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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_848_Библиотеки_им_академика_М_И_Перельмана
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Данная книга находится в списке для перевода на русский язык сайта https://meduniver.com/
SECTION
NON-METallIC SurgICal ObjECTS
CHAPTERS
Chapter 7: Catheters
Chapter 8: Tubes
Chapter 9: Drains
Chapter 10: Drip Sets
Chapter 11: Bags
Chapter 12: Sutures
Chapter 13: Miscellaneous
CaThETErS
Данная книга находится в списке для перевода на русский язык сайта https://meduniver.com/
FOLEY BALLOON CATHETER
CHAPTER
7
alient Features
S
Made up of latex/silicone
Size and capacity is mentioned on main or side channel
Circumference (in mm) = No. of catheter in French
scale/3
E.g. 18 Fr catheter - Approx. 6 mm diameter
Usually size 14 Fr is preferred for adult females and 16 Fr
for adult males
A) Two ways Foley catheter:
¾ Main channel for drainage of urine
¾ Side channel used to inate the balloon so as to make
it self-retaining
B) Three ways (Tri-way) Foley catheter:
¾ Additional third channel for either irrigation or
drainage in major surgeries like transurethral resection
of prostate (TURP)
ses
U
To relieve urinary retention
Used in major surgeries that require prolong
immobilization
Following urethroplasty
To monitor input and output in critically ill patients
To monitor urine output in renal failure patients
To administer intravesical chemotherapy for bladder
carcinoma
Non-urologic uses include:
To administer dye while doing distal loopogram
May be used in feeding jejunostomy for enteral feeding
To control posterior nasal epistaxis
Sterilized by- Gamma irradiation.
36
Section 2: Non-Metallic Surgical Objects
CONDOM CATHETER
alient Features
S
It is a condom-like device placed over penis with a
drainage tube attached to it to allow passage of urine into
a storage bag.
ses
U
Patients with urinary incontinence
Patients with altered mental status who have a tendency
to pull Foley catheter (risk of urethral injury).
isadvantages
D
Need to be changed daily
Can cause preputial skin infections
Expensive.
MALECOT CATHETER
Данная книга находится в списке для перевода на русский язык сайта https://meduniver.com/
Chapter 7: Catheters
37
alient Features
S
Self-retaining catheter
Dilated winged end helps in its proper retention
Made up of red rubber.
ses
U
For draining empyema thoracis
As a feeding gastrostomy tube
To drain urinary bladder after transvesical prostatectomy
To drain liver abscess.
NELATON CATHETER
ethod
M
The tube is straightened with the help of introducer and
left in cavity
Once introducer is removed, ower shaped end regains its
original shape, thus becomes self-retaining.
ey Points
K
Rarely used nowadays.
COLOR CODING
Size - Color code Size - Color code
6 - Green 16 - Orange
8 - Blue 18 - Red
10 - Black 20 - Yellow
12 - White 22 - Violet
14 - Green 24 - Blue
alient Features
S
Made up of non-irritant medical grade P.V.C compatible
with catheter lubricants
Frozen surface tubing for super smooth intubation
Distal end is coned for non-traumatic introduction with 2
lateral eyes
Proximal end has universal funnel shaped connection for
extension.
ses
U
For short-term bladder catheterization
As drains in abdominal surgeries
To dilate partial urethral strictures.
38
Section 2: Non-Metallic Surgical Objects
SUCTION CATHETER
alient Features
S
Disposable tube whose one end is connected to a suction
machine and the other end is used for suction
A plastic tip can be attached at suction end.
ses
U
For suction of blood, pus and uid in various surgeries like
laparotomy, etc.
Chapter 7: Catheters
Данная книга находится в списке для перевода на русский язык сайта https://meduniver.com/
CENTRAL VENOUS CATHETER
A central venous catheter is inserted into one of the central veins, usually in superior vena caval distribution.
39
ses
U
To measure central venous pressure (Right atrial pressure)
to monitor uid therapy
To administer long term intravenous antibiotic/parenteral
nutrition/inotropes
alient Features
S
May have 1-4 lumens
Parts:
¾ 1 catheter
¾ Guide wire
¾ Y shaped introducer needle
¾ Dilator
¾ Scalpel
¾ Suture wing
¾ Syringe 5 ml
¾ Hypodermic needle (20 G)
¾ Needle sponge.
To administer chemotherapy drugs
For frequent dialysis.
ommon sites of insertion
C
Internal jugular vein (Right and Left)
Subclavian vein (Right and Left).
ey Points
K
Procedure has been mentioned in the last section of this
book.
Tubes
NASOGASTRIC TUBE
Chapter
8
Chapter 8: Tubes
Данная книга находится в списке для перевода на русский язык сайта https://meduniver.com/
alient Features
S
One-meter long
Tip has lead shot inside it (radiopaque) to know the exact position of tube in radiograph
Holes present at end allow suction of GI contents
3 marks present
¾ At 40 cm - R.T at gastroesophageal junction
¾ At 50 cm - R.T in body of stomach
¾ At 60 cm - R.T at pylorus of stomach.
ses
U
A) Diagnostic indications:
Hollander’s test to nd success of vagotomy
Gastric aspirate for acid studies
To diagnose pyloric stenosis (If fasting 12 hours gastric output > 200 ml)
To diagnose TEF
To determine rate of gastric hemorrhage.
B) Therapeutic indications:
In intestinal obstruction to decompress stomach
In perforation peritonitis to limit peritoneal contamination
Used postoperatively in bowel surgery
Used for gastric lavage in cases of poisoning
To instill sclerosant / vasopressin drip in gastric bleed.
C) Feeding purpose:
In comatose patients for feeding
Following maxillofacial surgeries
In patients who can’t take orally.
↓
41
ethod
M
Explain the procedure to patient
Stand on patient’s right side holding his head in your left hand exing it
Take Ryle’s tube lubricated with lignocaine jelly and insert it through nostrils slowly and ask patients to swallow it
Check the position by pushing air via syringe through Ryle’s tube and hearing with a stethoscope at epigastrium or by an X-ray
abdomen
Fix it at nostrils via tape.
ey Points
K
Color coding of nelaton catheter and nasogastric tube is almost same.
42
Section 2: Non-Metallic Surgical Objects
INFANT FEEDING TUBE
alient Features
S
Similar to Ryle’s tube with some dierences-
Smaller in size
No lead shot
Used in small children and infants
Tube marked at 20 cm from distal tip.
ethod
M
First determine adequate length of tube to be introduced
in each case
Measure distance from tragus to angle of mouth plus the
distance between tragus to xiphisternum
Remaining procedure is same as Ryle’s tube insertion.
COLOR CODING
Size in FG - Color code Size in FG - Color code
4 - Red 8 - Blue
5 - Gray 9 - Orange
6 - Green 10 - Black
7 - White
ses
U
Same as that of Ryle’s tube
Also used for urethral catheterization in pediatric patients.
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