The tampon acts as a hæmostatic through its direct mechanical pressure, and dynamically by stimulating the uterus to contract. It should be removed in from twelve to twenty-four hours.
Fig. 88.—Tampon of vagina. (American Text Book.)
To tampon the vagina the woman lies on her back across the bed, with her feet on the knees of the doctor, who sits facing her. A sterile retractor holds back the posterior wall of the vagina.
With a pair of dressing forceps the doctor seizes the pledgets of cotton or gauze out of the lysol solution and carries them one by one as far as they will go, in various directions around the cervix. One is pushed forwards toward the bladder, the next back toward the rectum, the next in the middle, and so on until no more can be introduced. A pad and binder are applied tightly.
The uterine douche is sometimes employed for hæmorrhage. The field of operation and the doctor’s hands are prepared as usual. The nurse cools the boiled douche water down to 120° F. and if ordered, adds 2 drams of sterile salt to each quart.
The instruments are a vaginal retractor, a long uterine douche point, and one vulsellum forceps.
The cervix is seized and brought down, the long douche point connected with the tube from the reservoir is carried to the fundus and the water started. Care must be used that the return flow is free and unobstructed.
This method is most satisfactory in uterine hæmorrhage after the uterus has been entirely emptied. It stimulates a prolonged and profound uterine contraction.
Intravenous Injections.—The vein in the front of the elbow is usually chosen. (Median basilic or median cephalic.) A rubber bandage or tourniquet is wound tightly about the middle of the upper arm to make the veins stand out prominently. The surface of the skin should be sterilized for operation by scrubbing with green soap and hot water and rinsing with 50 per cent alcohol, followed by 1:2000 solution of bichloride, or by the application of tincture of iodine.