SURGERY
1. 3-way foley catheter(latex/silicon)
a) Parts and function of catheter:
Bladder opening
Balloon : inflated in the bladder to hold catheter in place
Balloon port : to inflate and deflate balloon with fluid
Urine drainage port: to drain urine from bladder
Irrigation port: for medication or irrigation of normal saline
b) Size: the size is the diameter measure in French unit(Fr). Size ie 10Fr.
c) Indication /contraindication/complication
INDICATION CONTRAINDICATION COMPLICATION
Therapeutic: Urethtral injury Ascending
Perioperative Suspected urethral injury: infection
monitoring of u/o Inability to void Urethral
Acute urinary retention Unstable pelvic fracture trauma
Incontinence Blooad at meatus Urethral
Fluid management of Scrotal hematoma stricture
patient Perineal echymosses
Irrigation of bladder High riding postate
after surgery
Also used as
gastrostomy tube
Diagnostic:
Urine for culture
Urodynamic studies
Cystourethrography-
instilll contrast
retrogradely
2. Nasogastric tube
Salem sump
Levin tube(one lumen) tube(double lumen)
Levin tube Salem sump
single lumen double lumen,
suction & feeding radiopaque
1st lumen: suction of
gastric cintents
2nd lumen: blue
extension(pig tail)
open to room air to
maintain continuous
flow of atmospheric
air into stomach
suction
Measuring NG tube
insertion
a) Parts:
Proximal end(outer)
Distal end(inner)
b) Indication & contraindication &complication
INDICATION CONTRAINDICATION COMPLICATION
Decompression of Severe facial and Epistaxis
stomach d/t neck fractures Erosions in
IO,p.ileus,UGIB Esophageal varices nasal cavity
Analysis of gastric Bleeding disorder and
content hx of gastric by pass nasopharynx
Drug surgeryknown Esophageal
administration(fine esophageal stricture penetration
bore tube) Intracranial
Enteral feeding insertion
aspiration
c) how to know measure for insertion ?
from tip of nose across cheekbone to tip of ear to bottom of
xiphisternum
roughly 40cm from nose
d) how to check correct placement?
Syringing the air down the tube while listening for bubbling over
epigastrium
Aspirate from tube – using pH paper if tested pH <4 (only useful if
patient isn’t taking PPI/antacids) Aspirating gastric content turn
litmus blue to red
CXR- in stomach below diaphgram
3. T-tube
a) Indication:
After removal of gallbladder(cholecystectomy) or a portion of bile
duct(choledochostomy)
b) Vertical limb (cross head) placed
in CBD while the horizontal limb
is connected to a bile bag
c) Time of removal: After 10 days
d) Therapeutic use:…………………
4. Sengstenken BlackmoreTube
a) Indication: to control esophageal bleeding
b) complication :
ischemic necrosis of esophageal mucosa
aspiration pneumonia
c) function of each lumen:
Esophageal balloon: inflate esophageal balloon
Esophageal aspiration: aspirate saliva and prevent aspiration
pneumonia
Gastric balloon: inflate gastric balloon
Gastric aspiration: decompress the stomach content
d) How to inflate the balloon:
Esophageal balloon: Connect to the BP set and inflate with pressure
30-40mmHg
Gastric balloon: Inflate with 200 ml water for injection (give
approximately 60 mmHg pressure)
Deflate esophageal balloon 8 minutes every 5 hours (reduce risk for
esophageal necrosis)
Reduce pressure in esophageal balloon to 25mmHg by 12 hours
Do not left the tube for more than 24 hours.
5. STOMA
Loop ileostomy
End ileostomy
Loop colostomy
a) DEFINITION:surgical procedure that involves connecting part of bowel
onto the anterior abdominal cavity
b) Examination of stoma:
Site Bag: contents,
Caliber:twin/wide surrounding skin
Number of lumens Any parastomal hernia
Functionaing/healthy Inspect perineum
Color/surface
c) Stoma
RUQ: LUQ:not usually, but if so, for same reasons as
- Defunctioning transverse LLQ:
colostomy: two lumens but not - End colostomy
spouted, flushed to skin - Double-barrelled
instead. - Loop
RLQ: LLQ:
- Usually spouted. Small bowel - End colostomy: resection of
contents are irritant: stands rectum/sigmoid/Hartman’s/AP
clear of skin resection
- End ileostomy: after total - Double-barrelled: after procedure if
colectomy unsafe to join but distal end long
- Loop ileostomy: temporary enough to be brought to surface
defunctioning - Loop: apex of sigmoid brought to
surface
d) Complications:
METABOLIC ANATOMICAL
Renal calculi Parastormal hernia
Electrolyte imbalance Prolapse ileostomies
Parastormal deformities
