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General Surgery Instruments Flashcards

1
Q

What are two contraindications for Sengstaken-Blakemore tube?

A
  1. Esophageal strictures
  2. Recent esophageal or gastric surgery
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2
Q

What are complications of Sengstaken-Blakemore tube?

A
  1. Airway obstruction
  2. Esophageal rupture
  3. Aspiration pneumonitis
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3
Q

What is the indication of SB Tube?

A

In unstable patients with gastric/esophageal variceal hemorrhage when medical therapy with endoscopic hemostasis and vasoactive agents have failed

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4
Q

How to insert SB tube?

A
  1. Intubate patient
  2. Make sure SB tube has no air leaks
  3. Inflate gastric balloon
  4. X-ray patient to make sure gastric balloon is in the right place
  5. If bleeding doesn’t stop, inflate the esophagealballoon
  6. Don’t leave the esophageal balloon for more than 6 hours – risk of necrosis
  7. Admit patient to the ICU [Because there is risk of esophageal or gastric ruptures]
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5
Q

What are the indications of NG tube?

A
  1. Decompression of the stomach (stomach obstruction, stomach perforation, SBO)
  2. Monitoring upper GI hemorrhage
  3. Administration of medication and feedings to those unable to swallow
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6
Q

What are contraindications of NG tube?

A
  1. Facial fractures (midface)
  2. Basilar skull fractures
  3. Esophageal strictures
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7
Q

What are complications of NG tubes?

A
  1. Epistaxis
  2. Sinusitis
  3. Accidental injury to nearby organs (esophageal perforation, pulmonary injury)
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8
Q

What are signs of basal skull fracture?

A
  1. Raccoon eyes
  2. CSF rhinorrhea
  3. CSF otorrhea
  4. Battle sign
  5. Hematotympanum
  6. Bump
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9
Q

What are indications for Central Venous Catheter?

A
  1. Hemodynamic monitoring (central venous pressure monitoring)
  2. Emergency venous access if peripheral venous access couldn’t be obtained
  3. For transfusing certain medications that are caustic to peripheral veins (chemotherapy, TPN)
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10
Q

What are contraindications of Central Venous Catheter?

A
  1. Coagulopathies or anticoagulant medications
  2. Infection over the placement site
  3. Vascular injury near the insertion site
  4. Morbid obesity
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11
Q

What are complications of Central Venous Catheter?

A
  1. Accidental puncture of arteries, leading to bleeding or hematoma formation
  2. Injury to the lung, possibly leading to pneumothorax
  3. Infection and sepsis
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12
Q

How do you treat pneumothorax?

A
  1. Decompress the chest by placing a large bore catheter in 2nd intercostal space, in the midclavicular line
  2. Chest tube is placed in the 4th/5th intercostal space to prevent air accumulation in the pleura
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13
Q

What is an indication of PEG tube?

A

Administering feeds/meds to patients with swallowing disorders or those who can’t currently swallow (ICU, comatose patients)

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14
Q

What are contraindications to PEG tubes?

A
  1. Coagulopathies
  2. Abdominal wall infection at placement site
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15
Q

What are complications of PEG tubes?

A
  1. Local infection at the insertion site
  2. Pneumoperitoneum
  3. Accidental insertion into nearby organs like the colon
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16
Q

What are the indications of Chest tube?

A
  1. Pneumothorax, Hemothorax, Empyema
  2. Post surgical drainage of fluids (cardiac and chest surgeries)
17
Q

What are contraindications of Chest tube?

A
  1. Coagulopathies/ on anticoagulant meds
  2. Skin infection over the chest tube insertion site
18
Q

What are complications of Chest tube?

A
  1. Damage to vital organs (lung, heart, liver, spleen)
  2. Damage to arteries or nerves
  3. Infection, mainly pneumonia
19
Q

What are complications of UWSD?

A
  1. Drain failure: clogging of drain by a blood clot, accidental disconnection of the drain, air leaks
  2. Air embolism formation
  3. Bacteremia
  4. Sepsis
20
Q

Aim of Incentive Spirometer

A

Patients with a lung illness/injury to take full and deep breaths, this helps in healing the lungs by keeping them active and free of fluid

21
Q

What are the indications of Incentive Spirometer?

A
  1. Prevention of atelectasis and other respiratory complications
  2. After certain major surgeries (abdominal, thoracic)
  3. In people with COPD after surgery
  4. Treatment of atelectasis
22
Q

What are contraindications of Incentive Spirometer?

A

Very young or very confused patients

Might misuse the device because they can’t properly follow instructions

23
Q

What are complications of Incentive Spirometer?

A
  1. Hyperventilation and respiratory alkalosis
  2. Fatigue and discomfort
24
Q

What are indications of IPC?

A
  1. DVT prophylaxis after long surgeries and surgeries that require bedrest
  2. Prevention of lymphedema after certain surgeries
25
What are the contraindications of IPC?
1. Acute skin infections in insertion site (arms or legs) 2. Unhealed fractures 3. Congestive heart failure
26
What are the complications of IPC?
1. Skin irritation 2. Injury to soft tissues and nerves 3. Discomfort and pain
27
What is the indication of Closed Suction Drain
Prevention and elimination of fluid collection (blood, pus, etc.) in wounds with high complication rates
28
Contraindications of Closed Suction Drain
1. Infection around the wound 2. Fragile surrounding skin (from radiation therapy, advanced age)
29
Complications of Closed Suction Drain
1. Bacterial infections and sepsis 2. Pain and discomfort 3. Drain failure (blockage, leakage)
30
Open vs Closed Drain System
* Open: does not use suction, higher risk of causing infection * Closed: uses suction, lower risk of causing infection
31
What is an example of open drain system?
Penrose drain
32
What are examples of closed drain system?
1. Hemovac drain 2. PJ drain
33
What is a cervical neck collar?
A device prevents head and neck movement in order to immobilize an unstable cervical spine
34
Indications of Cervical Neck Collar
Suspected or confirmed cervical spine injuries
35
Contraindication of Cervical Neck Collar
1. Penetrating neck injuries 2. Massive soft tissue swelling in the neck
36
Complications of Cervical Neck Collar
1. Skin damage and development of pressure ulcers (e.g., in the occiput, chin) 2. Increased intracranial pressure 3. Injury to nearby nerves like the marginal mandibular nerve
37
Indications of Endotracheal Tube
1. Provides ventilation during general anesthesia for surgery 2. Patients who can't protect their own airway (unconscious, ICU patients)
38
Contraindications of Endotracheal Tube
1. Severe airway trauma 2. Severe airway obstruction
39
Complications of Endotracheal Tube
1. Trauma to airway structures 2. Accidental intubation of the esophagus

General Surgery ELOOPS (4 decks)

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