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December 4, 1937

ACUTE INFECTIVE LARYNGOTRACHEOBRONCHITIS: ILLUSTRATING THE USE OF EPINEPHRINE (1:1,000 SOLUTION) INTRATRACHEALLY FOLLOWING TRACHEOTOMY

Author Affiliations

Riverside, Calif.

JAMA. 1937;109(23):1903. doi:10.1001/jama.1937.92780490001011

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Abstract

J. P., a girl, aged 17 months, was admitted to the Riverside Community Hospital, Jan. 5, 1937, because of an acute obstructive respiratory difficulty. The onset three days before was characterized by hoarseness and a high temperature (not recorded), followed by a croupy cough. On the second evening the rectal temperature rose to 104 F., with increasing laryngeal stridor and prostration. On the night of admission to the hospital the child seemed in such distress and so exhausted that intubation was attempted, but the tube was immediately expelled, bringing with it a plug of thick, gummy material. The child then breathed with greater ease for only a few hours, as obstructive symptoms returned with even greater intensity. Without further delay on the second hospital day a low tracheotomy was performed by one of us (E. P. M.), a No 3 tube being inserted. Thick, gummy material plugged the tube, often

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