Procedural skills

Question 1

How do you put in an NG-tube?

Answer 1

• normal gloves
• prepare and cut tapes (3 pieces, 1 of them split)
• measure length of tube required (nose to ear, ear to xiphoid)
• insert via nose (stop if bunny face)
• when reaches back of nasopharynx, proceed carefully
• when reach larynx (resistance), ask patient to swallow
• or rub front of neck to stimulate swallowing
• continue until desired length

Check if it’s in correct position:

• push air in and auscultate
• suction and pH paper
• X-ray
• tape the tube

Question 2

Taking ABG?

Answer 2

• usuals
• Alan’s test (compress radial and ulnar, clench fist -> white, then release ulnar -> pink)
• swab
• 45 degrees, hold like a dart
• auto fills up due to art. pressure
• pull out, apply pressure, needle stab to cube
• remove air bubble in syringe (careful with blood dripping), seal syringe
• label

Question 3

Inserting IDC catheter?

Answer 3

STERILE *
Size: male (16 18), female (12 14)
Tip: straight, angled
2-3 ends (balloon, drainage, flush)

Prep:

• open pack, catheter, gels, water for balloon
• connect water syringe to catheter (10ml)
• sterile gloves
• saline and gauze to clean

Procedure:

• put LIDOCAINE gel into urethra, wait
• gel on IDC, insert fully
• urine flushes out when in
• fill balloon
• connect to bag

Question 4

Blood cultures?

Answer 4

• wipe cap of bottle

- Aerobic first then anaerobic

Question 5

BLS?

Answer 5

Danger
Response (clav/sternal rub)
Send for help
Airway (head tilt, chin lift) (gadel: incisors to angle) (Nasopharyngeal (nose to ear)) (LMA: laryngeal mask airway)
Breathing - look, feel, listen
Compression- 1/3 chest depth, 30:2
Defib

Newborn
A - neurtal head position
C - two fingers, 15:2

Paeds
A- slight head tilt
C- as adults

Question 6

LMA insertion?

Answer 6

• deflate
• lubricate posterior surface
• insertion: push against roof using index finger and continue until pressure is met
• inflate mask

Question 7

LMA insertion?

Answer 7

• deflate
• lubricate posterior surface
• insertion: push against roof using index finger and continue until pressure is met
• inflate mask

Question 8

Intubation?

Answer 8

Equipment: blade, endotracheal tube, syringe
- connect tube and syringe

• insert blade until see epiglottis
• align handle 45 degrees to horizontal
• apply vertical force until vocal folds are visible
• insert tube with right hand until marking passes vocal folds
• inflate
• give oxygen
• auscultate both lungs
• tie in position and connect to ventilation machine

https://www.youtube.com/watch?v=CrLJwwSnUws