Common attachments Flashcards
What does a pulse oximeter measure?
Where can a pulse oximeter be placed?
What impairs the accuracy of the reading?
SpO2
Possible sites to put the oximeter are: finger, earlobe, toe, forehead
Accuracy reduced by: poor perfusion/hypotension, carbon monoxide poisoning, low O2 saturation, pigmentation, movement, nail polish, clubbing
What is an arterial line used for?
Any relevant CIs/Ps?
- take arterial blood samples for ABGs
- monitor mean arterial pressure
- CIs/Ps: don’t flex the joint with the arterial line in situ; femoral arterial lines are often considered a CI to sitting
What is a central venous catheter used to measure?
Are there any CIs to moving patients with this catheter?
- measures central venous pressure
- medical clearance and CXR required post CVC insertion due to risk of pneumothorax
What does an ECG monitor?
ECG measures the electrical activity of the heart
- 3 lead ECG used to monitor HR and rhythm
- 12 lead ECG required for diagnosis
What are pacemakers used for?
What are the precautions required for temporary pacemakers?
- demand pacemaker stimulates myocardial repolarisation as necessary
- fixed rate pacemaker fires at predetermined rate (thus HR may not increase with exercise, need to take necessary precautions)
- Precautions: patients with temporary pacing wires require medical clearance prior to PT intervention
What are extra ventricular drains used for?
Any precautions/CIs?
- EVDs are used to manage high ICP hydrocephalus; tip of EVD inserted into lateral ventricle
- EVD can also be used for ICP monitoring and CSF sampling
- medical clearance from neurosurgical team required prior to commencing any PT intervention
What is IVT used for?
Points for PTs?
Intravenous therapy is the administration of fluids and/or medications delivered to the vascular system via the venous system
PTs:
-potential complications: tissuing (infiltration of IV fluids into surrounding tissue) - infusion rate slows, swelling/hardness around needle site, signs of tissue necrosis –> notify medical staff; thrombophlebitis, air embolism, drip “runs through”
-avoid WB through part of body where the line is in place, may be able to temporarily disconnect from IVT, be cautious with exercises that may dislodge or block the needle eg. forearm and wrist movements
What is an NGT?
Physio points
Nasogastric tubes are used when stomach contents need to be aspirated or drained, or for the provision of nutrition if the patient is unable to swallow safely/effectively
PTs:
-if used for aspiration, the bag can be taken with patient during mobilisation
-may be temporarily disconnected if being used for nutrition
-care not to dislodge or tension the line
-watch for patients suffering from delirium or confusion trying to pull NGT out
-nasal specs and O2 masks can be fitted around NGTs
-caution when lying patient flat when feeds are running
What is an IDC?
PT points?
Indwelling catheter
-used for drainage of bladder prior to, during, or after surgery, to investigate bladder function, relieve urinary retention, measure UO, relieve urinary incontinence
PT:
-rapid drainage of large volumes of urine may result in hypotension – consider this if mobilising
-check the catheter is secured properly for mobilisation
-note the position of IDC before treatment
-avoid tipping the bag to enable accurate UO measurements
-catheter bag should be positioned below the level of the bladder to enable effective drainage
What is an UWSD?
Under water seal drain
-allows air and fluid to leave the pleural cavity but prevents their return. This helps to restore the negative pressure within the pleural cavity that may have been disrupted by: pneumothorax, operations, malignant pleural effusion, empyema (pus in pleural cavity)
PT:
-check chart for S (swinging), D (draining) and B (bubbling)
-monitor UWSD throughout treatment and after
- don’t touch the clamp
-pt needs to be aware of dangers when mobilising - bottle lower than chest, connections intact, must not kink or pull on the tube
-unpin before mobilising patient
-don’t let the bottle fall over, if it does return to upright and instruct patient to take 4-5 deep breaths
-if drain is on suction, check with medical staff before mobilising otherwise may be restricted to bedside mobility only
-don’t kink or compress tubing
What is a PCA used for?
Precautions for physiotherapy?
Patient controlled analgesia is used to provide rapid pain relief (within 2mins)
Precautions: only the patient can press the PCA button, side effects are: sedation and reduced RR, thus will usually be on low flow O2 via nasal specs
What are wound drains used for?
PT points?
-used to collect and measure fluid loss after surgery. Usually removed 24-48hrs after surgery
PTs:
-ensure drain is able to move with the patient
-be sure to leave all drains clearly visible when returning to bed
What are TEDs used for?
DVT prophylaxis
