Instruments

Dr. Mahadev Desai (MD)

Consultant Physician, Ahmedabad
 List of Instruments (The list is never complete!!!)
• Syringes & Needles, Scalp vein/Butterfly needle
• Syringes Infusion pump
• IV set / BT set
• Venflon, Three-way stop cock
• IV fluids
• Vacutainer blood collection tubes
• Vacutainer Multi-Sampling Luer Adapter
• Ryle’s tube, Gastric Lavage Tube
• Urine-Catheters
• Suction catheter
• Oxygen Masks, AMBU bag
• Endotracheal tube
• Inhalers, Nebulizers & Spacers
• Biopsy Needles
 Methods of Sterilization

• Autoclaving
− Steam at 121o C for 15 minutes at 15 psi (100 kpa) atmospheric
pressure, kills all bacteria, virus, fungi & spores except Prions (CZ
disease)
− Plastic material cannot be autoclaved (heat labile)
psi= pounds per square inch; kPa= kilo pascal (pressure exerted by 10
gm mass in 1 cm2 area= 1 kPa); 101.3 kPa= 1 Atm

• Boiling
• Chemical (Ethylene oxide, EO or Eto; Formaldehyde)
• Irradiation: Gamma, X-rays, Electrons…

Irradiation does not make materials radioactive, because the energy

used is too low. Generally an energy of at least 10 MeV is needed
to induce radioactivity in a material
 Syringes & Needles

• Conventional syringes: 1, 2, 5, 10, 20 mL

• Large volume syringes: 50 mL
• Special syringes:

Tuberculin syringe Insulin syringe

Needles
 Disposable Syringe & Needles

Flange
 Needles & Connectors

Butterfly needle (Scalp vein)

Venflon Three-way stop cock Dial Flow

 IV set & BT set

Bag spike
Drip chamber (Murphy)

Filter
Needle end

Roller Clamp

IV set BT set
 Syringe Infusion Pump

• Electrically driven
• Battery Back up
• Alarm for - empty syringe,
power failure

Drugs infused in very small quantity (e.g. 1 mL/hour)

− Noradrenaline/Adrenaline
− KCl
− Insulin
− Nitroglycerine
− Heparin
Dosifix
 Intravenous Fluids

Characteristics Type of Fluid

Most physiological Ringer’s lactate (RL)
Rich in sodium Isotonic saline, DNS
Rich in chloride Isotonic saline, DNS, Isolyte-G
Rich in potassium Isolyte-M, P and G
Corrects Met. Acidosis Ringer’s lactate, Isolyte-E, P & M
Corrects Met. Alkalosis Isolyte-G
Cautious use in renal
Ringer’s lactate, Isolyte-G, M, P & E
failure
Avoided in liver failure Ringer’s lactate, Isolyte-G
Glucose free Isotonic saline, Ringer’s lactate
Sodium free (Glucose
5%, 10%, 20% and 25%-dextrose
rich)
Potassium free Isotonic saline, DNS, Dextrose fluid
 Ryle’s tube

Measurements • Length: 105-120 cms

• Markings:
1. GE junction: 40 cms
2. Body of stomach: 50 cms
3. Pylorus of stomach: 60 cms
4. Duodenum: 70 cms

Uses • Feeding
• Gastric analysis: Achlorhydria
(PA), ZE syndrome
• Lavage/Stomach wash:
Confirming Tube Position:
Poisoning, Gastric
• Ask the pt to speak, if he can,
decompression tube has not passed vocal cord
Contra- • Corrosive poisoning or In lungs
• Unconscious pt. • pH of aspirated contents (<5.5)
indications
• Air insufflations
• Kerosene poisoning
• X-ray
Gastric Lavage Tube
 Urine Catheters
Simple
Foley

Male
External
Catheter
Suction
catheter
 Oxygen Masks

No. Type of Mask Delivered Flow Rate O2 O2 Delivered

1. Nasal Canula (Prongs) 0.5 to 5.0L/min 24 to 40%

2. Simple Face Mask 6 to 10 L/min 40 to 60%

Non-Rebreathing Mask +
3. 10 to 15 L/min up to 95%
Reservoir

O2 Flowmeter &
Simple Face Mask Non-rebreathing mask Humidifier

NRB mask
 Endotracheal Tubes

Ventilator
Suction port connector

Pilot Balloon

Distance
Pt. end from Pt end
Cuff

Internal Diameter
 AMBU Bag (Bag Valve Mask)

Artificial Manual Breathing Unit

A squeezable bag, a one-way valve and a face mask

 Inhalers

DPI MDI
 Spacer

Nebulizer

Nebulizer: Drug delivery device where drug is delivered in form of mist

(aerosol) inhaled in to lungs: Budesonide, Salbutamol, Ipratropium
Vacutainer Glass/Plastic tubes

Hep GL Ser PT
 Blood Collection Tubes

• Red  (no additive) chemistries, serology, x matching

• Purple (EDTA)  for CBC, contains anticoagulant thorough mixing by
inverting tube 8 times
• Light Blue (Na-citrate)  Prothrombin time
• Dark blue (EDTA)  trace metals zinc, copper,
• Light Green (Heparin) chemistries ammonia, lithium
• Light Gray (fluoride)  glucose
• Yellow  blood culture
• Black (buffered Na-citrate)  ESR
• Pink (K-EDTA)  viral load, molecular studies
• Orange (thrombin)  quick studies of chemistries
 Clinical thermometers
Mercury  Digital  Infra red digital  Plastic fever strip

Temp. Range: 94.0 F to 108.0 F, 35.0 C to 42.0 C

 Biopsy Needles

Liver Biopsy Needle LP Needle B. M. Aspiration

Needle
Thank You