ADJUSTING THE COLLAR FOR TRACHEOTOMY IN A PATIENT IN A RESPIRATOR

Abstract
During the recent epidemic of poliomyelitis in New York State, several patients with the bulbar-respiratory type of the disease who had been placed in one of the common cylinder type (Emerson) respirators required emergency tracheotomy. The problem arose of how best to adjust the rubber respirator collar about the patient's neck to make room for the tracheotomy tube without interfering with the air-tight fit essential to the efficiency of the respirator. Various methods attempting to solve this problem have been described by others,1but in our hands the emergency method devised by us has proved both simple and efficient. The equipment necessary for this method consists of (1) any mediumsized retractor of the type commonly used in abdominal surgery, (2) a roll of 1 inch (2.5 cm.) gauze and (3) a band of 2 inch (5 cm.) stockinet, 1½ feet (46 cm.) long, stuffed with cotton. The retractor blade
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