Instruments

Question 1

Tracheostomy

Answer 1

Definitive airway as it remains in trachea and protects lungs from aspiration. Temporary vs permanent

Indications: ITU ventilation, upper airway obstruction

Insertion: In theatre by surgical cricothyroidectomy

Complications:
Immediate: bleeding, pneumothorax, RLN injury

Later: infection, erosion of trachea, trachea oesophageal fistula

Question 2

Chest drain bottle

Answer 2

Attaches to chest drain, seen this in Tx of persistent PTX

Contains prime level, filled with sterile water acts as a seal

Place below level of chest, you will see bubbling as air leaves pleural space and swinging

Inerted via STERILE procedure in safe triangle using Seldinger technique:
Base of axilla
Lat dorsi
Pec major
5th ICS

Check position with CHEST XRAY

Question 3

Sutures

Answer 3

Braided or monofilament
Natural or synthetic
Absorbable or non absorbable

Braided = silk (natural, NOT absorbable), Vicryl (synthetic,absorbable)
Monofilament = monocryl (synth, absorbable), ethilon (synthetic, non absorbable)

CRYL = ABSORBABLE

Question 4

O2 delivery

Answer 4

Nasal cannule 1-4L/min
Simple face mask 6-10L/min
Non rebreathe 15L/min

Question 5

Spinal needle

Answer 5

L4-L5

CIs: raised ICP, coagulopathy, etc