Instruments Flashcards
Blood Culture Bottles
These are two blood culture bottles, one for aerobic bacteria and one for anaerobic bacteria. The blood is
injected in a sterile manner into the bottles using a different needle from the one the blood was drawn with.
Blood cultures are a useful investigation in a case of pyrexia or suspected systemic sepsis.
Catgut Suture
This is catgut suture, which is an example of a natural absorbable suture. Catgut as been replaced my many
of the newer synthetic absorbable materials, however you will still see it being used in the formation of
stomas and circumcisions.
Chest Drain Bottle
This is the bottle to which the chest drain is attached.
If you look carefully on these there will be a line called prime level which is filled with sterile water. The chest drain tubing is connected to a tube which is under the sterile water and therefore acts as a water seal. After a chest drain has been inserted you can see bubbling in the water as the air leaves the pleural space. The chest drain bottle can also be used to collected blood, fluid and pus from the pleural space. The system can be driven by attaching suction to the top of the bottle making it an example of a active closed drainage system.
Devers Retractor
This is a type of retractor which is used in open abdominal surgery to allow the surgeon to operate. There are different sizes and types of retractors available, you may frequently be asked to use one during you
clinical training when you are assisting in theatre.
Disposable Rigid Sigmoidoscope
This is a disposable rigid sigmoidoscope, which is used for the inspection of the rectum and lower sigmoid colon. After explaining to the patient what you are about to do, you must attach a light source and a air pumping
device. The patient is placed in the left lateral position and a digital rectal examination is performed. The sigmoidoscope is then lubricated with jelly and inserted pointing towards the umbilicus. Air is pumped into
the rectum to allow you see the direction of the rectal lumen.
Biopsies can also be taken of rectal mucosa through the sigmoidoscope e.g. in a case of ulcerative colitis
Drainage Bag
This is a drainage bag which can be connected top either a nasogastric tube or a drain coming out of the abdomen. Drainage relies on gravity so this is an example of a closed passive drainage system.
Endotracheal Tube
This is an adult endotracheal tube which is used to provide a definitive airway for patients for example during long operations e.g. laparotomies and during cardiac arrests or trauma. The endotracheal tube is inserted using a laryngoscope, through the laryngeal folds. The end of the tube should lie just above the carina to allow ventilation of both lungs. After inserting the tube a balloon at the end of the tube is inflated with air through the blue side port. Position of the tube is checked by looking for symmetrical rising of the chest on ventilation breath sounds bilaterally and no gurgling over the epigastrium indicating oesophageal intubation. The tube is then tied into place.
Feeding NG Tube
This is a feeding nasogastric tube (clinifeed tube) which is used to long term enteral nutrition in patients. It is thin bore and soft making it more comfortable for patients, it is also made of silastic which blocks less often.
After explaining to the patient what you are about to do the tube is inserted into the nostril after it has been lubricated. These tubes come with a wire inside them to aid their introduction, you advance the tube as the
patient swallows. Correct position of the tube is checked by x-raying for the wire. When you are happy with the position of the tube the wire is removed and the feed attached in a sterile manner.
Five Percent Dextrose
This is a bag of 5% dextrose, which can be used in conjunction with normal saline to provide the normal daily fluid requirement for a patient.
One litre of 5% dextrose contains 50g of dextrose in 1 litre of water.
It should be remembered that because the sugar in this fluid is metabolised to carbon dioxide and water you
are essentially giving them water
Fracture Plate
This is a plate that is used in conjunction with screws to internally fix a bone fracture.
note that in order to properly secure a fracture there needs to be two scrws on either side of the fracture line.
Gelofusin
This is 500ml of gelofusin which is an example of an artificial colloid solution.
Colloid solutions raise the plasma oncotic pressure and hence expand the intravascular compartment. There are other colloids and some available are natural e.g. albumin and blood. Colloids are useful in cases of
shock e.g. due to sepsis or hypovolaemia
Hartmann Solution
This is an example of a crystalloid solution, which contains sodium, chloride, bicarbonate and lactate. It has a similar composition to the extracellular fluid. It can be used to provide the normal daily fluid requirement of a patient or to supplement the patient for additional loses.
Hartmann’s solution is a favorite solution of anaesthetists and is the fluid advocated to be given initially in trauma in the Advanced Trauma and Life Support (ATLS) guidelines.
Hemiarthroplasty
This is a hemiarthoplasty hip prosthesis.
It is used in cases of intracapsular fractures of the neck of femur, as these fractures are prone to avascular
necrosis of the femoral head.
Hickman Line
This is a an example of a long term central venous line which is inserted in a similar way to a central line (usually subclavian).
The remnant of the line is tunnelled subcutaneously which decreases the incidence of line infection. These are indicated for longterm parenteral nutrition, longterm intravenous antibiotic therapy and
chemotherapy.
Hip Replacement
This is the femoral part of a total hip replacement which articulates with an plastic acetabular cup.
The main indication for a hip replacement is pain from osteoarthtis of the hip.
IM Femoral Nail
This is an intramedullary femoral nail which is used to internally fix femoral shaft fractures. Interlocking screws are used to fix the nail. They are usually removed after 12 / 18 months.