Surgical Tubes and Drain Flashcards

1
Q

Procedure for tube insertion (14 steps)

A
  1. Consent
  2. Prepare instruments
  • Tube, Sterile glove, Antiseptic solutions, Sterile drapes, Blade and artery forceps
  1. Check the tube
  • Type, size, expiry date
  1. Check balloon patency if the tube/catheter has balloon.
  2. Cleaning
  • Clean the area using antiseptic solution (povidone iodine , cetrimide or chlorhexidine for
    perineum)
  1. Draping
  • “Square” draping or “hole” draping
  • Using linen or paper

7)Local anaesthetic

With 1% lignocaine, if skin incision is needed

  1. Lubricant

(lignocaine gel, KY gel) if to insert catheter through natural orifice.( eg: Continuous Bladder
Drainage )

  1. Insert the tube
  2. Check proper placing of tube.
  3. Connect tube/catheter to reservoir
  4. Anchor tube to skin
  5. Dressing as necessary
  6. Monitoring
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2
Q

Chest tube
-indication
-contraindication
-complication
-insertion technique

A
  • Indications

Pleural effusion, Pneumo/haemo/chylothorax, empyema

  • Contraindications

Pleural space adhesion, refractory coagulopathy

  • Complications

-Injury to the lung/heart/aorta/liver/spleen/diaphragm, reexpansion pulmonary
edema, infection

  • Insertion technique
    Supine position
    Sterile technique
    Site: 5th ICS, just anterior to midaxillary line or “safety Triangle”
    LA 1% lignocaine
    Skin incision
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3
Q

Nasogastric Tube
-indication
-contraindication
-complications
-insertion technique

A
  • Indications

Gastric decompression, enteral feeding, administration of medications, gastric lavage

  • Contraindications

Base of skull fracture, severe facial injury, esophageal obstruction, gastric bypass.

  • Complications

Nasal bleeding, esophageal perforation, nasal and esophageal erosion, aspiration
pneumonia, intracranial penetration

  • Insertion technique

Upright position
Sterile technique
Lubricant gel
Insert through nostril
Tests for tube placement: Aspiration stomach content,
guggling sound upon injecting air, litmus paper, x-ray.

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4
Q

T tube
-indication
-contraindication
-complications
-insertion technique

A

Indication
-following exploration of CBD
-splint for CBD
-choledocholithiasis
Contraindication
-charcot’s triad (pain ,fever ,jaundice)
-pain or leakage after clamping
Complication
-occlusion
-dislodgment biliary peritonitis
-pancreatitis ,cholangitis
Insertion
-during open CBD exploration

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5
Q

Percutaneous Transhepatic Biliary Drainage (PTBD tube)
-indication
-insertion technique

A
  • Indication: To decompress biliary system
  • Inserted by radiologist under ultrasound guided
  • May be replaced by biliary stenting later, for long
    term management of biliary obstruction
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6
Q

Sengstaken-Blackmore Tube
-indication
-insertion technique

A
  • Indications
    Bleeding esophageal varices
  • Insertion technique
    Aseptic technique
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7
Q

Foley’s catheters
-indications
-contraindications
-complications
-insertion technique

A
  • Indications

Comatose/paralysed, urine output monitoring, urinary retention etc

  • Contraindications

Urethral injury / stricture

  • Complications
  • UTI, urethral injury, retained tube, false passage, bleeding
  • Insertion technique

Supine position
Sterile technique
Lubricant gel
Insert while penis in vertical position

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8
Q

How many kinds of drains we have ? and what it is ?

A

2 ; rubber and silicon

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9
Q

We have 2 types of drain . Name it .

A

Passive and Active drain

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10
Q

Name the passive drains

A

Rubber drain (most common)
Penrose drain
Sump drain

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11
Q

Name the active drain.

A

Jackson Pratt drain
-a suction drainage device used to pull excess fluid from the body by constant suction
Redivac drain
-high negative
pressure drain used for larger draining amounts.

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12
Q

Gastrostomy tube

A
  • Tube inserted through a small incision in the abdomen or endoscopically (PEG tube) in to the
    stomach.
  • Tube used:
    – Malecot’s catheter
    – Foley’s catheter
    – PEG tube(Percutaneous
    Endoscopic Gastrostomy)
  • Indications
    – Enteral feeding: for long term feeding in patient who cant tolerate oral feeding , but has normal
    gut function.
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