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Transitioning the Nutritional Support Patient to Homecare
Published in Michael M. Rothkopf, Jennifer C. Johnson, Optimizing Metabolic Status for the Hospitalized Patient, 2023
Michael M. Rothkopf, Jennifer C. Johnson
The doctor carried his tools and medications with him. The stethoscope, sphygmomanometer and head mirror are examples of such portable medical technology. Diagnosis, treatment and even surgery were often performed in the patient’s bedroom (now converted to a “sickroom”). The hospital’s role in these earlier times was limited to providing custodial care for the infirm and invalid, many of whom were destitute or contagious.
Acute sinusitis and its complications
Published in S. Musheer Hussain, Paul White, Kim W Ah-See, Patrick Spielmann, Mary-Louise Montague, ENT Head & Neck Emergencies, 2018
Many children will not tolerate nasal endoscopy, although this is certainly possible in older children and teenagers and will often show pus in the region of the sinus ostia. Otherwise, anterior rhinoscopy can be carried out. Often the most useful tool for this purpose is an otoscope rather than the traditional head mirror/light and speculum, which children generally find uncomfortable and intimidating.
The ENT history and examination
Published in Rogan J Corbridge, Essential ENT, 2011
The basic principle of the head-mirror is that light is reflected from the mirror on to the patient. The mirror is concave and thus the light is focused to a point. Also, it has a hole through which the examiner can look, thus allowing binocular vision. Correct positioning of the patient, the examiner and the light source is important (Figure 1.3).
Indications and complications of rigid bronchoscopy
Published in Expert Review of Respiratory Medicine, 2018
As early as the fourth century BC, Hippocrates suggested the introduction of a pipe into the larynx of a suffocating patient. Desault (1744–1795) suggested nasotracheal intubation as a treatment for suffocation and FB aspiration [3]. However, it was not until 1894 when Kirstein in Berlin started to intentionally intubate the larynx with the esophagoscope. He suggested that his experience needed further study, but warned that the lower trachea was a very dangerous place. Rhinolaryngologist, Gustav Killian of Freiburg University attended Kirstein’s lecture in 1895 at the second Congress of the Southern German Laryngologists in Heidelberg; and began his experiments with the new method [3]. In 1897, Gustav Killian removed a pork bone from the right main stem bronchus of a farmer who had aspirated while eating soup. Dr Killian used a head mirror as an external light source and a 33.5-cm esophagoscope to remove the 11 × 3-mm bone fragment while performing the first documented FB retrieval utilizing bronchoscopy [4]. He made some very early observations of the bronchial anatomy and sparked the growth of bronchoscopy [5]. To grasp the true significance of his achievements, one must consider the fact that at that time most patients fell chronically ill after aspiration of a FB. Many of them developed chronic pneumonia and hemorrhage, which had over a 50% mortality. Even surgical procedures like lobectomy and pneumonectomy were introduced after 1910 [3].