left hand encircle the tube. Withdrawal is then done with the left
hand; the fingers of the right hand maintaining closure of the
forceps.]

[164] _Bringing the Foreign Body Through the Glottis_.--Stripping of
the foreign body from the forceps at the glottis may be due to:
1. Not keeping the object against the tube mouth as just mentioned.
2. Not bringing the greatest diameter of the foreign body into the
sagittal plane of the glottic chink.
3. Faulty application of the forceps on the foreign body.
4. Mechanically imperfect forceps.

Should the foreign body be lost at the glottis it may, if large become
impacted and threaten asphyxia. Prompt insertion of the laryngoscope
will usually allow removal of the object by means of the laryngeal
grasping forceps. The object may be dropped or expelled into the
pharynx and be swallowed. It may even be coughed into the naso-pharynx
or it may be re-aspirated. In the latter event the bronchoscope is to
be re-inserted and the trachea carefully searched. Care must be used
not to override the object. If much inflammatory reaction has occurred
in the first invaded bronchus, temporarily suspending the aerating
function of the corresponding lung, reaspiration of a dislodged
foreign body is liable to carry it into the opposite main bronchus, by
reason of the greater inspiratory volume of air entering that side.
This may produce sudden death by blocking the only aerating organ.

_Extraction of Pins, Needles and Similar Long Pointed Objects_.--When
searching for such objects especial care must be taken not to override
them. Pins are almost always found point upward, and the dictum can
therefore be made, "Search not for the pin, but for the point of the
pin." If the point be found free, it should be worked into the lumen
of the bronchoscope by manipulation with the lip of the tube. It may
then be seized with the forceps and withdrawn. Should the pin be
grasped by the shaft, it is almost certain to turn crosswise of the
tube mouth, where one pull may cause the point to perforate,
enormously increasing the difficulties by transfixation, and perhaps
resulting fatally (Fig. 80).

[FIG. 80.--Schematic illustration of a serious phase of the error of
hastily seizing a transfixed pin near its middle, when first seen as
at M. Traction with the forceps in the direction of the dart in Schema
B will rip open the esophagus or bronchus inflicting fatal trauma, and
probably the pin will be strip