Flashcards in Procedures for the Surgical Ward and Clinic Deck (16):
How do you place a peripheral IV catheter?
1. Place a rubber tourniquet above the site
2. Use alcohol antiseptic
3. Place IV into vein with flash of blood
4. Remove inner needle while advancing IV catheter
5. Secure with tape
How do you draw blood from the femoral vein?
Nerve, Artery, Vein, Empty space, Lymphatics.
Place needle medial to the femoral pulse.
How do you remove staples?
Use a staple remover then place Steri-Strips
How do you remove stitches?
1. Cut the suture next to the knot
2. Pull end of suture out by holding onto the knot
3. Place Steri-Strips
How do you place Steri-Strips?
1. Dry the skin edges of the wound
2. Place adhesive (e.g. benzoin)
3. With the Adson pickup or with your fingers, place strips to gently appose epidermis (avoid tension)
How do you place a Foley?
1. Stay sterile
2. Apply Betadine to the urethral meatus
3. Lubricate the catheter
4. Place catheter into urethra
5. As soon as urine returns, inflate balloon with saline
How do you find the urethra in females?
First find the clitoris and clitoral hood.
The urethra is just below these structures.
Wiping Betadine-soaked sponge over this area will often result in having the urethra wink open.
How do you determine how much of the NGT should be advanced into the body for the correct position?
Rough guide: from nose around ear, to 5 cm below the xiphoid
How do you place the NGT in a nare?
First place lubrication, then place NGT straight back (not up or down)
What is the best neck position for advancing the NGT?
Neck flexed (also have patient drink some water using a straw)
What if there is 3 L per 24 hours drainage from an NGT?
Think duodenum (the NGT may be in the duodenum and not the stomach).
Check an XR.
How can you clinically confirm that an NGT is in the stomach?
Use a Toomey syringe to inject air while listening over the stomach with a stethoscope.
You will hear the "swish" if the NGT is in place.
What must you obtain and examine before using an NGT for feeding?
CXR/AXR to absolutely verify placement into the stomach and not the lung
How do you draw a radial artery blood gas?
Feel for the pulse and advance directly into the artery.
ABG syringes do not have to have the plunger withdrawn manually.
How do you drain an abscess?
After using local anesthetic, use a #11 blade to incise and then open the abscess pocket.
Large abscesses are best drained with a cruciate incision or removal of a piece of skin.
Pack the open wound.