INSTRUMENTS
152-157
SELF INFLATING BAG (AMBU BAG)
●Self inflating bag and face mask
●Procedure:
○Stand at head end
○Neck in neutral or slight extension
○Face mask – cover mouth and nose not eyes,hold firmly on face to
obtain a good seal
○Compress the bag using fingers not hands
SELF INFLATING BAG
●Indications :
○Apnea or gasping
○Heart rate less than 100bpm
●Contraindications:
○Diaphragmatic hernia
ENDOTRACHEAL TUBE
●Indications:
○BMV ineffective
○Diaphragmatic hernia
○Airway blocked with thick secretions
●Vocal cord guide
●ET tube size (inner diameter in mm):
○Uncuffed = (Age/4) + 4
○Cuffed = (age/4) + 3.5
●Depth of insertion of ET tube =
○ Nasotragal length + 1cm
LARYNGOSCOPE
●Straight blade
○Preterm neonate -0’
○Term neonates – 1’
●Endotracheal intubation procedure
LARYNGOSCOPE
OROPHARYNGEAL AIRWAY
●It is sized by measuring the centre of mouth to angle of jaw
●Use :
○maintain airway by preventing tongue falling back
○Avoid biting tube in intubated children
IV CANNULA
●Purple 26G
●Yellow 24G
●Blue 22G
FEEDING TUBE
●Radiopaque line +
●Tip closed
●Lateral openings at end
●Indications:
○ Feeding
○ Decompression
○ Gastric lavage
●Measure the distance from either the nostril or the mouth (depending on insertion
site) to the tragus (lobe of the ear) to the half way point between the
xiphisternum and the umbilicus
SUCTION CATHETER
●No radiopaque line
●Tip open
●One lateral eye
●Length 53cm
FOLEY’S CATHETER
●Indications :
○Shock
○Unconscious patients
○Urinalysis
○AKI (urine output)
○Acute urinary retention
●Complications:
○Injury ,UTI
FOLEY’S CATHETAR
BONE MARROW NEEDLE
●Indication:
○ALL,AML,CML,Hodgkin,Non Hodgkin lymphoma
○Aplastic anemia
○Suspected metastasis
○Infiltrative storage disease
○TB
●Site :
○<1Yr tibial tuberosity
○Iliac crest
●Complications:
○Bleeding ,pain
BONE MARROW ASPIRATION NEEDLE
BONE MARROW BIOPSY NEEDLE
●Jamshidi’s BM biopsy needle
○Preferred
OXYGEN THERAPY
●Indications:
○Impaired lung gas exchange (pneumonia,bronchiolitis,ILD)
○Impaired circulation (shock,CHF)
○Procedure requiring sedation
●Classification:
■O2 without Positive pressure (nasal cannula,face mask,oxygen
hood,Venturi mask,non – rebreathing mask)
■O2 with positive pressure (high flow nasal cannula, continuous
positive airway pressure-CPAP, Ventilator)
○Low flow (nasal cannula, face mask), high flow
NASAL CANNULA
●Parts:
○Oxygen tubing
○2 nasal prongs
●Flow rate 2-6L/min
●FiO2 upto 40%
●Feeding possible
●Disadv:drying
OXYGEN HOOD
OXYGEN MASK
●Parts:
○Face mask
○Connected to O2 tube
○Holes in side (for exhalation)
●6-10L/min
●60%
●Interfere with feeding
NON REBREATHER MASK
●Parts:
○Face mask
○Reservoir
○One way valves
●10-15L/ min
●90%
●Indications: (utilized for short periods)
○ resuscitation
○Severe respiratory distress
VENTURI MASK
●Indicated for precise titration of percentage of oxygen
●4-8L/min
●24-60%
MDI WITH SPACER
MDI WITH SPACER
●Fixed amount of drug in aerosal form delivered
●Use : exacerbation and maintainemce therapy of
asthma
●Adv: large amount deposited in lung , no need
coordination,young patients
●Disadv: bulky,costly,not used in infants and toddlers
LUMBAR PUNCTURE NEEDLE
●Site : interspace between L3-L4 or L4- L5
●Lateral decubitus
LP NEEDLE
●Indications:
○CNS infections – meningitis,meningoencephalitis
○Subarachnoid hg
○Metastatic leukemia
●Contraindications
○Raised ICP
○Local infection
○Bleeding diathesis
●Complications:
○Head ache
○Local back pain / infection
○Brain herniation
DRIP SET
●Microdrip → 1ml = 60 drops
●Macrodrip → 1ml = 20 drops
BP CUFF
BP CUFF
●Cuff width →40% of MUAC
●Cuff length →80% of MUAC
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