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Instruments for PACES > Instruments for PACES station > Flashcards

Instruments for PACES station Flashcards

1
Q

What is this?

A

Absorbable sutures

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2
Q

Compare the 2 types of absorbable sutures

A

Monocryl – monofilament, increased throws for stable knot (9).

Vicryl – polyfilament is braided and so is less likely to loosen at the surgical knot, less throws (3) but has increased fraying issues and local tissue inflammation and is more susceptible to infection

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/absorbable-sutures/ + https://geekymedics.com/suture-material/

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3
Q

What is this?

A

Arterial blood gas syringe

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4
Q

What information do you get from an ABG?

A
  • pH
  • pO2 and pCO2 – for identification of respiratory failure (arterial)
  • Bicarbonate
  • Lactate
  • Hb
  • Na+/K+

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/arterial-blood-gas-syringe/

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5
Q

What does the purple blood bottle contain, and what is it used for?

A

EDTA
Haematology

(Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/blood-bottles/)

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6
Q

What is the pink blood bottle used for?

A

EDTA
Group and Save and cross match

(Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/blood-bottles/)

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7
Q

What does the blue bottle contain and what is it used for?

A

Buffered sodium citrate
Used for coagulation screening

(Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/blood-bottles/)

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8
Q

What does the gold blood bottle contain and what is it used for?

A

Silica particles and serum separating gel

Used for various including U&E and LFT

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9
Q

What does the grey blood bottle contain and what is it used for?

A

Sodium fluoride and potassium oxalate

Used for glucose and lactate

(Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/blood-bottles/)

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10
Q

What does the red blood bottle contain and what is it used for?

A

Silica particles
Sensitive tests eg toxicology

(Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/blood-bottles/)

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11
Q

What is the rust top blood bottle used for?

A

Viral immunology

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12
Q

What are these?

A

Blood culture bottles
Anaerobic = purple top
Aerobic = blue top (fill first)

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13
Q

What is this?

A

Blood glucose monitoring kit

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14
Q

Recall some examples of how blood glucose monitoring kits are used

A
  1. Diabetic patients use CBG measurements to guide insulin dosing
  2. Acutely, CBG measurements are needed to guide treatment in diabetic crises, such as DKA, non-ketotic hyperglycaemia, hypoglycaemia and reduced GCS

(Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/blood-glucose-monitoring-kit/)

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15
Q

What are these?

A

Breast implants

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16
Q

Recall some possible complications of breast implants

A 
Rupture (tend to last 10-15 years, may rupture after this) 
Infection
Capsular contracture
Erosion
Migration
ALCL (anaplastic large cell lymphoma)

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/breast-implants/

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17
Q

What is this, and when might it be used?

A

Catgut suture
Rarely used nowadays but sometimes still used in formation of stomas and circumcision

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/catgut-suture/

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18
Q

What is this?

A

Catheter bag

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19
Q

What is this?

A

Seldinger central line insertion pack

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20
Q

Which veins might a central line be inserted into?

A

Subclavian

Internal jugular

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21
Q

What can central lines be used for?

A
  1. Delivery of medications/fluids that may be harmful orally or peripherally
  2. Blood tests and central venous pressures

(Examples: parenteral nutrition, emergency venous access, fluid resuscitation, infusion of irritant drugs, vasopressors, inotropes)

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/central-line-insertion-pack/

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22
Q

Recall some possible complications of central line insertion

A

Pneumothorax, sepsis, thrombosis and misplacement

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/central-line-insertion-pack/

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23
Q

What is this?

A

Chest drain bottle

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24
Q

What are the 2 types of chest drain bottle

A

The first type contains a small amount of water, which acts as a seal preventing air or fluid coming back up the tube into the chest.

Alternatively, an electronic chest drainage device may be used (a Thopaz machine), which can deliver suction (to help the lung re-expand) and allows the doctors to measure if there is any ongoing air leak between the lung and pleural cavity.

Source: NHS North Bristol Trust - https://www.nbt.nhs.uk/our-services/a-z-services/respiratory-medicine/respiratory-patient-information/chest-drain

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25
Q

Where does the chest drain act?

A

It drains air/blood/pus etc from the pleural space

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/chest-drain-bottle/

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26
Q

Instructions to pt about chest drain?

A
  • Bottle must always be below level of waist
  • May be asked to cough so HCP can check if it’s working
  • You will have a waterproof dressing over the suture site
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27
Q

What is this?

A

CSF manometer

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28
Q

What is a CSF manometer used for?

A

Identification of opening pressures

Measurement is in cm H2O

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/csf-manometer/

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29
Q

What are the ranges of normal opening pressures on LP?

A

10-18 cm H2O if patient is lying on their side

20-30 cm H2O when sat up

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/csf-manometer/

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30
Q

What is this and what is it used for?

A

Devers retractor

Retraction in abdominal surgery

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31
Q

What is this?

A

Diathermy (monopolar)

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32
Q

What are the possible complications of diathermy?

A
  • Risk of burning hands

- Risk of fire if alcohol wash used

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33
Q

What is this?

A

Disposable rigid sigmoidoscope

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34
Q

What is this?

A

Drainage bag that may be attached to NG tube/ abdo drain (passive)

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35
Q

What is this?

A

Endotracheal tube with tape and syringe

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36
Q

How is an endotracheal tube inserted?

A

Using a laryngoscope and bougie

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/endotracheal-tube/

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37
Q

How is positioning of an endotracheal tube checked?

A

Looking for symmetrical rising of the chest on ventilation, breath sounds bilaterally and no gurgling over the epigastrium indicating oesophageal intubation

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/endotracheal-tube/

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38
Q

What is this?

A

Epidural insertion pack (needle, catheter, catheter adaptor)

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39
Q

What is this?

A

Faeces sample pot

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40
Q

What is this?

A

Feeding NG tube

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41
Q

What is this?

A

5% dextrose solution

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42
Q

What is this?

A

Fluid giving set

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43
Q

What are these?

A

Forceps (toothed and non-toothed)

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44
Q

What is this?

A

Fracture plate

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45
Q

What is this?

A

Hemiarthroplasty

46
Q

What is this?

A

Hickman line - long term central venous line

47
Q

What is a Hickman line most often used for?

A

Longterm parenteral nutrition

48
Q

What is this?

A

Total hip replacement

49
Q

What is this?

A

Histology specimen pot

50
Q

What is this?

A

IM femoral nail - used to internally fix femoral shaft fractures

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/im-femoral-nail/

51
Q

What is this?

A

Instillagell - anaesthetic lubricant gel used for catheterisation

52
Q

Recall the guage of blue, pink and grey IV cannulas

A 
Blue = 22G 
Pink = 20G
Grey = 16G
53
Q

What is this?

A

Laparoscopic port

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/laparoscopic-port/

54
Q

What is this?

A

Laryngeal mask

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/laryngeal-mask/

55
Q

What are these?

A

Airway adjuncts (i Gels) = supraglottic

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/laryngeal-mask/

56
Q

What are laryngeal airways used for?

A

Supraglottic airway used prior to intubation

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/laryngeal-mask/

57
Q

What is the main difference in function between a laryngeal airway and an iGel?

A

Laryngeal airway has an inflatable cuff whereas iGels contain a thermoplastic elastomer (styrene) that moulds to the perilaryngeal framework with patient temperature

Medlearn says iGel prevents aspiration and LMAs don’t but I can’t find any other info to backt this up online

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/laryngeal-mask/

58
Q

Recall 2 risks of laryngeal airways

A

Inflation can cause pressure lesions and nerve palsies

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/laryngeal-mask/

59
Q

What is this and what is it used for?

A

Leg bag
For mobile patients with catheters

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/leg-bag/

60
Q

Recall 2 uses for mannitol

A
  1. Lower raised ICP
  2. Drive the urine output in a patient with obstructive jaundice to prevent hepato renal syndrome.

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/mannitol/

61
Q

How much oxygen can be delivered by nasal cannulae?

A

Usually used to carry 1-3L of oxygen per minute (can be upto 5L/min)
This delivers between 28-44% of oxygen

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/nasal-cannulae/

62
Q

Recall 2 complications of nasal cannulae

A

Nasal sores
Epistaxis

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/nasal-cannulae/

63
Q

What is this and what is it used for?

A

Nasal speculum - for examining inside nose

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/nasal-speculum/

64
Q

What is this and what is it used for?

A

Nasopharyngeal airway
Used as an airway in people with decreased GCS/decreased gag reflex

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/nasopharyngeal-airway/

65
Q

How should nasopharyngeal airway be sized?

A

Diameter should be sized against patient’s own diameter of little finger distal phalanx
Length should be determined by measuring from tip of nose to earlobe

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/nasopharyngeal-airway/

66
Q

What is one important contraindication for nasopharyngeal airway?

A

Suspected basal skull fracture

67
Q

How do you prevent inhalation of nasopharyngeal airway?

A

Put a safety pin at the end

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/nasopharyngeal-airway/

68
Q

What is this?

A

Nebuliser mask and chamber

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/nebuliser-mask-chamber/

69
Q

What are these?

A

Needle holders

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/needle-holders/

70
Q

Neurology: What size tuning fork is used for vibration of joints vs Rinne’s and Weber’s?

A

Joints: 128 Hz

Rinne’s/Weber’s: 512 Hz

71
Q

What are these?

A

Ethylon non-absorbable sutures

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/non-absorbable-sutures/

72
Q

What are non-absorbable ethilon sutures usually used for and why?

A

Usually used for percutaneous sutures as more likely to loosen over time than prolene non-absorbable sutures

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/non-absorbable-sutures/

73
Q

Recall 2 uses of prolene sutures

A

Vascular and bowel anastamosis

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/non-absorbable-sutures/

74
Q

What is this?

A

Non rebreather mask

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/non-rebreather-mask/

75
Q

What is the flow rate of a non-rebreather mask and what % oxygen can it deliver?

A

10-15L/min
Up to 90% oxygen

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/non-rebreather-mask/

76
Q

What is this?

A

Oropharyngeal airway

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/oropharyngeal-airway/

77
Q

How should oropharyngeal airways be sized?

A

Measure size from angle of mouth to angle of mandible

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/oropharyngeal-airway/

78
Q

How should oropharyngeal airways be inserted?

A

Upside down then rotated (apart from in children, where it is inserted the right way up)

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/oropharyngeal-airway/

79
Q

What is this?

A

PICC line
Inserted peripherally and advanced into a central vein

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/picc-line/

80
Q

Recall 3 uses of PICC lines

A

(Peripherally inserted central catheter)

  1. Long-term vascular access for blood sampling
  2. Chemotherapy administration
  3. Infusion of hyperosmolar solutions such as those used for total parenteral nutrition

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/picc-line/

81
Q

What is this?

A

Protoscope

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/proctoscope/

82
Q

What is this?

A

Ryles NG tool

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/ryles-ng-tool/

83
Q

What is a Ryles NG tool used for?

A
  • Primarily used for drip and suck
  • Can also be used to insert drugs or contrast into the GIT

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/ryles-ng-tool/

84
Q

What is this?

A

Scalpel

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/scalpel/

85
Q

What is this?

A

Seldinger chest drain insertion pack

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/seldinger-chest-drain-insertion-pack/

86
Q

What is this and what is it used for?

A

Self-retaining retractor

Holds wounds open for surgery

Source: https://www.vetorthopaedics.com/product/travers-self-retaining-retractor/

87
Q

What is this?

A

Self-inflatable bag valve mask

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/self-inflatable-bag-valve-mask/

88
Q

How much oxygen can a bag valve mask deliver?

A

100% oxygen at 10L/min and above

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/self-inflatable-bag-valve-mask/

89
Q

What is this?

A

Shouldered syringe

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/shouldered-syringe/

90
Q

What is a shouldered syringe used for?

A

Injection of haemorrhoids with 5% phenol in almond oil

Injection aided by protoscope and done under dentate line

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/shouldered-syringe/

91
Q

What is this?

A

Single lumen CVC

Source: https://www.exportersindia.com/product-detail/4-6mm-single-lumen-central-venous-catheter-3920463.htm

92
Q

Recall 3 drugs/ drug classes that need to be inserted via a central line

A

Amiodarone, chemotherapy and dopamine

https://medlearn.imperial.ac.uk/clinical-skills/glossary/single-lumen-cvp/

93
Q

What are these?

A

Specimen swabs

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/specimen-swabs/

94
Q

What are these?

A

Spinal needles

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/spinal-needles/

95
Q

What are these each used for?

A

Top one is traumatic needle for epidural
Bottom one is ‘pencil top’ needle - needle of choice for LP as much lower risk of post-LP headache

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/spinal-needles/

96
Q

What is this and how is it used?

A

Stiff neck cervical collar

Used in conjunction with sand bags and tape to immobilise neck in trauma patients

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/stiff-neck-cervical-collar/

97
Q

How are stiff neck cervical collars sized?

A

By measuring the number of fingers from the clavicle to the angle of the mandible, and this is then compared to the measuring peg on the stiff neck collar

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/stiff-neck-cervical-collar/

98
Q

What is this? Recall 3 patients who might have this

A

Stoma bag - mainly used in patients who’ve had ileostomy, colostomy or ileal conduit

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/stoma-bags/

99
Q

What is this?

A

Surgical chest drain

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/surgical-chest-drain/

100
Q

What is this?

A

Swan-Ganz catheter

Source: https://www.edwards.com/gb/devices/Hemodynamic-Monitoring/swan-ganz-catheters

101
Q

What can Swan Ganz catheters be used for?

A

Pressures in heart, PAWP and cardiac output

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/swan-ganz-catheter/

102
Q

What is this?

A

Synthetic absorbable suture

Source: https://www.sciencedirect.com/topics/biochemistry-genetics-and-molecular-biology/calcium-stearate

103
Q

What is this?

A

Tracheostomy

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/tracheostomy/

104
Q

What is this?

A

Triple lumen CVC

Source: https://tragate.com/product/three-lumen-central-venous-catheter-triple-lumen-breathing-anesthesia-and-emergency-apparatus-139571

105
Q

What is this and what is it used for?

A

Trucut needle - for taking biopsies for histological specimens

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/trucut-needle/

106
Q

What are these?

A

Urinary catheters - centre is Foley (up to 28 days) and left is longterm catheter

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/urinary-catheter/

107
Q

What is this and what is it used for?

A

Three way catheter
Used in haematuria for bladder washout and irrigation

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/urinary-catheter/

108
Q

What is this and what is it used for?

A

Urometer drainage bag
Measures urine output

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/urometer-drainage-bag/

109
Q

What is this?

A

Venturi mask and valves

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/venturi-mask/

110
Q

Recall the flow rate and % oxygen for each venturi valve (blue, white, yellow, red + green)

A

–BLUE = 2-4L/min = 24% O2
(Blue rhymes with two, 2-4L –> 24%)

–WHITE = 4-6L/min = 28% O2
(White = 5 letters = 4-6L/min)

–YELLOW = 8-10L/min = 35% O2
(Yellow is a happy colour = on cloud 9 = 8-10L/min)

–RED = 10-12L/min = 40% O2
(Red = colour of raspberries = 11 letters = 10-12L/min)

–GREEN = 12-15L/min = 60% O2
(Green rhymes with fifteen)

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/venturi-mask/

111
Q

In what clinical scenario are venturi masks most often used?

A

In COPD patients where it is important not to over-oxygenate the patient

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/venturi-mask/

112
Q

VAC drain?

A

Instruments for PACES (1 decks)

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