Instruments
1. Urine Collection Bag
1. Sterile plastic bag used to collect urine from catheterized patients.
2. Connected to Foley’s catheter via tubing.
3. Has graduated markings to measure urine output (ml).
4. Comes in two types – bedside (2L) and leg bag (smaller, for ambulatory patients).
5. One-way valve prevents backflow and infection.
6. Drainage port at the bottom allows emptying without disconnection.
7. Should be kept below bladder level to prevent reflux.
8. Must be emptied and cleaned at regular intervals.
9. Helps in monitoring urine output in critical care.
10. Risk of infection if asepsis not maintained → Catheter-associated UTI (CAUTI).
2. Foley’s Catheter
1. Flexible, double-lumen tube inserted into the bladder for drainage.
2. Made of latex or silicone.
3. Sizes: commonly 12–24 Fr; pediatric 8–10 Fr.
4. One lumen for drainage, the other for balloon inflation (5–30 mL).
5. Balloon holds the catheter in place inside bladder.
6. Indications: retention, output monitoring, perioperative drainage.
7. Inserted under strict aseptic precautions.
8. Connected to sterile urine collection bag.
9. Complications: infection, urethral injury, blockage.
10. Removal involves balloon deflation and gentle withdrawal.
3. Ryle’s Tube (Nasogastric Tube)
1. Soft, flexible tube passed through nose into stomach.
2. Used for feeding, aspiration, or gastric lavage.
3. Typically 100 cm long with radiopaque line.
4. Graduated markings help in correct placement (usually ~55–65 cm from nostril).
5. Sizes: 8–18 Fr.
6. Position checked by air insufflation or X-ray.
7. Materials: polyurethane or PVC.
8. Used in unconscious, dysphagic, or postoperative patients.
9. Complications: aspiration, mucosal trauma, malposition.
10. Should be flushed regularly to prevent blockage.
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4. Green Cannula
1. Peripheral IV cannula, 18G size.
2. Used for rapid fluid transfusion or blood sampling.
3. Flow rate ~90 mL/min.
4. Made of Teflon or polyurethane.
5. Has an introducer needle with flashback chamber.
6. Color coding follows ISO standard (green = 18G).
7. Commonly used in adults for IV therapy.
8. Inserted into large peripheral veins (e.g., forearm).
9. Requires aseptic technique.
10. Should be changed every 72–96 hours to avoid phlebitis.
5. Pink Cannula
1. 20G IV cannula.
2. Used for infusion of medications and fluids at moderate rate.
3. Flow rate ~60 mL/min.
4. Common for routine IV access in adults.
5. Color coded pink.
6. Compatible with most IV fluids and blood transfusions.
7. Inserted into superficial veins.
8. Has injection port for drug administration.
9. Secure with adhesive dressing.
10. Watch for infiltration or thrombophlebitis.
6. Grey Cannula
1. 16G IV cannula.
2. Used for rapid volume resuscitation and blood transfusion.
3. Flow rate ~180 mL/min.
4. Color coded grey.
5. Suitable for trauma, surgery, and emergency settings.
6. Requires large peripheral vein (antecubital).
7. Allows quick infusion of colloids and crystalloids.
8. Slightly larger bore increases patient discomfort.
9. Aseptic insertion essential.
10. Complications: infiltration, hematoma, thrombosis.
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7. Blue Cannula
1. 22G IV cannula.
2. Used in pediatrics, elderly, or small-vein patients.
3. Flow rate ~36 mL/min.
4. Color coded blue.
5. Ideal for drug infusions and maintenance fluids.
6. Less painful and easier to insert.
7. Should not be used for viscous solutions or rapid transfusion.
8. Typically used on hand or dorsum veins.
9. Replace every 72–96 hours if needed.
10. Observe for leakage or blockage.
8. Lumbar Puncture Needle
1. Specialized hollow needle used for CSF collection or spinal anesthesia.
2. Consists of needle + stylet + hub.
3. Length: 8–9 cm; Gauge: 20–22G (adults), 22–25G (children).
4. Inserted between L3–L4 or L4–L5 interspaces.
5. Stylet prevents coring of epidermal tissue.
6. Beveled tip designed to minimize dural trauma.
7. Used for diagnosis (meningitis, SAH) and therapy (intrathecal drugs).
8. Aseptic technique mandatory.
9. Complications: headache, infection, nerve injury.
10. Needle orientation — bevel parallel to dural fibers reduces CSF leak.
9. Bone Marrow Biopsy Needle
1. Used to obtain bone marrow core for histopathological examination.
2. Made of stainless steel with sturdy handle and stylet.
3. Common site: posterior superior iliac spine.
4. Types: Jamshidi, Klima, Salah.
5. Gauge: usually 11–14G.
6. Produces a cylindrical core sample of marrow.
7. Sterile and disposable or reusable.
8. Local anesthesia required.
9. Complications: bleeding, infection, pain.
10. Helps diagnose leukemias, myelofibrosis, anemia, etc.
10. Liver Biopsy Needle
1. Used to obtain liver tissue for histopathology.
2. Types: Menghini, Tru-Cut, or Silverman needles.
3. Gauge: 14–18G, length 10–15 cm.
4. Introduced percutaneously under ultrasound guidance.
5. Provides cylindrical core for diagnostic purposes.
6. Indications: chronic hepatitis, cirrhosis, malignancy.
7. Requires pre-procedure coagulation profile.
8. Local anesthesia given; patient supine.
9. Complications: bleeding, bile leak, peritonitis.
10. Post-procedure monitoring for 6–8 hours recommended.
11. AMBU Bag (Bag-Valve-Mask)
1. Manual resuscitator used for assisted ventilation.
2. Consists of self-inflating bag, one-way valve, mask, and oxygen inlet.
3. Can deliver up to 100% O₂ with reservoir attached.
4. Used during cardiopulmonary resuscitation (CPR).
5. Sizes: adult, pediatric, neonatal.
6. Allows positive pressure ventilation.
7. Portable and simple to use.
8. Should maintain proper mask seal to avoid air leak.
9. Complications: gastric inflation, barotrauma.
10. Can be attached to endotracheal tube during intubation.
12. Laryngoscope
1. Instrument used for visualization of larynx and vocal cords.
2. Used during endotracheal intubation.
3. Consists of handle (with batteries) and detachable blade.
4. Blades: Macintosh (curved), Miller (straight).
5. Light source — bulb or fiber-optic.
6. Handle contains batteries to power the light.
7. Should be checked for illumination before use.
8. Inserted on the right side of mouth, lifting tongue anteriorly.
9. Must be sterilized before reuse.
10. Complications: dental injury, soft-tissue trauma, bradycardia (in children).
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