightly elevated, insert the free end of the rubber 

 tubing in the trachea tube and let the fluid flow into the 

 trachea in a moderate stream until it is filled and the animal 

 makes expulsive efforts, when the inflow is stopped and the 

 animal permitted to lower his head and expel the fluid, then 

 raise the head again and repeat until the fluid is expelled 

 clear. Repeat the operation according to requirement. In 

 cases of suppurative bronchitis, peroxide of hydrogen may 

 be added to the solution. 



