A nurse's guide for the operating room / by Nicholas Senn. Pub. under the direction of the sisters of charity, St. Joseph's hospital...Chicago.

  • Senn, Nicholas, 1844-1908.
Date:
1905
Catalogue details

Licence: Public Domain Mark

Credit: A nurse's guide for the operating room / by Nicholas Senn. Pub. under the direction of the sisters of charity, St. Joseph's hospital...Chicago. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    During the time attempts are being made to restore respiration other means of counteracting the toxic ef- fects of chloroform are employed. The most potent physiologic antidote for chloroform is strychnin. Hora- tio C. Wood advises heroic doses. In adults the first dose should not be less than one-sixth of a grain by subcutaneous injection. This may be safely repeated in ten or fifteen minutes if the nervous centers do not respond to the first dose. Inhalations of nitrite of amyl stimulate the heart's action and are well calculated to relieve the stagnant capillary circulation. Slapping the chest with a towel wrung out of cold or hot water and the rubbing of the extremities are valuable agents in accomplishing the same object. Faradization of the phrenic nerve is an- other valuable resource in restoring respiration tem- porarily suspended by the toxic action of chloroform on the respiratory center. The two electrodes are applied: one on each side of the neck over the clavicle at the outer border of the sterno-cleido-mastoid muscle. Al- though the immediate cause of death from chloroform is generally its toxic action on the center of respiration, alarming and fatal complications may set in which are directly referable to its depressing effect on the heart muscle. Such accidents usually occur when least ex- pected and with a suddenness that is appalling. In a moment the color of the face is changed to a deadly pallor; the pupils dilate and do not respond to light; the corneal reflex disappears; the lower jaw drops cadaver-like; the pulse is either very small, rapid and flickering or imperceptible; the heart sounds are in- audible; bleeding of the wound ceases; respiration, al- though shallow and irregular, may continue for a short time until it ceases after a few spasmodic efforts similar to those observed in a dying person. Such a terrible scene is fortunately rare, and when it does occur it is most frequently met in anemic patients and in those the subjects of organic disease of the heart. Nevertheless