Equipment/Techniques in OR Flashcards
Session 5
Primary IV tubing
- Most common
- 10-15 drops/1mL to patient
- Has one way valve at top to ensure medication doesn’t back up into the bag
- Vent cap is used when using glass containers (opens to atmosphere)
Minidrip/Microdrip IV tubing
- 60 drops/1mL
- Use for pediatrics, if you want to deliver slower, kidney patients, piggy backs
- One way valve near the top
- Vent cap is used when using glass containers (opens to atmosphere)
Y tubing (Blood tubing)
- Intraoperative blood products allows you to run blood products on one line and flush the line with saline at the same time
- If no vent, you can vent with sticking a needle through the rubber cap of glass bottle
IV pump tubing
- Piggy back infusion at a certain rate
- Fits in an IV pump to adjust rate
Secondary IV tubing
- Very short, no bolus ports but has roller clamp
- Usually use to run antibiotics into primary IV line
- Has vent cap
Lure lock IV port
- Main port
- No one way valves
- Fluid can back up into syringe so never leave attached
Mannifold ports
-One way valves built in, prevents back up
Twin site extension tubing
- Has 2 luer lock bolus ports
- Makes IV line longer and allows more ports to give medications
Saline lock
-Allow disconnect of IV to use later
Syringe pump tubing (Propofol tubing)
- No roller clamp or bolus ports (non compliant)
- Can connect syringe pump to main line from distance
Stopcock use
- Whatever way it is pointing it is the opposition of flow
- Points to syringe thats off
- 45 degree between syringes stops both
- Down position allows both to be pushed
Albuterol Administration through ETT
- Remove cartridge and use 60cc syringe
- Push plunger against canister to ensure its working
- Remove capnograph tubing and inject two squirts while inspiration of bag/hold for a few seconds
- Repeat as needed
Bougie for difficult intubation
- Also called Eschmann Stylet
- Use split finger grip to adjust angle while advancing
- Typically only use when you can only see artynoid cartilage
- Place bougie in vocal cords, slide ETT over and then remove bougie while keeping ETT in place
OG/NG tube placement
-Lube distal portion of tube
-Lift face off table by holding lower jaw
-Place tube at 90 degree angle, angled towards the esophagus NOT brain
-Advance until resistance is felt
-To secure use 4-5 inches of tape, tear down the middle 3/4 way, place untorn on ridge of nose.
-Take one side of tape and wrap around tube and use other end to wrap around once and reattach to ridge of nose
To remove OG/NG: hold proximal tip with right hand, pull all of tube out with left hand so that you’re only contaminating left hand
Securing an ETT tube
- 12 inch piece, 1 inch tape
- Make tabs on each end of tape, to make removing easier
- Place tape on one side of face near ear and then wrap around ETT twice then back down the other side of the face.
- Make sure not to tape the lip, but secured close to the lip.
- If someone is sweaty or bearded, use Mastisol (pop seal and apply on cheeks, dry by fanning, apply tape after dry) or Trach Tie technique (wrap around face loosely, then tie near jaw - don’t occlude ETT tube or tie too tight)
Suctioning lungs and ETT
- Pt needs to be paralyzed or heavily anesthetized to prevent coughing
- Turn ventilator off
- Disconnect air tubing
- Place lung suction catheter through ETT until resistance met
- Place suction on end of catheter
- Occlude and pull catheter out at same time, discard contaminated catheter and plug tubing back on ETT
- Turn ventilator back on
Armboards and Supine Arm Positioning
- Locate levers underneath (usually 1 or 2)
- Depress lever and angle armboard up in order to attach to table
- Continue holding lever down while bringing down armboard and let it click in place
- Suppinate arms to avoid pressure on the ulnar groove
- If wrists are “hanging”, place cloth padding under to avoid median nerve injury
- Place blanket on top of arm and secure with Velcro strap
Emptying a Foley Catheter
- Unclamp tubing
- Place in container
- Unclamp metal clamping while tip in container
- Metal silver clamp should only be open when it’s emptying into saline bottle
- Reclamp metal clamp while tip is still in container
- Click tube back into place on bag
