TRACHEOTOMY 193 



gency operation in the dog to avert impending suf- 

 focation during iattacks of laryngitis, foreign bodies 

 in the pharynx or esophagus, and sometimes in 

 cases where the nasal chambers become plugged with 

 clotted blood or mucous. 



Place the patient in the dorsal position, with neck 

 fully extended, and apply a local anesthetic of cocain 

 and adrenalin solution. The following instruments 

 must be ready for use : scalpel, razor, rat-toothed 

 forceps, tracheal retractor, and tracheotomy tube. 

 Also have plenty of dressings and swabs at hand. 



Technic. — After shaving and disinfecting an area 

 about three inches square immediately below the 

 larynx, a median incision is made through the skin 

 and muscles onto the trachea. The incision should 

 begin about one inch below the larynx and extend 

 backwards about one and one-half inches. Hemor- 

 rhage must be completely controlled before the 

 next step of incising the trachea is taken. The 

 trachea is then seized with the rat-toothed forceps 

 and an incision made in its middle line, long enough 

 to allow of the insertion of the tube. To facilitate 

 this, the trachea wound should be dilated w'ith the 

 retractor, as otherwise considerable difficulty may 

 be experienced in inserting the tube. The after- 

 treatment consists of removing the tube daily anxi 

 cleaning it, cleaning the wound, and reinserting the 

 tube. After permanent removal, the wound should 

 be treated antiseptically and allowed to heal by 

 granulation. 



