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General Drains
Drains
| Drains | Description | Indication | Complications |
|---|---|---|---|
| Penrose | Piece of latex tubing. It is an open passive drain. | Drainage of intrabdominal abscess, retropubic drains, post nephrectomy, flaps to prevent seroma | procedure: false passage, damage membranous urethra long term: infection, fistulae, |
| Corrugated drain | Stiff piece of plastic with corrugations. Has radioopaque blue line. Open Passive | Thicker collections | |
| Indwelling double lumen Foley catheter | 2 ports: output & insufflation. Atraumatic with opening. Bulb that can be filled with varying amount of fluid. Made of latex | Diagnostic: UO, cystourethrogram/urethrogram Tx: Urinary retentn | 1. |
| How long is male urethra? | 25cm | ||
| What are the 10 inches structures in the body? | Male urethra, femoral shaft, oesophagus, duodenum, ureters | ||
| What instrument should you never use on a urethra? | Urethral dilator/bougie (for urologists only) | ||
| what if bulb in foley cannot deflate? | ultrasound guided deflation of bulb (22G needle) | ||
| why isnt air usually used in foley bulb | may explode in bladder if over distended | ||
| what is a three port foley used for? | bladder irrigation in pt with haematuria, post turp, chemotherapeutic agents | ||
| what are extraurinary uses for foley | 1. abdominal drain 2. elevate orbital fracture 3. feeding gastrostomy 4. cervical ripening 5. chest tube in child 6. tracheostomy 7. sling intraop 8. tamponade | ||
| Stoma bag | Opening with adhesive, filter, reservoir, sometimes opening used to cut to size | New principle is to minimise stoma use 1. Decompression,Diversion. Terminalisation | |
| Types of stomas | Loop, double barrel, end | ||
| How do you care for colostomy | Clean bag, wash, ensure barrier product used | ||
| What are the complications of a colostomy | Anaethesia Procedure (bowel tear, create fistula), Immediate postop: stoma failure, strangulation , infection Long term: prolapse, stricture, parastomal hernia | ||
| How do you treat a parastomal hernia? | Hernioplasty but risk of infection, so sometimes stoma recited at another point | ||
| Malicot drain | 3 point cross section, Used in suprapubic cystostomy. Closed passive | ||
| NG tube | Plastic, distal end which is atraumatic with several holes. Graduated lines. closed passive | Decompression ex intest obstr, diagnose upper GI bleed, gatric lavage, meds, feeding | procedure: trauma, airway short term; dislodged long term: sinusitis, pressure necrosis, aspiration, |
| Describe a T-tube | Closed passive drain. Latex in a T shape, T area lies in biliary tract, stalk lies outside | ||
| What are the uses of a T-tube | Tx: Decompression of biliary tree after exploration of biliary tree, conduit 4 removal of cbd stones Dx: Intraop cholangiogram, postop cholangiogram | ||
| how do you pass foley | |||
| how do you pass ng tube | |||
| how does a t-tube work | Creates fistula between CBD and external environment, to prevent leakage of bile into peritoneum. (due to competency of ampulla of Vater). tube placed and connected to reservoir | ||
| how long does it take for a fistula to form with a t tube? | approx 10 days | ||
| what if the t-tube was yanked out day 1 postop? | return to OT and replace Ttube | ||
| how would you prepare a pt with obstructive jaundice for surgery? | Important points: impairment in fat sol vitamins ADEK. therefore pt comes in 3 days preop and gets parenteral Vit K to correct clotting anomalies. Prevent hepatorenal syndrome by hydrating patients fully preop, give Abx on table and for 24h postop | ||
| how do T-tubes cause a tract to form? | Creates an intense tissue reaction | ||
| What are the advantages of penrose drains? | soft, pliable, affordable, easy to use, available, less tissue reaction | ||
| What are you gonna do if foley cannot be passed in a man with AUR in BPH? | If using 18F, then use 20 as it is stiffer. If that does not work, try smaller size. If not, inform urologist who may do SPC | ||
| How do you convert foley diameter to mm? | divide by pi |
Created by:
IonaDel
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