Nasogastric Tube (Gastrocath)

Features:-
For nasogastric introduction of nutrition and aspiration of intestinal secretion
Closed distal end with radio-opaque material for accurate placement
 Infant N-G tube

Different size N-G tube For neonatal and paediatric

Nutritional feeding
N-G tube
 Uses of N-G tube

✓ Acute intestinal obstruction.

✓ Acute peritonitis.
✓ Gastric hemorrhage for instilling sclerosing agent or
cold vasopressin drip.
✓ For feeding and avoiding aspiration in comatose
patient.
✓ Following facio-maxillary surgery or injury.
 Complications of N-G tube

✓Injury to the upper respiratory tract injury and

bleeding.
✓Trauma to the pharynx and esophagus.
✓May be introduced to the trachea leading to
aspiration pneumonia.
✓Obstruction to the stomach.
✓Kinking of the tube.
✓Damage to the mucosa.
I.V Canula

is used to give medical personnel access to a patient’s vein for the withdrawal of fluid
(blood) or insertion of medicine or other fluids.
The size depends on the color
Proper sites for insertion I.V canula
 Central venous catheter

used to:
Give long-term medicine treatment for pain, infection, or cancer, or to supply nutrition.
Give medicines that affect the heart, especially if a quick response to the medicine is wanted.
Give large amounts of blood or fluid quickly.
Take frequent blood samples without having to "stick" someone with a needle.
To receive kidney dialysis if you have kidney failure.
 Triple lumen

Double lumen

Single lumen

Central venous catheter

 Indications of I.V canula

✓ Giving blood and I.V fluid.

✓ Administration of drugs.
✓ Parenteral feeding.

Complications

✓Bleeding.
✓Infection.
✓Thrombophlebitis.
✓Air embolism.
✓Obstruction by clot.
Foley’s Catheter
(2-ways type)
1 for urine, 1 for
Inflation using
Normal saline Self retaining catheter, can be left in place balloon capacity:
For 2-3 days. 30 ml
It is composed of the main channel for drainage
And side channel for infiltration connected to a bulb
Which can be inflated with saline or water.

Pediatric size
Adult size
balloon capacity:
30 ml

Different size
Foley’s Catheter
(3-ways type)
1 for urine, 1 for inflation,
1 for drainage.

This catheter mainly used

After prostactomy.
 malecot’s catheter
Self retaining catheter, made of rubber, the tip is bulbous & winged.
It is not used a urethral catheter.

Uses:-
I. Suprapubic cystostomy drainage.
II. Gastrostomies & cholecystostomies.
III. For drainage of empyema.
IV. For relieving pneumothorax.
V. For drainage of nephrostomy.
Malecot’s catheters
 Plain catheter
(An urological catheter)

Plain tube made of rubber.

The terminal end of the tube is blunt and rounded
Plain catheter
Gibbon’s catheter
Urological catheter
 Indications of foley’s catheter

✓To relieve acute or chronic urine retention.

✓To relieve clot retention.
✓In all pelvic and perineal operations for
emptying the bladder.
✓To drain after prostatectomy or bladder
operation.
✓Irrigation the bladder with antiseptic solution.
 Contraindications of foley’s catheter
✓Local urethral sepsis.
✓Apply with pressure in urethral stricture.
✓Apply with pressure in urethral injury

Complications

✓Infection.
✓Urethral injury.
✓Urethral stricture may developed when the catheter
introduce rapidly and forcefully.
Collecting bag
Collecting bag (urine bag)
Collecting bag connecting to Foley’s catheter
Under Water Seal Drain
underwater seal drain (UWSD) is the specialized drain, which
is attached to the chest tube
Under Water Seal Drain & Chest Tube
A chest drain is used to drain air, blood,
fluid or pus from the pleural space

Proper site for insertion of chest tube

Under Water Seal Drain & Chest Tube
 Face Mask
(Oxygen Mask)

Features
Suitable for oxygen therapy
Swivel connector for patient comfort
Elongated facemask for long term use
Clear and soft mask for patient comfort
Adjustable elastic strip and integrated nose clip for proper positioning of mask
210 cm long star lumen tubing to ensure continuous flow of oxygen
Proximal end of tube is connected with funnel shape connector for easy connection with
Oxygen source.
Face Mask Nebulizer Mask
Specially designed nebulizer
Chamber.
Ambu-Bag

Is used to breathe for the baby if she/he

Is not breathing, is having difficulty breathing
Or when suction the baby.
Ambu-Bag
Infusion giving set
Infusion giving set
Blood bag
Blood bags
Blood giving set
 Volumetric Drip Set

Used to calculate the amount of I.V

Fluid.
Volumetric Drip Set
Infusion set

Micro-drip set
Disposal Syringes
Disposal syringes
Insulin Syringe
Different types of I.V fluid
do not depend on the color, read the name on the bottle
5% Dextrose(glucose water)
Sterile water for injection
A drug in vial form with sterile water for injection
 citoswab
For sample collection
One-Piece Colostomy Bag
Two-Piece Colostomy Bag+Skin Barrier
Colostomy bag with skin barrier
Standard & Extended Wear Skin Barrier (Flange)
For colostomy
Surgical tape
Zinc oxide blaster tape for dressing wound
Silk plaster tape
brown cotton medical bandage with plastic cover
Permeable Surgical Hydrocolloid Dressing Medical Surgical Tape For Wounds
Elastic bandage
A sterile adhesive bandage.
Gauze dressing
Gauze dressing
Paraffin gauze
 Paraffin gauze
Paraffin gauze is one of the simplest dressings for a burn
Gloves
Surgical protective mask
Surgical gowns
 Penrose drain
(Corrugated drain)

It is an open drain which is made of soft latex rubber

Tubing and is used as a wick (drain pus, serum , blood,
Or other fluids from body cavity)
Penrose drain
Closed suction drain

Used to drain serous

Or bloody fluid from
Dissections sites or from
Around intraperitoneal
anastomosis.
Closed suction drain
 Sump drain

Large caliber, multi- lumen tubes that provided for both

Continuous irrigation and aspiration.
Sump drain
 Indications for drains

✓Drainage of pus
✓Remove transudate from a wound
✓To provide early warning of complications like
bleeding.
✓Irrigation of serous lined cavities & joint
spaces
✓Life saving indications such as using the chest
tube in tension pneumothorax.
 Contraindications for drains

✓the peritoneal cavity is difficult or impossible

to drain so we put the drain on the localized
area of surgery.
✓Pancreatitis.
✓Appendicitis.
 Complications of drains

✓ Allergic tissue reaction.

✓ Trauma during insertion.
✓ Soft tissue bleeding.
✓ Infection.
✓ Slipping of drain inside the wound or inside the
abdomen.
✓ Obstruction or kinking of the tube.
✓ Herniation through the opening.
✓ Failure to drain adequately.
 T-tube

Indications
A-diagnostic;-
T-tube cholangiogram, a method by which a contrast medium is given by
The tube to the biliary system and then take x-ray film.

B-therapeutic:-
1. Exploration of the common bile duct in dilation, stone, obstructive jaundice……
2. Injury to the ureters.
3. Injury to the fallopian tubes.

Complications:
1. Infection.
2. Hemorrhage.
3. Slipping.
4. Fibrosis & stricture.
5. Adhesion.
6. Ischemic necrosis.
7. Kinked in common bile duct or in peritoneal cavity.
T-tube
 Endotracheal tube

Indications:-
I. Head injury & unconsciousness.
II. Fracture of the base of skull & bleeding of the trachea.
III. Facio-maxillary injury (swallow of the tongue).
IV. Paralysis of the cord (vocal cord).
V. Diphtheria.
VI. Cervical injury.
VII. Lung abscess.
VIII. Poisoning.
IX. General anesthesia.
 Endotracheal tube

Advantages:-
a. Provide patent airway.
b. Can do suction through it.
c. The cuff will prevent inhalation.
d. We can do assisted ventilation.

Disadvantages:-
a. Can not be kept more than 48 hours.
b. May be blocked or irritated.
c. Can not be kept in conscious patient.
d. Pressure necrosis.
e. Descending infection.
f. Atelectasis.
Endotracheal tube
 Tracheostomy tube

Indications:-
I. upper airway obstruction.
II. Decrease the dead space (from the nose to the trachea).
III. Comatosed patient.
IV. Weak patient with collection of pus in the bronchial tree.
V. Neurological problems that affect respiration.
 Tracheostomy tube

Complications:-
a. Apnea.
b. Trauma to the vessels & bleeding.
c. Trauma to the esophagus.
d. Surgical emphysema.
e. Trauma to the recurrent laryngeal nerve.
f. Wound infection.
g. Early dislodgment of the tube.
Tracheostomy mask
Upper midline incision
Lower midline incision
Paramedian incision
Pfannensteil’s incision
used for caesarian section
Rutherford’s Morrison’s incision
Used for appendicular abscess

Hockey stick
 Subcostal incision
(Kokher’s incision)

The right incision used for hepatobiliary surgery

While the lift one used for surgery of the stomach and spleen.
 Muris incision

Used for renal surgery

 Plain cat gut sutures
)‫(اصفر‬

It is an absorbable monofilament suture which is indicated

For bowel anaestamosis and suturing the subcutaneous tissue .
 Chromic cat gut suture
)‫(قهوائي‬

Cat gut sutures are natural

Used in infection.
 Polydiaxanon suture

It is an absorbable synthetic monofilament suture

Used in bowel anaestamosis.
 Vicryl suture
(‫)بنفسجي‬

It is an absorbable synthetic multifilament suture

With good knotting, little tissue reaction and expensive.
Used in bowel anaestamosis as in incisional hernia.
 Virgin silk sutures
)‫(اسود‬

It is non-absorbable natural monofilament suture

Used for skin suturing and bowel anaestamosis also used
In colon surgery.
 Braided silk suture

It is non-absorbable synthetic multifilament

Suture
 Stainless steel wire

Non-absorbable synthetic monofilament

Suture, difficult to handling and used for
Wiring of fractures .
 Nylon suture
)‫(ازرق‬

Non-absorbable synthetic monofilament suture

Of smooth surface, used for sheathes and tendons.
 Prolene suture
)‫(ازرق‬

Non-absorbable synthetic monofilament suture

Used for infection.
 Teflon(poly-fluro-ethylene)PTFE suture

Non-absorbable synthetic monofilament suture

Used in aortic surgery.
 Complications of suture

✓Infection.
✓Leakage.
✓Diverticulae formation.
✓Necrosis.
✓Dehiscence.
✓Bleeding.
✓Stenosis.
Types of needles