Croup : case of traumatic hemorrhage following tracheotomy, arising from the imperfect form of the tracheal tubes used, and some remarks on the treatment of croup by inhalation of steam, illustrated by cases / by Lewis A. Sayre.

  • Sayre, Lewis A. (Lewis Albert), 1820-1900.
Date:
1864
Catalogue details

Licence: Public Domain Mark

Credit: Croup : case of traumatic hemorrhage following tracheotomy, arising from the imperfect form of the tracheal tubes used, and some remarks on the treatment of croup by inhalation of steam, illustrated by cases / by Lewis A. Sayre. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

    11/18
    The following day I inserted a double tube, on account of the opening constantly filling up with false membrane. I could not prevail upon the father to keep the temperature as high or as moist as I wished, and the result was that the false membrane continued to be formed. The following night I was summoned in great haste and found the child dying from suffocation, in fact, she presented the same appearance which she had at the time of the operation. The tube had almost become closed with tough mucous, which could not be wiped out. The windows and doors were all open, and the air was very cold and dry. I immediately cut the straps and pulled out the tube from the trachsea, and with it a firm coagulum of inspissated mucus, an inch and more in length, which had blocked up the instrument and trachea, and looked like a piece of maccaroni. The child immediately breathed freely and all the dangerous symptoms passed off. In attempting to wash the tube in cold water, it was found impossible to remove the membrane, it seem- ed so firmly dried fast to it, but upon putting it into boiling water, it was immediately dissolved, and the tube cleaned with- out any trouble. Now if the boiling water will dissolve this tenacious secretion in a tube, after it has become dried there and closed it up. Steam inhaled into the tube, will keep the secretion liquefied, and prevent this adhesion, and enable the patient to cough it off, and thus prevent suffocation. When the parents became satisfied of this explanation, which was proved by the melancholy experiment they had just witness- ed, they very willingly complied with my instructions, and for several days the temperature was kept up to 85° or 90° and the room filled with steam by boiling water on the stove, and by heating bricks and putting them in pails of water in different parts of the room. The child progressed from this time without an unpleasant symptom, and on the 10th of August was perfectly well. It is now nearly four years since the operation—she is a stout healthy girl, and her voice is perfectly clear and strong. Case Second.—On the 15th November, 1863, I was sent for by Dr. Johns to come immediately and perform tracheotomy, on a child of Mrs. Johnson, aged three years, at No. 11, Jay street. It had been ill five days with laryngitis.