Instruments Flashcards
Self retaining -Urithral cathether
Parts
Drainage funnel
Inflation funnel
Cathether shaft
Balloon seal
Drainage eye
Cathether tip
Urithral cathether
Features
2way-drainage outlet , valve for inflating ballon
3way- 2 + irrigation using normal saline
Urithral cathether
Indications
Acute urinary retention
Monitoring urine output :shock or intraop 0.5-1 ml/kgper hr , 1-2mls ped
For urinary diversion spinal injury
Delivering drugs esp cytotoxic to bladde
To stent the Urithral following urethroplasty
To carry out investigation eg urethrogram
For continuos bladder irrigation
In unconscious bedridden patients
3 way -especially ind for bladder irrigation in conditions where there is bleeding into the bladder after prostatectomy , hematuria prevent clot
Procedure UC
An aseptic procedure requires an assistant
Explain procedure
Take consent
Assemble the materials :
Assistant opens and you pick
Connect catherther to bag
Place the pt in a lit hoto my position
Wear sterile gloves
Part the labia majors in females and wipe up to down
In males clean from tip of glans penis down to shaft using cotton wool and savlon
Apply lubricant on sterile catherther
Insert slowly til y junction and stop
Inflate with 5mls of water for injection
Try pulling gently to ensure it’s secure insitu
Complications UC
Bleeding
Urinary tract Infection
False passage
Injury to bladder
Stone formation
Stricture
Retained cathether faulty valve
Contraindication UC
Pt refusal
Absence of skilled attendance
Chronic urinary retention to prevent post op diuresis
High riding prostate
Resistance to passage
Urithral injury
Urine bag
Draining urine via Urithral catherther
Used for creating an abdominal drain
Connected to Ng tube during bowel decompression
Ng tube
125 cm length
Marks 5
Radio plaque line to detect in X-ray
Ng tube procedure
Explain to patient and take consent
Hand hygiene and gather supplies
Inspect nasal and oral cavity
Asses best nostril to use by occluding and sniffing ask about preveious injustices
Position pt 45-90
mark
lubricate the tube
Apply lidocaine spary to nasopharynx
Pt flex the head down the breath through the nose closes epiglottis and opens eosophagus
pass slowing if pt is conscious ask to swallow until you reach the marked point
secure in place with a plaster
Verify placement
Ambu bag ( ambulatory mechanical breathing unit )
Parts : face mask , valve and the bag
Use in manual resuscitation to give positive protection pressure ventilation
Complications: may rupture the alveoli if pressure applied is too much
Endo tracheal tube
Parts
Beveled tip:o2 outlet to trachea
Murphy s eyes:
Cuff:prevents aspiration of fluid into lungs when aspirated
Pilot: for inflation of the cuff
Connector:
Ballon curved graduated tube
Endo tracheal tube indicated
Indications:
1.To secure the airway in an unconscious patient
2.Used to maintain patency of the airway in anaesthesia
3.Used to prevent aspiration of substances in Px with full stomach.
Endotracheal tube complication
COMPLICATIONS.
1.Trauma to the airway
2.Infections e.g laryngitis, sore throat
3.Kinking
4.Accidental oesophageal intubation.
5.Tracheo-oesophageal fistula.
Pneumatic
Dental injury
Vocal cord accident
Difficult breathing
Complicated ett
COMPLICATIONS.
1.Trauma to the airway
2.Infections e.g laryngitis, sore throat
3.Kinking
4.Accidental oesophageal intubation.
5.Tracheo-oesophageal fistula.
Oropharyngeal airway
Depress the tongue to maintain airway
Unconscious pt
During general anaethesia
Sizes :color
Adult 2-4 green yellow and red
Tracheostomy tube
For relieving upper airway obstruction
Types metallic , portex ,
Parts
Introducer
Tube
Inflating valve
Cuff ballon
Anchor
Tracheostomy tube
Indication
Upper airway obstruction:tumors foreign body
Head and neck surgery
Lower airway toileting
Surgical prophylaxis
Complications
Fibrosis
Pressure necrosis
Wound infection
Tube migration
Tube occlusion fistula formation
Bell
Pen and paper
Suction machine
Oxygen
Tracheal dilator
A spare tube
Laryngeal mask airway
Deliver anesthetic gasses
Supra glottis
Ventilation during general anesthesia for short duration of procedure
Laryngoscope
Visualize the larynx , for Endotracheal intubation
Blade and handle
Rigid cervical collar
For splinting the cervical spine in conditions like
Fractures cervical vertebrae
Cervical spondylosis
Subluxation of the cervical spine
Philadelphia type is preferred trauma pt
Chest tube indications
Pleural effusion
Pneumothorax
Haemothorax
Pyothorax
Emphyema
Post thoracotomy
X-ray before , after , before removal
Chest tube care
STOP
storage:note volume
Tube :check if tube is still patent
Opening : area of the skin the tube enters the body dress
Patient : examine pt and check for any complications
Chest tube contraindications
Pt refusal
Absence of skilled attendant
Coagulopathy
Platelet dysfunction
Suspected mesothelioma
Pure tb effusion
