Practical procedures

Practical proceduresCVLChest tubeCBDParacentesisTPN Peripheral and Central

CBDContinuous Bladder CatheterizationIndications :Monitoring urine output perioperatively or in critically ill patients or post void residualAcute urinary retentionChronic urinary retentionAid to abdominal and pelvic surgery (prevention of bladder injury)Facilitate bladder irrigation

Male catheterizationFoleys catheter, most commonly used 14G. Drainage tubing and bag.Sterile dressing set, sterile gloves, sterile drapes (preferably CC towel)Cleaning solution, sterile NS for irrigationLignocaine gel, KY jelly (sterile)GauzeIf necessary, bottle for sampling

Procedure must be done with aseptic techniqueClean hands and put on sterile gloves

TipsUse plenty of gel. If difficult to indentify orifice, retract foreskin fullyNo urine? Palpate the bladder. Bladder just emptied, try aspirate with 3cc syringe. Or tip blocked with gel, try introduce 10cc of water and aspirate.Inability to insert? Try smaller catheter.

Female catheterizationCHAPERONE for male doctors

TIPSDifficult identifying orifice? Place index finger in vagina to elevate the anterior vulva. Guide the catheter along finger and push gently into urethra.

ParacentesisIndication : Diagnostic evaluation of ascitesTherapeutic drainage of ascitesSterile dressing setSterile towel drapesSterile glovesCleansing solution (Povidone/Steriprep)10cc syringe + 21G needle + 25G needle50cc syringe + 16G branulaThree-way cockDrainage bag and tubingSpesimen container as necessary

injection

TIPSLoculated ascites. Ultrasound guidance will be helpful.Blood or faeculent material. PUNCTURED vessel or viscus.