Surgical instrument Flashcards
Contraindication of NG tube insertion
- Esophageal stricture: due to risk of esophageal perforation
- Basilar skull fracture/ facial fracture: potential for intracranial misplacement
How to estimate the length of tube to be inserted
Points to measures:
- bridge of the nose
- tragus of the ear
- point halfway between the xiphisternum and the navel
How to check correct placement of NG tube
- Aspirating a sample of gastric content to test with litmus
- Auscultating the epigastrium while injecting air through the tube
- Obtaining an x-ray
Indication for short-term urinary catheterization
- Relief of acute retention of urine
- Bladder washout
- Cystourethrogram
- Administration of intra-vesical drugs
- Urine output monitoring
Indication for long-term indwelling catheterization
- Refractory bladder outlet obstruction
- Chronic retention of urine
- Incontinence
Contraindication of urinary catheterization
- Presence of urethral injury
- Urinary tract infection
Complication of urinary catheterization
- Infection
- Stricture formation
- Creation of false passage
- Severe bladder spasm due to irritation of the bladder
Contraindication for chest tube insertion
- Infection over insertion site
- Uncontrolled coagulopathy
Triangle of safety for chest tube insertion
- Lateral border of pectoralis major
- 5th intercostal space
- Lateral border of latissimus dorsi
Complication of chest tube insertion
- Laceration or puncture of the intrathoracic organ
- Damage to the intercostal nerve, artery or vein
- Subcutaneous emphysema
Type of surgical drain
- Open vs close
- Active vs passive
- Silastic (inert, minimal tissue reaction) vs rubber (red rubber induce intense tissue reaction, eg: form tract in biliary T-tube)
When to remove a drain
- Once the drainage has stopped or
- < 25ml/ day
Indication for NG tube
- Gastrointestinal decompression for ileus or bowel obstruction
- Administration of medication for who cannot swallow or neurological impaired
- Enteral nutrition
- Stomach lavage
Complication of NG tube placement
- Malposition, coiling or knotting
- Pharyngeal and pyriform sinus misplacement
- Esophagitis/ esophageal stricture: due to impaired lower esophageal sphincter, making the patient more susceptible to reflux of gastric contents
- Perforation of pulmonary structures or GIT
Uses of mayo curved scissors
- Used to cut thick tissues such as those found in uterus, muscles, breast and foot
- Used for removing bandages and trimming thermoplastic
Indication of urinary catheter
> Diagnostic
- Cystourethrogram
- Urine output monitoring
> Therapeutic
- Relief acute retention of urine
- Bladder washout
> Prophylactic
- Drain the bladder to improve access to the pelvis in urological or pelvic surgery
Complication of urinary catheter
- Infection
- Stricture formation
- Creation of a false passage due to wrong technique of insertion
- Irritation of the bladder may cause severe bladder spasm
Features of Babcock forceps
- Ring-handled and ratcheted forceps
- Circumferential jaw
- Horizontal serration across the edge of the tip of the jaw
