Diseases Of The Nose Throat And Ear

CHAPTER 4
GENERAL NOTES ON TREATMENT

In the following chapters reference will be made to standard forms of
treatment, and general directions for these are given here.

NASAL LAVAGE OR DOUCHING

This is used to clear the nose of crusts or sticky secretions. It should never be
employed during acute infections or if the patient has a cold. The temperature
of the fluid should be about blood heat, and the solutions should be isotonic
with blood plasma. The usual solutions are of common salt or sodium
bicarbonate or a mixture of these using two teaspoonfuls in a pint (0-51) of
water. The patient should sit with the head low over a basin to catch the
return flow, and the solution should be gently injected into the nose by means
of a Higginson's syringe or a rubber ball syringe. The practice of sniffing up
fluid from cupped hands is not to be encouraged as this serves to drag the
infected material posteriorly where it may infect the auditory tubes. One side
is douched at a time, and if the patient breathes through the mouth the fluid
can run through the nasal cavity and into the nasopharynx and down both
nasal cavities without any entering the pharynx.

NASAL DROPS

Various medications are prescribed in the form of drops. The patient should
lie on his back across a bed with his head hanging over the edge. As the drops
are instilled he should sniff in as this disperses the fluid with the inspired air,
and prevents it from running uselessly through the nasal cavity into the
nasopharynx,

. NASAL SPRAYS

Medications may be sprayed into the nose by means of a glass atomizer
equipped with a rubber bulb and a nozzle which has a bulbous end to fit into
the nostril. There are many proprietary preparations which are sold in plastic
containers with a fine aperture. Pressure on the container releases a fine spray
if the aperture is pointed vertically upwards, but ejects a jet if the aperture is
pointing down. Spraying of the nose is performed with the patient upright so
that the drug is dispersed through the nose.

STEAM INHALATIONS

These are generally used in inflammatory conditions, and great care must be
taken if they are prescribed for children in case the hot water should spill and

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