Page 635 - My FlipBook

THE OPERATION OF EXTRACTION. 633

rlivtlim, aud with unconsciousness comes involuntary suspension for some
seconds, and should it occur in one who becomes quickly asphyxiated
the few seconds of suspension are sufficient to produce alarming symp-
toms which will require some etfort to counteract. Second, if the
patient breathe slower or less deeply than is natural there is a sense
of suiFocation produced which grows in intensity until unconscious-
ness supervenes, when the lungs and diaphragm will exert tiieir func-
tion, producing violent respiratory effort which will be follo^\-ed by
marked exhaustion upon recovery. Xone of these effects need be
priKluced if the operator have complete control of the situation.
Xo one can explain the symptoms of approaching and complete
anesthesia in such a manner as will inform a novice sufficiently well to
undertake the responsibility of administering the gas ; these can only be
learned through observation and experience, but the first prominent
indication will be a discoloring of the lips and subsequent pallor of
countenance, which is not, however, an indication of cardiac depres-
sion, but is due to the blood color shoAvn through the skin. Should
the patient be of the blonde and florid type this appearance will be
more marked, and it is here that the admission of a small amount
of air is called for, particularly if the blueness seems to approach
more rapidly than the anesthesia.
If the pure gas is given to complete narcosis, there will be twitching
of the muscles of the neck and wrists. Stertor and irregular breathing
and sometimes decided convulsive action occur, which to one inexperi-
enced becomes distressing, if not alarming, to behold.
All these symptoms are at once relieved by air-breathing, and if
there is a judicious admission of air during the administration of the
anesthetic they will be avoided entirely.
The patient being anesthetized—and the instruments being always in
place so that there will be no delay in picking up the i)air of forceps
required, so that every second of time may be utilized by the work
in hand—the next step is the extraction.
The Operation of Extraction.—The proper Avay to perform the
operation is to stand in one position, at the right side of the patient,
durino^ the whole proceeding;. For extractino- with the greatest facility
the operator should assume such a position that in standing erect the
patient's head will be about opposite his upper waistcoat pocket. To
do this a pair of stools should be used, one just back of the chair and
one by the side Avhich may be easily pushed aside when not needed.
While administering, the operator can stand upon the floor, and ascend
the stool just before the time for operating. This position is assumed
by the most successful operating specialists, and is adopted as the residt