Catheters, Tubes & Drains Flashcards
Catheters purpose:
. Remove fluid or other objects (thrombi; stones)
. Monitor body functions
. Insert fluids; including contrast media & medications
Cholangiocath
. Used to inject Hypaque or Renografin (contrast agent) in common bile duct
. Attaches to Leuk-Lok syringe
What is Hypaque or Renografin
contrast agent used in the common bile duct
Urinary Catheters purpose and sizes?
. Used to drain urine but have other uses like irrigation
. Nonretaining & Self retaining
. French scale for sizing: 5 Fr (infant & peds) -> 30Fr
Average cath. Size used by adult men = 14 Fr->16 Fr
Urinary Catheters purpose and sizes?
. Used to drain urine but have other uses like irrigation
. Nonretaining & Self retaining
. French scale for sizing: 5 Fr (infant & peds) -> 30Fr
Average cath. Size used by adult men = 14 Fr->16 Fr
Non-Retaining Catheter:
- Temporarily inserted
- Obtain specimen
- Decompression of bladder
- Maneuver around an obstruction
- DOES NOT require urine bag
EX.
. Robinson “red rubber” or “straight cath”
. Coude Cath
Robinson “red rubber” or “straight cath”
Non-Retaining Catheter
- Straight, Plain Tip
Coude Cath
Non-Retaining Catheter
- similar to Robinson catheter but has rigid curved tip
Self-Retaining Catheter or Indwelling Urethral Catheter AKA Foley Catheter
. Indwelling, catheters
. Uses sterile water, rather than saline to inflate 8-10cc for 5cc
. Uses ballon to retain the catheter (5 or 30 cc capacity)
. Used for a period of time
. Some foley cath. Contain a thermometer in the tip
Ex.
- 2 way cath or 3 way cath
- Suprapubic cath
2 way cath or 3 way cath is an example of what?
Self-Retaining
. For transurethral resection of the prostate (TURP)
Suprapubic catheter
– Placed to the bladder
through a surgical
opening in the
abdominal wall
– e.g. Foley, Pezzer
(mushroom), Malecot
(winged tip)
Ureteral catheter
– Placed in the ureter with
an assistance of a
cystoscope
– Introduce contrast
media during retrograde
pyelography
– Passive/gravity
Intravascular catheters
Give ex.
– Infuse fluids or meds
– Obtain diagnosis
– Monitor body functions
– Remove thrombi
– May be inserted
percutaneously or
through a “cutdown”
Ex. Fogarty Catheter, Angio-Cath & Groshong
Fogarty catheter
– Balloon tipped
– Used for removing
thrombus or stone
(embolectomy)
Angio – Cath
– Vascular catheter used
for peripheral line access
Groshong
– central vein catheter
Tubes
– Used to remove air and
fluids for decompression
– Maintain patency of a
lumen & administration of oxygen, gases, medications, fluids including nutrition supplememts
Ex. Gastrointestinal (GI) Tubes,
Gastrointestinal tubes
– Used to aspirate fluids from the GI tract
– Feeding hole = (stoma)
– Sump = Dual lumen tube in which one lumen is used for evacuation of fluid & second allows air to enter for equalizing pressure with in a structure
? slide 16 double-lumen nasogastric
tube
- used for suction and irrigation of the stomach.
- One lumen is attached to
suction for the drainage of
gastric contents and the
second lumen is an air vent.
Airway tubes
- are used to maintain airway patency
Ex.
– ET tube
– Oral Airway
(Pharyngeal airway)
– Nasal Airway (trumpet)
– Tracheotomy tube
– LMA Laryngeal Mask Airway
Laryngeal Mask Airway (LMA)
. is a medical device that
keeps a patient’s airway open during anesthesia or
unconsciousness.
* composed of an airway tube that connects to a soft mask with a cuff which is inserted through the patient’s mouth, down the windpipe to form an airtight seal on top the glottis (unlike tracheal tubes which pass through the glottis)
Endotracheal Tube (ET)
- Catheter that is inserted into the trachea to maintain a patients airway and to ensure the adequate exchange of oxygen and carbon dioxide. (unlike LMA which stay on top of the glottis)
- Adult tubes are cuffed (balloon)
- Pediatric are uncuffed
Nasopharyngeal Airway (NPA) aka nasal
trumpet or nose hose
- A tube that is designed to
be inserted into the nasal
passageway to secure an
open airway. - When a patient becomes
unconscious, the muscles
in the jaw commonly relax
and can allow the tongue
to slide back and obstruct
the airway.
Tracheostomy Tube
- involves creating an opening in the neck to place a tube into a person’s windpipe.
- The tube is inserted through a cut in the neck below the vocal cords.
- This allows air to enter the lungs.
Oropharyngeal Airway (OPA) aka Oral airway or Guedel airway
- When a person becomes unconscious, the muscles in their jaw relax and allow the tongue to obstruct the airway which prevents the person from breathing.
Chest Tube aka thoracic
catheters
– Inserted to evacuate air and fluid from the pleural space
– Reestablish negative pressure in lungs
– Connected to a closed water seal drainage system maintaining negative pressure
- Curved or straight
- Different sizes: infants to adults; small for air and large for fluid
* Material is: PVC & silicone
Ex.
. Safe-T-Centesis
. Surgical Chest Tube
. Pig Tail
. PluerX
Tube thoracostomy
. (standard tube, pigtail) is a common procedure in which any tube or small catheter is placed through the chest wall into the pleural cavity and used primarily to drain air or fluid
. also be used to instill agents to induce pleurodesis (pleural
space is artificially obliterated) or to treat empyema, hemothorax & pneumothorax.
Size used: 28-40 Fr “surgical tube”
*In most cases of (PTX) Pneumothorax or Parapneumonic effusion 8 Fr pigtail as good as largebore surgical chest tube. The latter usually preferred for Traumatic hemothorax or concern for repeated clogging from empyema
Safe-T-Centesis
Diagnostic thoracentesis or paracentesis
Size used: 6-8Fr
Pigtail
Drainage of plural fluid, ascites, pleurodesis, pneumothorax
Size used: Usually 12-14 Fr
May kink more easily because of the small size & shape/flexibility
PleurX
Chronic drainage (ie. palliative drainage of malignant effusion
Size Used: 15 Fr
Tubes
- The underwater seal
prevents backflow of air
or fluid into the pleural
cavity. - Appropriate chest drain management is required to maintain respiratory function and hemodynamic stability.
Surgical Suction Connecting
Tubing
- available with female molded connectors (male connector also included)
Drains
– Used to evacuate air
and fluids from a
surgical or traumatic
wounds
– Passively
– Actively
Active Drains
– Makes use of negative
pressure
Examples:
. Hemovac
. Jackson Pratt
. Stryker drain
Hemovac
Typically used following orthopedic procedures when a moderate amount of drainage is expected
Jackson Pratt
. Typically used following abdominal procedures when a moderate amount of drainage is expected
. Also used in neurosurgery and other general surgery procedures such as a momoplasty
Stryker drain
Typically used following orthopedic procedures. Effective in reducing dead space due to the strength of the battery-operated evacuation pump
Passive Drains
– Allow fluid or air flow
from a high to a low
pressure area
Ex.
. Penrose Drain
. Cigarette Drain
. T-tube
. Gastostomy Tube
. Ostomy Pouch
. Cystostomy Tube
. Nephrostomy Tube
Penrose Drain
- Latex tubing
- Allow fluid to move by
passive capillary
action
Cigarette Drain
- Penrose with gauze
- Wicking action 32
T-tube
– Placed in the
biliary system
– Drains bile into
the bile bag
– Passive / gravity
Gastrostomy Tube
– Inserted in the abdomen
– Removes gastric contents or give nourishments
Ostomy Pouch
- An ostomy pouching system is a prosthetic medical device that provides a means for the collection of waste from a surgically diverted biological system and the creation of a stoma (opening)
- Pouching systems are most commonly associated with colostomies, ileostomies, and urostomies.
Cystostomy tube
– Inserted in the abdominal wall to the bladder
– Removes urine and
decompresses the bladder
Nephrostomy tube
– Inserted percutaneously
in to the kidney
– Removes urine
Non suture needles
– Hypodermic needles
– Spinal needles
– A/V cannula needles
– Heparin Needles
– Biopsy Needles
Hypodermic needles
- inject meds in tissues or intravenous tubing
- may be used to withdraw fluid from tissues
Length Range: 1/2-4in
Gauge Size: 12-30; with smaller needles having the large gauge number
SR uses them to withdraw meds into a syringe from a vial held by a circulator
Spinal needles
- typically used to introduce anesthetic agents into the epidural or subdural space – can obtain cerebral spinal fluid for diagnostic purposes
Size: Assemblies are 3-4 in long w/ a sharp, beveled stylet with in the metal cannula
A/V cannula needles or Venous/Cannula Needle
- a needle to introduce a plastic indwelling catheter into a vessel (Commonly called an IV in order to deliver fluids, blood or blood products into the circulatory system
- can obtain arterial blood gases or are attached to a line leading to a transduce to directly monitor arterial blood pressure
Ex. Intravenous cannula/needles ex. Angio-Cath, are attached to IV lines to introduce fluids or medications
Ex. Arterial needles ex. Potts-Cournand needle/cannula are used to introduce diagnostic or angioplasty guiding catheters over guiding wires into the arterial system
Ex. Venous needle w/ aspirating syringe are used to puncture large veins to introduce a monitoring catheter ex. Swan-Ganz
Heparin Needles
attached to syringes that are used during open cardiovascular procedures to irrigate open arteries with a saline-heparin solution
Biopsy Needles
- to obtain tissue samples from with in the body for biopsy
- can sometimes be guided w/ the aid of CT scan or fluoroscopy
Ex.
. Dorsey cannulated needle: used for biopsy of cerebral tissue through a burr hole
. Chiba biopsy needle: used for biopsy of the liver & other internal organs
. Tru-Cut biopsy needle: has a sharp cutting cannula to facilitate insertion into the tissue and cutting the tissue
Irrigators and Syringes
Are not actually needles but small diameter cannulated tubes attached to a plastic needle hub for placement on a syringe
– Used to irrigate, aspirate, inject
– Plain (Luer slip): accepts needles that slip over the syringe tip
– Locking (Luer lock): locks needle tips with a twist motion
– 1, 5, 10 20 60cc syringe is the most commonly
used
Syringes consist of 3 components:
. Barrel
. Plunger
. Tip - which can be plain(slip) or locking(lock)
What is the most commonly used syringe used?
1, 5, 10 20 60cc syringe is the most commonly
used
Irrigating syringe
– Bulb type
– Bulb/barrel
– Asepto syringe
* 120cc
* Most used
What is the most used irrigating syringe
Asepto syringe
* 120cc
* Most used
