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Flashcards in Surgical Attachments & Drains Deck (37)
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What do the following words mean?
- Ectomy
- Otomy
- Oscopy
- Ostomy

Ectomy: Removal of
Otomy: Cutting into
Oscopy: Looking into
Ostomy: Opening into


What is a laparotomy incision used for?

- Removal of cancerous bowel, spleen, pancreas, gall bladder, stomach or liver
- Division of adhesions (scar tissue) interfering with bowel movement
- Repair of abdominal aortic aneurysm (AAA)


What is a sternotomy incision used for?

Cardiac surgery
- Cardiac artery bypass grafting (CABG)
- Aortic or mitral valve replacement


What is a thoracotomy incision used for?

Thoracic surgery
- Removal of lung cancer (pneumonectomy, lobectomy)


What are considered to be attachments?

Anything that is not part of a patient's body but is connected to them in some way


What is an arterial line?

- Plastic catheter that goes into an artery
- Connected to transducer
- Most commonly in radial artery
- Only in ICU


What are the 2 main functions of an arterial line?

- Allows frequent/painless ABG sampling without a Dr present
- Constantly monitors BP


What would happen if an arterial line was dislodged?

Heavy arterial bleeding


Why is a resting splint sometimes used with an arterial line?

- To prevent it from being dislodged
- To keep the wrist neutral & prevent kinking in the artery


What is a central venous catheter (CVC) or central line?

- Tube into superior vena cava in right atrium
- Connected to transducer
- Can be jugular or subclavian


What are the 2 main functions of a central line?

- Fast administration of drugs/fluids
- Measurement of central venous pressure (CVP) - gives an indication of heart performance


What is a variation of a central line?

Peripherally inserted central catheter (PICC line) - Long term central line


What is an epidural?

- Injection into epidural space outside dura mater
- Combination of anaesthetic & opioid
- Can be at any spinal level


What is an epidural often used in?

- Childbirth
- AAA repair
- Hip replacement
- Intestinal surgery


What are some important things to note about epidurals?

- Very fine tubing, easy to dislodge (yellow stripe)
- Sensory vs motor block (motor block is bad, monitored with BP)
- Often require oxygen therapy
- Patient can be mobilised (check for motor block first)


What should be monitored on patients who have had an epidural?

Blood pressure


What is an intravenous catheter (ICV)?

- Simple catheter inserted into peripheral vein
- Allows delivery of fluids and medications (i.e. drip)


What is an indwelling catheter (IDC)?

- Catheter inserted into bladder, held via balloon
- Used to drain urine
- Attached to drainage bag


What is important to remember when handling patients with an IDC?

- Keep the bag below the bladder
- Keep the bag close to the patient (can hang off frame)


What is an intercostal catheter (ICC)?

- Tube inserted into pleural space
- Sutured in place
- Attached to underwater sealed drain (UWSD)


What is the function of an ICC?

Used to drain air (pnemothorax), blood or pleural effusion


What is the function of under water sealed drains (UWSDs)?

- Allows tube drainage but not air to rise back into pleural space
- Measures drainage in mL
- Attached to wall suction - constant pressure to prevent pneumothorax
- Can see 'swing' and 'bubble' (indicator of ongoing air leakage)


What are some of the safety issues associated with UWSDs?
**Exam question**

- Always have clamps nearby (clamp tube close to chest if UWSD fails/breaks to prevent air going in)
- Always keep UWSD below patient's chest (avoid drainage running back into pleural space)
- Always check if patient requires continuous suction or is allowed to mobilise without suction


What is a naso gastric tube (NG)?

- Inserted through nose into stomach
- Inserted blind by medical staff
- Requires CXR to double check placement
- Secured with tape


What is the function of a NG?

Allows feeding directly into stomach or drainage of stomach


Why would you remove a NG when mobilising/exercising?

So digestion can be paused


What is an exception to removing a NG during mobilisation?

High insulin dependency requiring constant feed to maintain blood sugar level


What are pacing wires?

- Wires placed directly after cardiac surgery (ensures cardiac output)
- Attached to pacing box (set heart rate)


Where can a pacing box be placed when moving a patient?

Tucked into the patient's cough teddy


When are pacing wires typically removed?

- 2-3 days post survey if spontaneous heart rhythm established
- Patient required to rest in bed for 1-2 hours post removal (check with nurses before mobilising cardiac surgery patients)