NG Tubes:

Indications: 1. 2. 3. 4. Diagnostic Evaluation of upper gastrointestinal (GI) bleed (ie, presence, volume) Aspiration of gastric fluid content Identification of the esophagus and stomach on a chest radiograph Administration of radiographic contrast to the GI tract

Therapeutic 1. Gastric decompression, including maintenance of a decompressed state after endotracheal intubation, often via the oropharynx 2. Relief of symptoms and bowel rest in the setting of small-bowel obstruction 3. Aspiration of gastric content from recent ingestion of toxic material 4. Administration of medication 5. Feeding 6. Bowel irrigation Contraindications:

Severe midface trauma Recent nasal surgery Coagulation abnormality Esophageal varices or stricture Recent banding or cautery of esophageal varices Alkaline ingestion

Catheters:
Indications: Diagnostic 1. 2. 3. 4. Collection of uncontaminated urine specimen for diagnostic purposes Monitoring of urine output Imaging of the urinary tract Can be used to diagnose hematuria Therapeutic : Acute urinary retention (eg, benign prostatic hypertrophy, blood clots) Chronic obstruction that causes hydronephrosis Initiation of continuous bladder irrigation Intermittent decompression for neurogenic bladder

1. 2. 3. 4.

5. Hygienic care of bedridden patients 6. Used to administer medication eg chemotherapy, antibiotics for cystitis Contraindications: Lower urinary tract trauma which is suspected when there is pelvic or straddle-type injuries or clinical suspicion such as a boggy or high-riding prostate on DRE, perineal hematoma or blood at the meatus. Types of catheters classified based on: Size in French gauge eg. 12-small 16-large 20-very large Material latex, silastic (silicone) Shape- foley, coude (elbow), teeman, 3 way catheters

Chest Tube Insertion:

Indications: Pneumothorax- opened or closed Hemothorax Hemopneumothorax Hydrothorax Chylothorax Empyema Pleural effusions Post operatively- thoracotomy, cardiothoracic surgery Contraindications: Coagulopathy Pulmonary bullae Pulmonary, pleural, or thoracic adhesions Loculated pleural effusion or empyema Skin infection over the chest tube insertion site Types of surgical drain Drains can be:

Open or closed: Open drains (Including corrugated rubber or plastic sheets) drain fluid on to a gauze pad or into a stoma bag. They are likely to increase the risk of infection. Closed drains are formed by tubes draining into a bag or bottle. Examples include chest, abdominal and orthopaedic drains. Generally, the risk of infection is reduced. Active or passive: Active drains are maintained under suction (which may be low or high pressure) eg JVac

Passive drains have no suction and work according to the differential pressure between body cavities and the exterior eg catheter bags Silastic or rubber: Silastic drains are relatively inert and induce minimal tissue reaction. Red rubber drains can induce an intense tissue reaction, sometimes allowing a tract to form (this may be considered useful - for example, with biliary T-tubes).

Damn nuisance