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General Drains


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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