Pediatric

Instruments
Dr Niranjan K
Consultant Pediatrician
 LIST OF INSTRUMENTS
AIRWAYS
• AMBU BAG
• LARYNGOSCOPE
• ENDOTRACHEAL TUBES
• GUEDEL’S AIRWAY
• INFANT FEEDING TUBE.
• SUCTION CATHETER
• SUCTION BULB
• OXYGEN MASK
• MDI WITH SPACER
 NEEDLES
• LUMBAR PUNCTURE NEEDLE
• BONE MARROW ASPIRATION NEEDLE
• BONE BIOPSY NEEDLE
• VIMS SILVERMANNS NEEDLE
• IV CANNULAS
 SCHEME
• IDENTIFICATION
• PARTS
• INDICATIONS
• CONTRAINDICATIONS
• EXTRA FEATURE IF ANY
 AMBU bag
• Artificial Manual breathing unit.
• It’s a bag valve mask .

PARTS
• Mask at patient end
• Self inflating bag
• Pressure release valve
• Gas inlet end with oxygen and reservoir connection.
Indications
• Cardiopulmonary resuscitation
• Neonatal resuscitation.

Contraindications
Congenital diaphragmatic hernia
 Special features
• Volume 250ml to 750ml
• Reservoir can increase oxygen conc. to 100%
• Squeeze-2-3
 Laryngoscope
• Stainless steel made instrument,used for endotracheal intubation.

Parts
• Blade
• Handle with inbuilt battery case
• Light source
Indications
• Endotracheal intubation
• Direct larygnoscopy
• Biopsy of hypopharynx
• Placing transesophageal echocardiac probe.

Contraindications
• No such absolute contraindications
• Epiglottitis
• Bossini
• Articulating and check.
 Endotracheal tube
• Portex/PVC made transparent tube for intubation introduced into
trachea with prime purpose to establish and maintain a patent and
functional airway.
PARTS
• Proximal end with 15mm universal adapter
• Transparent tube with graduations
• Cuff (cuffed vs uncuffed)
• Distal end with murphy s eye
Uses / indications
• Mechanical ventilation
• Cardio pulmonary resuscitation

Contraindications
No absolute contraindications
Epiglottitis
 Guedels airway
• Oropharyngeal airway curved hard plastic device to prevent tongue from falling
backwards

PARTS:
Suction port within the tube

Indications :
In unconscious patients without gag reflex
Suctioning

Measure from corner of patients mouth to angle of jaw.

• It’s a plastic tube for feeding neonates or infants

• PARTS
• Blunt end (non traumatic )
• Universal adapter
• Transparent tube.
• Radio-opaque marker.
Indications
• To instill food solution/medications.
• To obtain gastric contents for
-poisoning/
DIAGNOSTIC: to obtain gastric aspirate for
AFB?CBNAAT
for tracheoesophageal fistula /esophageal atresia
• Venous cut down
• Administration of surfactant in INSURE

Contraindications
No absolute contraindications as such
Head trauma.
• Size
• Measurement
 Suction catheter
• Plastic catheter for suctioning.
• Open traumatic end.
• 10 F for neonatal resuscitation./12F for meconium secretion

INDICATIONS:
• In newborn resuscitation for suction of secretions from oral/nasal cavity
MàN
• ET tube suctioning. not>6seconds
COMPLICATIONS
• Trauma to mucosa of nose & pharynx.
Suction bulb
 Oxygen mask
• Mask for delivery of oxygen
• Cushioned vs uncushioned
• Round type /triangular
Oxygen mask
 MDI With SPACER
• A drug delivery system making use of aerosolised from of drug
delivery
• PARTS:
canister
Acutator
Metering valve
 Spacer
• Holding chambers
• Main objective :better drug delivery system.
• Types: volumatic device &Aerochamber
• Advantages
• Reduces jet effect
• Overcomes hand breath co-ordination problems
• Disperses aerosol
• Patient can breath in n out of chamber without breath holding suiting
small children
Needles
 Spinal needle
Instrument
• Sterile spinal needle with stillete, 22 – gauge (black),
• length according to age (1.5-3.5 inch)
PARTS
• Needle
• Catheter
• Leur lock.
Indications
– Diagnostic
• CNS infections like meningitis, encephalitis,
• subarachnoid hemorrhage, pseudo-tumor cerebri,
• Inflammatory CNS diseases like Guillain – Barre syndrome
• Instillation of intrathecal dye for imaging procedures (e.g.:
myelography )
• Measurement of CSF pressure.
Therapeutic
• Instillation of intrathecal medications ( e.g.: chemotherapeutic CNS
prophylaxis in leukemia, tetanus immunoglobulin in tetanus ,rarely
antibiotics in severe meningitis)
• Spinal anesthesia
Contraindications
• Elevated Intracranial pressure owing to a suspected mass lesion of the
brain or spina cord.( So fundus examination & head CT are
mandatory)
• Severe respiratory distress & shock etc. as that may worsen with
positioning in flexion.
• Thrombocytopenia. ( ˂ 20,000 cells/mm3 )
• Local infection at the site
 Salah bone marrow aspiration
Stainless steel needle with stellate
Indications
– Diagnostic
• Diseases like leukemia, to detect marrow infiltration in disorders like
lymphomas and other non hematologic malignancies.
• To rule out malignant process in ITP before starting steroid therapy
• Bone marrow culture in diseases like typhoid, malaria.
Salah bone marrow aspiration
 BONE MARROW BIOPSY
• Instrument- Jamshidi trephine biopsy needle
Site
• Posterior iliac spine
Indication
• Dry tap in BMA
• Suspected Aplastic anemia and myelofibrosis
• Leukemia
• Lymphoma
• Contraindications
Hemorrahgic diathesis
Skin infections.
Vim silverman LIVER biopsy needle
• Stainless steel needle used for liver biopsy
PARTS
• Trocar
• Bifid /pronged needle.
Indications
• Chronic hepatitis,cirrhosis, storagedisorders
• Malignancies,
• undiagnosed
Pre- requisites
• Prothrombin Time
• Blood group & crossmatching
• Vitamin K administration
 Intravenous cannula

These are PVC made cannulas for intravenous access.