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Instruments for PACES > Instruments for PACES station > Flashcards

Instruments for PACES station Flashcards

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1
Q

What is this?

A

Absorbable sutures

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2
Q

Compare the 2 types of absorbable sutures

A

Monocryl – monofilament, increased throws for stable knot (9).

Vicryl – polyfilament is braided and so is less likely to loosen at the surgical knot, less throws (3) but has increased fraying issues and local tissue inflammation and is more susceptible to infection

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/absorbable-sutures/ + https://geekymedics.com/suture-material/

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3
Q

What is this?

A

Arterial blood gas syringe

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4
Q

What information do you get from an ABG?

A
  • pH
  • pO2 and pCO2 – for identification of respiratory failure (arterial)
  • Bicarbonate
  • Lactate
  • Hb
  • Na+/K+

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/arterial-blood-gas-syringe/

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5
Q

What does the purple blood bottle contain, and what is it used for?

A

EDTA
Haematology

(Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/blood-bottles/)

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6
Q

What is the pink blood bottle used for?

A

EDTA
Group and Save and cross match

(Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/blood-bottles/)

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7
Q

What does the blue bottle contain and what is it used for?

A

Buffered sodium citrate
Used for coagulation screening

(Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/blood-bottles/)

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8
Q

What does the gold blood bottle contain and what is it used for?

A

Silica particles and serum separating gel

Used for various including U&E and LFT

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9
Q

What does the grey blood bottle contain and what is it used for?

A

Sodium fluoride and potassium oxalate

Used for glucose and lactate

(Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/blood-bottles/)

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10
Q

What does the red blood bottle contain and what is it used for?

A

Silica particles
Sensitive tests eg toxicology

(Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/blood-bottles/)

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11
Q

What is the rust top blood bottle used for?

A

Viral immunology

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12
Q

What are these?

A

Blood culture bottles
Anaerobic = purple top
Aerobic = blue top (fill first)

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13
Q

What is this?

A

Blood glucose monitoring kit

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14
Q

Recall some examples of how blood glucose monitoring kits are used

A
  1. Diabetic patients use CBG measurements to guide insulin dosing
  2. Acutely, CBG measurements are needed to guide treatment in diabetic crises, such as DKA, non-ketotic hyperglycaemia, hypoglycaemia and reduced GCS

(Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/blood-glucose-monitoring-kit/)

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15
Q

What are these?

A

Breast implants

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16
Q

Recall some possible complications of breast implants

A 
Rupture (tend to last 10-15 years, may rupture after this) 
Infection
Capsular contracture
Erosion
Migration
ALCL (anaplastic large cell lymphoma)

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/breast-implants/

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17
Q

What is this, and when might it be used?

A

Catgut suture
Rarely used nowadays but sometimes still used in formation of stomas and circumcision

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/catgut-suture/

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18
Q

What is this?

A

Catheter bag

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19
Q

What is this?

A

Seldinger central line insertion pack

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20
Q

Which veins might a central line be inserted into?

A

Subclavian

Internal jugular

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21
Q

What can central lines be used for?

A
  1. Delivery of medications/fluids that may be harmful orally or peripherally
  2. Blood tests and central venous pressures

(Examples: parenteral nutrition, emergency venous access, fluid resuscitation, infusion of irritant drugs, vasopressors, inotropes)

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/central-line-insertion-pack/

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22
Q

Recall some possible complications of central line insertion

A

Pneumothorax, sepsis, thrombosis and misplacement

Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/central-line-insertion-pack/

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23
Q

What is this?

A

Chest drain bottle

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24
Q

What are the 2 types of chest drain bottle

A

The first type contains a small amount of water, which acts as a seal preventing air or fluid coming back up the tube into the chest.

Alternatively, an electronic chest drainage device may be used (a Thopaz machine), which can deliver suction (to help the lung re-expand) and allows the doctors to measure if there is any ongoing air leak between the lung and pleural cavity.

Source: NHS North Bristol Trust - https://www.nbt.nhs.uk/our-services/a-z-services/respiratory-medicine/respiratory-patient-information/chest-drain

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25
Where does the chest drain act?
It drains air/blood/pus etc from the pleural space Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/chest-drain-bottle/
26
Instructions to pt about chest drain?
- Bottle must always be below level of waist - May be asked to cough so HCP can check if it's working - You will have a waterproof dressing over the suture site
27
What is this?
CSF manometer
28
What is a CSF manometer used for?
Identification of opening pressures Measurement is in cm H2O Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/csf-manometer/
29
What are the ranges of normal opening pressures on LP?
10-18 cm H2O if patient is lying on their side 20-30 cm H2O when sat up Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/csf-manometer/
30
What is this and what is it used for?
Devers retractor Retraction in abdominal surgery
31
What is this?
Diathermy (monopolar)
32
What are the possible complications of diathermy?
- Risk of burning hands | - Risk of fire if alcohol wash used
33
What is this?
Disposable rigid sigmoidoscope
34
What is this?
Drainage bag that may be attached to NG tube/ abdo drain (passive)
35
What is this?
Endotracheal tube with tape and syringe
36
How is an endotracheal tube inserted?
Using a laryngoscope and bougie Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/endotracheal-tube/
37
How is positioning of an endotracheal tube checked?
Looking for symmetrical rising of the chest on ventilation, breath sounds bilaterally and no gurgling over the epigastrium indicating oesophageal intubation Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/endotracheal-tube/
38
What is this?
Epidural insertion pack (needle, catheter, catheter adaptor)
39
What is this?
Faeces sample pot
40
What is this?
Feeding NG tube
41
What is this?
5% dextrose solution
42
What is this?
Fluid giving set
43
What are these?
Forceps (toothed and non-toothed)
44
What is this?
Fracture plate
45
What is this?
Hemiarthroplasty
46
What is this?
Hickman line - long term central venous line
47
What is a Hickman line most often used for?
Longterm parenteral nutrition
48
What is this?
Total hip replacement
49
What is this?
Histology specimen pot
50
What is this?
IM femoral nail - used to internally fix femoral shaft fractures Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/im-femoral-nail/
51
What is this?
Instillagell - anaesthetic lubricant gel used for catheterisation
52
Recall the guage of blue, pink and grey IV cannulas
``` Blue = 22G Pink = 20G Grey = 16G ```
53
What is this?
Laparoscopic port Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/laparoscopic-port/
54
What is this?
Laryngeal mask Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/laryngeal-mask/
55
What are these?
Airway adjuncts (i Gels) = supraglottic Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/laryngeal-mask/
56
What are laryngeal airways used for?
Supraglottic airway used prior to intubation Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/laryngeal-mask/
57
What is the main difference in function between a laryngeal airway and an iGel?
Laryngeal airway has an inflatable cuff whereas iGels contain a thermoplastic elastomer (styrene) that moulds to the perilaryngeal framework with patient temperature Medlearn says iGel prevents aspiration and LMAs don't but I can't find any other info to backt this up online Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/laryngeal-mask/
58
Recall 2 risks of laryngeal airways
Inflation can cause pressure lesions and nerve palsies Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/laryngeal-mask/
59
What is this and what is it used for?
Leg bag For mobile patients with catheters Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/leg-bag/
60
Recall 2 uses for mannitol
1. Lower raised ICP 2. Drive the urine output in a patient with obstructive jaundice to prevent hepato renal syndrome. Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/mannitol/
61
How much oxygen can be delivered by nasal cannulae?
Usually used to carry 1-3L of oxygen per minute (can be upto 5L/min) This delivers between 28-44% of oxygen Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/nasal-cannulae/
62
Recall 2 complications of nasal cannulae
Nasal sores Epistaxis Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/nasal-cannulae/
63
What is this and what is it used for?
Nasal speculum - for examining inside nose | Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/nasal-speculum/
64
What is this and what is it used for?
Nasopharyngeal airway Used as an airway in people with decreased GCS/decreased gag reflex Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/nasopharyngeal-airway/
65
How should nasopharyngeal airway be sized?
Diameter should be sized against patient's own diameter of little finger distal phalanx Length should be determined by measuring from tip of nose to earlobe Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/nasopharyngeal-airway/
66
What is one important contraindication for nasopharyngeal airway?
Suspected basal skull fracture
67
How do you prevent inhalation of nasopharyngeal airway?
Put a safety pin at the end Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/nasopharyngeal-airway/
68
What is this?
Nebuliser mask and chamber Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/nebuliser-mask-chamber/
69
What are these?
Needle holders Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/needle-holders/
70
Neurology: What size tuning fork is used for vibration of joints vs Rinne's and Weber's?
Joints: 128 Hz | Rinne's/Weber's: 512 Hz
71
What are these?
Ethylon non-absorbable sutures Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/non-absorbable-sutures/
72
What are non-absorbable ethilon sutures usually used for and why?
Usually used for percutaneous sutures as more likely to loosen over time than prolene non-absorbable sutures Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/non-absorbable-sutures/
73
Recall 2 uses of prolene sutures
Vascular and bowel anastamosis Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/non-absorbable-sutures/
74
What is this?
Non rebreather mask Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/non-rebreather-mask/
75
What is the flow rate of a non-rebreather mask and what % oxygen can it deliver?
10-15L/min Up to 90% oxygen Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/non-rebreather-mask/
76
What is this?
Oropharyngeal airway Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/oropharyngeal-airway/
77
How should oropharyngeal airways be sized?
Measure size from angle of mouth to angle of mandible Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/oropharyngeal-airway/
78
How should oropharyngeal airways be inserted?
Upside down then rotated (apart from in children, where it is inserted the right way up) Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/oropharyngeal-airway/
79
What is this?
PICC line Inserted peripherally and advanced into a central vein Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/picc-line/
80
Recall 3 uses of PICC lines
(Peripherally inserted central catheter) 1. Long-term vascular access for blood sampling 2. Chemotherapy administration 3. Infusion of hyperosmolar solutions such as those used for total parenteral nutrition Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/picc-line/
81
What is this?
Protoscope Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/proctoscope/
82
What is this?
Ryles NG tool Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/ryles-ng-tool/
83
What is a Ryles NG tool used for?
- Primarily used for drip and suck - Can also be used to insert drugs or contrast into the GIT Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/ryles-ng-tool/
84
What is this?
Scalpel Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/scalpel/
85
What is this?
Seldinger chest drain insertion pack Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/seldinger-chest-drain-insertion-pack/
86
What is this and what is it used for?
Self-retaining retractor Holds wounds open for surgery Source: https://www.vetorthopaedics.com/product/travers-self-retaining-retractor/
87
What is this?
Self-inflatable bag valve mask Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/self-inflatable-bag-valve-mask/
88
How much oxygen can a bag valve mask deliver?
100% oxygen at 10L/min and above Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/self-inflatable-bag-valve-mask/
89
What is this?
Shouldered syringe Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/shouldered-syringe/
90
What is a shouldered syringe used for?
Injection of haemorrhoids with 5% phenol in almond oil Injection aided by protoscope and done under dentate line Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/shouldered-syringe/
91
What is this?
Single lumen CVC | Source: https://www.exportersindia.com/product-detail/4-6mm-single-lumen-central-venous-catheter-3920463.htm
92
Recall 3 drugs/ drug classes that need to be inserted via a central line
Amiodarone, chemotherapy and dopamine https://medlearn.imperial.ac.uk/clinical-skills/glossary/single-lumen-cvp/
93
What are these?
Specimen swabs Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/specimen-swabs/
94
What are these?
Spinal needles Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/spinal-needles/
95
What are these each used for?
Top one is traumatic needle for epidural Bottom one is 'pencil top' needle - needle of choice for LP as much lower risk of post-LP headache Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/spinal-needles/
96
What is this and how is it used?
Stiff neck cervical collar Used in conjunction with sand bags and tape to immobilise neck in trauma patients Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/stiff-neck-cervical-collar/
97
How are stiff neck cervical collars sized?
By measuring the number of fingers from the clavicle to the angle of the mandible, and this is then compared to the measuring peg on the stiff neck collar Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/stiff-neck-cervical-collar/
98
What is this? Recall 3 patients who might have this
Stoma bag - mainly used in patients who've had ileostomy, colostomy or ileal conduit Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/stoma-bags/
99
What is this?
Surgical chest drain Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/surgical-chest-drain/
100
What is this?
Swan-Ganz catheter Source: https://www.edwards.com/gb/devices/Hemodynamic-Monitoring/swan-ganz-catheters
101
What can Swan Ganz catheters be used for?
Pressures in heart, PAWP and cardiac output Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/swan-ganz-catheter/
102
What is this?
Synthetic absorbable suture Source: https://www.sciencedirect.com/topics/biochemistry-genetics-and-molecular-biology/calcium-stearate
103
What is this?
Tracheostomy Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/tracheostomy/
104
What is this?
Triple lumen CVC Source: https://tragate.com/product/three-lumen-central-venous-catheter-triple-lumen-breathing-anesthesia-and-emergency-apparatus-139571
105
What is this and what is it used for?
Trucut needle - for taking biopsies for histological specimens Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/trucut-needle/
106
What are these?
Urinary catheters - centre is Foley (up to 28 days) and left is longterm catheter Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/urinary-catheter/
107
What is this and what is it used for?
Three way catheter Used in haematuria for bladder washout and irrigation Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/urinary-catheter/
108
What is this and what is it used for?
Urometer drainage bag Measures urine output Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/urometer-drainage-bag/
109
What is this?
Venturi mask and valves Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/venturi-mask/
110
Recall the flow rate and % oxygen for each venturi valve (blue, white, yellow, red + green)
–BLUE = 2-4L/min = 24% O2 (Blue rhymes with two, 2-4L --> 24%) ``` –WHITE = 4-6L/min = 28% O2 (White = 5 letters = 4-6L/min) ``` –YELLOW = 8-10L/min = 35% O2 (Yellow is a happy colour = on cloud 9 = 8-10L/min) ``` –RED = 10-12L/min = 40% O2 (Red = colour of raspberries = 11 letters = 10-12L/min) ``` –GREEN = 12-15L/min = 60% O2 (Green rhymes with fifteen) Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/venturi-mask/
111
In what clinical scenario are venturi masks most often used?
In COPD patients where it is important not to over-oxygenate the patient Source: https://medlearn.imperial.ac.uk/clinical-skills/glossary/venturi-mask/
112
VAC drain?

Instruments for PACES (1 decks)

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