Oropharyngeal airway
What is the indication for an oropharyngeal airway?
Emergency airway for impaired level of consiousness. It lifts the tongue off the posterior pharyngeal wall
What are the complications of an oropharyngeal airway?
1. Trauma to soft palate
2. Airway hyperreactivity
3. Gagging
How do you use an oropharyngeal airway?
It is inserted into the mouth upside down and rotated within the oral cavity
What is the name of this?
Tracheostomy (temporary)
What is the indication of a tracheostomy tube?
Allows more efficient ventilation in the intensive care unit
Patients that have an upper airway obstruction/ severe maxfax trauma
How do you use a tracheostomy?
Insertion into a tracheostomy stoma which is a transverse incision 1cm above sternal notch
What are the complications of a tracheostomy?
Immediate - Bleeding, trauma to oesophagus
Early - Tube displacement
Late - Tracheoesophageal fistula
What is the name of this?
Self Inflatable Bag-valve Mask
What are the indications of using a bag-valve mask?
Patients with respiratory failure
Patients unable to protect their own airway
Patients undergoing anaesthesia in elective procedures
What are the complications of a bag-valve mask?
Gastric insufflation which can lead to vomiting and aspiration
What is the name of this?
Hickman line
How would you use a Hickman line?
Insert tube through the subclavian vein though subcutaneous tunnel
What are the indications of a hickman line?
IV meds for long-term use
Long term parenteral nutrition
Regular chemotherapy
Blood sampling
What are the complications from a Hickman line?
Infection
Incorrect insertion
Damage to carotid artery
Pneumothorax
Thromboses
What is the name of this?
Hartmann's solution
What are the indications of hartmann's solution?
Provide normal daily fluid to a patient or supplement electrolyte loss
It is typically used initially in trauma in ATLS guidelines
What is the name of this?
Vacuum drain
What are the indications of a vacuum drain?
Commonly used post-breast surgery
Reduce incidence of seroma complications post surgery
What are the complications of a vacuum drain?
Occlusion by a blood clot or tissue
Haematoma
Infection
What is the name of this?
Laryngoscope
What is the use of a laryngoscope?
Place in left hand and use guide wire in right hand, to visualise larynx by displacing tongue laterally
What are the indications of a laryngoscope?
Aid endotracheal intubation
Visualisation of larynx to aid diagnosis of problems/ strictures
What are the complications of laryngoscope?
Soft tissue injury
Laryngeal/ Pharyngeal scarring
Ulceration
What is the name of this?
Proctoscope
What is a proctoscope used for?
To visualise the anal canal and lower rectum and is lubricated and inserted in the left lateral position
What are the indications of a proctoscope?
Hemorrhoids
What is the name of this?
Intramedullary femoral nail
What are the indications of a intramedullary femoral nail?
Femoral shaft/ long bone fractures
What are the complications of an intramedullary nail?
Infection
Malposition
Implant displacement
What is the name of this?
Absorbable sutures
What are the 2 types of absorbable sutures?
Vicryl
Monocryl
What are the indications for absorbable sutures?
Deep tissue repair
Tissue that heals rapidly repair eg. Small bowel anastamosis, skin grafts
What are the complications of absorbable sutures?
Fraying
Local tissue inflammation
Infection
Adhesions
What is the name of this?
endotracheal tube
How do you use an endotracheal tube?
Tube is inserted into trachea via oropharynx using a laryngoscope and then balloon is inflated using side port
What are the complications of an endotracheal tube?
Inappropriate positioning
injury to larynx
pneumothorax
atelectasis
What is the name of this?
Devers retractor
What are the indications of a Devers retractor?
Open abdominal surgery
What are the complications of a devers retractor?
Injuries to other organs during the operation
What is the name of this?
Trucut needle
What is the name of this?
Drainage bag
What are the complications of a trucut needle?
Haemorrhage
Tumour seeding
infection
What are the indications for a trucut needle?
Take histological biopsies from specimens eg. breast lump
What is the name of this?
Central line insertion pack
What are the indications of inserting a central line?
Parenteral fluids/ medications
emergency venous access
fluid resus
How would you perform a central venous insertion?
Find internal jugular vein via ultrasound
Use ultrasound to guide needle into vein
Then place guide wire in vein
Then place dilator in skin
Nip the skin with scalpel
Insert catheter whilst drawing guide wire out
What are the complications of inserting a central venous line?
Pneumothorax
Sepsis
Misplacement
Thrombosis
What is the name of this?
CSF manometer
What does a CSF manometer do?
Measure the opening pressure of the CSF
What are the ranges for the opening pressures?
10-18cm H2O when lying down
20-30cm H2O when standing up
What is the name of this?
Disposable rigid sigmoidoscope
How would you use a sigmoidoscope?
have the patient lying in left lateral position
perform DRE
Lubricate and insert sigmoidoscope
pump air into rectum to see rectal wall
Can be used to take biopsies
What are the complications of a sigmoidoscope?
Continue bleeding
Inflammation of rectum
What is the name of this?
Epidural Insertion pack
What are surgeries are indications for epidural?
Childbirth
Gynae surgeries
Hip and Knee surgeries
What are the complications of an epidural?
Haematoma
Misplacement
Damage to local tissue
What are the components of an epidural insertion pack?
Epidural needle
Epidural catheter
Epidural catheter adapter
What is the name of this?
Nasogastric feeding tube
What is an NG feeding tube used for?
Long term enteral feeding in patients
How is a NG tube inserted?
through the nose
advancing down the pharynx
Ask the patient to swallow
Check correct positioning by taking aspirate/ CXR
If in correct position remove guide wire
What are the complications of NG tube insertion?
Nasal ulceration
Malpositioning
Reflux
Aspiration
When should a non-toothed forcep be used over a toothed forcep?
When in the peritoneal cavity
What is the name of this?
Fracture plate
When is a fracture plate used?
to hold pieces of bone that are too small together
What is the use of gelofusin?
it is an artificial colloid solution that raises the oncotic pressure - which is useful in shock or trauma
What is the name of this?
Hemiarthroplasty prosthesis
When is a hemiarthroplasty used?
Intracapsular neck of femur fractures
What is the use of instillagel?
it contains local anaesthetic and lubricant gel for male and female cathetherisation
What is the name of this?
Laproscopic port
What is the name of this?
Laryngoscope
What is the indication for laryngoscope?
Aid intubation
Visualisation of larynx
What is the complications of laryngoscope?
Soft tissue injury
Laryngeal and pharyngeal scarring
Abscess
What is the name of this?
Laryngeal mask
What is the name of this?
iGel
When is a laryngeal mask/igel indicated?
They are the step prior to intubation
Cardiac arrest
Elective procedures
Pre hsopital airway management
How to use an igel?
Put in standing behind patient with the number on the igel facing towards you
What are the complications of a laryngeal mask/ airway?
Pressure lesions
Nerve palsies
Risk of aspiration
What is the name of this?
Leg bag
What are the complications of a leg bag?
Skin irritation
Risk of restricting lymphatic flow/ blood drainage
What is the name of this?
Monopolar diathermy needle
What is a monopolar diathermy needle used for?
Cut or coagulate tissue with high frequency current
What are the complications of monopolar diathermy needle?
Thermal injury to surrounding tissue
Contrainidcated in those with pacemakers
What is the name of this?
Nebuliser mask
What is a nebuliser mask used for?
Used to deliver liquid medication to lungs via inhalation
How do you use a nebuliser mask?
Pour liquid into medicine cup and attach medicine cup to the mask
What are the complications of using a nebuliser mask?
infection if nebuliser isnt fitted properly
What is the name of this?
Non rebreather mask
What is a non breather used for?
Used for unwell for sats 85-90%
What are the complications of using a non-breather mask?
Dry mouth
Oxygen toxicity
What is the name of this?
Oxygen tubing
What is the name of this?
Seldinger Chest drain insertion pack
What is the complications associated with an oxygen tube?
Trip hazard due to cable slack
What are the indications of chest drain insertion?
Tube may be dislodged or fall out
Tube may be congested
Infection may occur at the site
What is a chest drain used for?
remove air, fluid and pus that has collected in the pleural space
What is the name of this?
Spinal needle
What are the complications of a stoma bag?
irritation of the skin surrounding the stoma
Leakage of the stoma bag
What is the name of this?
Two way urinary catheter
What is the name of this?
Three-way urinary catheter
What are the complications of a urinary catheter?
Infection
Urethral injury
What is a two way urinary catheter used for?
To relieve urinary retention
Short term drainage of bladder
What is a three-way catheter used for?
Irrigate bladder to prevent/ manage blood clots in bladder
relieve short term urinary retention
Short term drainage of bladder
What is the name of this?
Swan ganz catheter
What is a swan Ganz catheter used for?
Used to measure the pressures in the heart
Measure cardiac output
Measure pulmonary wedged pressure
When is a swan ganz catheter used?
In intensive care setting
What are the complications of a swan ganz catheter?
Infection
Pneumothorax
Thrombosis
Misplacement
What is the name of this?
Urometer Drainage bag
What is a urometer drainage bag used for?
Measuring urine output per hour and used during and post surgery to assess fluid status
What is the complication of a urometer drainage bag?
Ascending infection
When are compression stockings contraindicated?
In people with peripheral arterial disease