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Surgery - Osce: Foley'S Two Ways Urinary Catheter
Surgery - Osce: Foley'S Two Ways Urinary Catheter
SUMITH &
HASHAN
SURGERY OSCE
FOLEYS TWO WAYS URINARY CATHETER
Blunt end
x
Balloon(Prevent self retaining)
x
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A NASOGASTIC TUBE
o There are metal boalls in the end to ensure the tube in correct place by using Xray
o By applying air we have to auscultate the bubbling sound to ensure the possition
a
Air tube (metal tube)
Around this there is a rubber tube
1.
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b
d
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e.g.:-halothane
To ventilate pts. In intra oral
surgeries.
To prevention by use of cuff.
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Anesthesia mask
Oxygen mask
IV CANULA
Use to establish IV drips, Blood
transfusion, Fluid transfusion,
Nourishment
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LARYNGOSCOPE
Use to examine the larynx, intubation( placing of tube in to hollow organ), removal of foreign
bodies obstructing from larynx
Pt
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1. Used for
Transfusion of blood
2. What is a?
The filter
3. What is the advantage?
Remove clot and clump
formed due to breakdown
of cells and rouleux (stock
of RBC/ blood clot)
formation
4. What is empty chamber?
Estimate the rate
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OROPHARYNGEAL AIRWAY
What are the uses of it?
To depress the tongue preventing the tongue falls back
To maintain a pts airway
To keep air way pt until recovering from anesthesia
Berman airway
NASOPHARYNGEAL TUBE
Keep to pts airway empty
Indication
Epileptic pt(dont put in mouth)
Contraindication
Fracture of skull (Bone septa may
damaged)
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LARYNGEAL MASK
To keep a pts airway
Ex: In an emergency
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TONGUE DEPRESSOR
It is used for lowering down the tongue during oral surgeries or when the need is to visualize oropharynx
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DEXTROSE
What are the indications of this?
5% dextrose
To replace water deficits post operatively (Dehydration)
Fluid management
Fasting
50% dextrose
To produce with parental nutrition
Infuse through CV catheter (Central venous catheter) to ovoid thrombosis,
hypoglycemia, hyperkelemia, with insulin
To reduce cerebral edema
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Dextrans.
0.9%
HS
NaCl
Hartmans
solution
Contra indications:
Hypertensive patients.
Cardiac failure
Renal failure
Colloid: crystalloid = 1:3
When crystalloid given only 20% of fluid remains in the vascular comportment after 10 minutes.
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500ml vial
100ml-25g
500ml-125g
25% D
500 75=300
125
Needed
15g- 100ml
75g-500ml
-300ml contains 75g
-Dilute until 500ml
b. How do you make 500ml at 20% dextrose out of this vial using both?
20% dextrose in 500ml
100ml 29g
500 100g
25%D
25%D
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e.
I.
II.
19G 1.5 used to transfuse blood reduce rupturing of cells for rapid infusion.
To give large amount.
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Site
Size
Shape
Margie
Edge
Floor
Base
Regional lymph nodes
Surrounding areas
O2 cylinder
N2O cylinder
Green in color
h. A 40 year old man patient presented with an ulceration lesion on his right leg above the ankle
Take history
Onset
Duration
Pain
Fever
Associated diseases
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70 kg man had an operation to remove a part of his mandible due to cancer. How do you
maintain fluid and electrolyte balance for the second day after surgery?
Fluid and electrolyte balance and fluid replacement
For 1st 10kg=100ml/kg
So 1st 10kg require 100X10=1000ml
For 2nd 10kg =50ml/kg
So 10-20 kg require 50X10=500ml
Rest of the body weight require 20ml/kg
For 50kg 20X50=1000ml
Total fluid requirement =25000ml
Electrolyte balance
Na+ 1-2mmol/kg/g
70kg = 1-2X 70 = 70mmol/d
0.9%NaCl 500ml contains
70mmol of NaCl
So 5000ml of 0.9%NaCl is enough to replace Na+ requirement
Remain fluid requirement is replaced by 5% dextrose 2000ml
KCl 80-100need
KCl comes as vials which contain 20mmol of KCl given for 500ml
Total vial requirement = 4 vial for 2000ml dextrose
Pt at ICU does not give K because due to tissue destruction it can be released to out
j.
BUTTERFLY NEEDLE
What is used for?
To deliver IV drug to children
Use in pneumothorax for emergency
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k.
I.
o
o
o
II.
l.
Adrenaline-1:8000 concentration
I.
What are the uses?
Cardiac arrest pt 1:1000
Anaphylactic shock pt 1:1000
Local anesthesia 1:8000 (dental procedure)
As a treatment of glaucoma
Hypertensive pt are not given
II.
How it give?
IM
III.
Why?
IV administration cause arrhythmias
m. Atropine-Antimuscarinic parasympathetic blocker
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n.
I.
II.
o. Ulcer
Site
Margin
Base
Discharge- present,
absent, color, smell
Size
Edge
= 2.5l
=2 X bodyweight X surface area of burns
=2 X 70 kg (18+6+1+9+9+9)
=2 X 70 X46
9%
=8940ml
Total requirement per day
= 25000+ 6440
38%
= 8940ml
For the 1st 8 hours
= X 8940ml
9%
1%
9%
=4470ml
Next is for the next 16 hours
So for the next 4 hours
= 4470/16 X 4 = 1117.5ml
st
So for 1 12 hours
= 4470 + 1117.5ml
18%
18%
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r.
How many vials do you need to replace daily requirement of calories for a 50kg weight pt?
5Kcal/kg/day needed
Total daily calorie requirement
=calories /kg/day X weight
=35 X 50
=1750 Kcal
One vial of 50% dextrose carries
o 50g dextrose in 100ml
o In 25ml 50/100 X 25
= 12.5g
o 1g = 4 Kcal
o So that 12.5g
= 50Kcal
Require number of vials
= 1750Kcal/50Kcal
=35 vials
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t.
Colloids ( Monnitol)
o Expensive
o Elicit allergic reaction
o Interferes with blood
o Get blood and match before infusion
o Fever amount needed
o No risk of pulmonary edema
D/07/023
D/07/091
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