ADs, WC Specs, Lines, Tubes, Other Equipment, and Diagnostic tests

From Equipment and Devices in CM

What are primary uses of an AD during ambulation?

• Decreasing WB on the LEs

• MM weakness of the trunk or LEs

• Dec balance or impaired kinesthetic awareness

• Pain

What AD is the most stable for beginning ambulation with a patient?

Parallel bars

What height is used for parallel bars, walkers, canes, and axillary crutches?

To allow for 20-25 dgs of elbow flexion when grasping 4-6 inches in front of the body (and to the ulnar styloid process when arms are at the side)

What gait pattern is a walker most suited for?

3-point

How much spaces should their be between the top of axillary crutches and a patient’s axilla (armpit)?

At least 3 finger widths away

What side should a cane be used on?

The non-affected side (strong side)

How do you measure for a WCs seat height/leg length?

Measure from the user’s heel to the popliteal fold and then add 2 in. (avg is 19.5-20.5 in.)

How do you measure for a WCs seat depth?

Measure from the user’s posterior glute, along the lateral thigh, to the popliteal fold and then subtract 2 in. (avg is 16 in.)

How do you measure for WC seat width?

Measure from the widest aspect of the users glutes, hips, or thighs and add 2 in. (avg is 18 in.)

How do you measure for WC back height?

Measure from the seat of the chair to the floor of the axillar with the user’s shoulder flexed to 90 dgs, then subtract 4 in. (avg is 16-16.5 in.)

How do you measure for WC armrest height?

Measure from the seat of the chair to the olecranon process with the user’s elbow flexed to 90 dgs and then add 1 in. (avg is 9 inches above the chair seat)

Wheelchair parts

Nasogastric (NG) tube

A plastic tube inserted through the nostril that extends to the stomach

• Used for short-term feeding, administering meds, or to remove gas from the stomach

Gastrostomy (G) tube

A tube is inserted through a small incision in the abdomen into the stomach

• Used for long-term feeding when swallowing is difficult due to anatomic or neuro disorders or to avoid aspiration

Jejunostomy (J) tube

A tube inserted through endoscopy into the jejunum via the abdominal wall

• Used for long-term feeding for patients who cannot receive food by mouth

Intravenous system (IV)

A sterile fluid source, a pump, a clamp, and a catheter to insert into a vein

• Used to infuse fluids, electrolytes, nutrients, and meds when the intestinal tract is not able to digest and absord food

• Most commonly inserted into the basilic, cephalic, or antecubital

Arterial line

A thin catheter that is inserted into an artery and attached to an electronic monitoring system (EM)

• Used to measure arterial blood pressure, obtain blood samples, or administer meds

• *If displaced, the therapist should apply pressure to limit blood loss and call for assistance

Central venous pressure catheter

Used for measuring pressures in the R atrium or the sup vena cava through an indwelling venous catheter and pressure manometer

• Also used to evaluate R ventricular function, R atrial venous pressure, and circulating blood volume

Indwelling right atrial catheter (Hickman)

Runs through the cephalic or internal jugular vein and is threaded into the sup vena cava or R atrium

• Used for long term admin of substances into the venous system such as chemo agents, parenteral nutrition, and antibiotics

Intracranial pressure (IP) monitor

Measure the pressure exerted against the skull or pressure within the brain

Pulmonary artey catheter (Swanz-Ganz catheter)

A flexible catheter that is inserted through a vein into the pulmonary artery

• Used to provide continuous monitoring of pulmonary artery pressure

Nasal cannula

Tubing extending approx. 1 cm into each nostril of a patient

• Used to deliver up to 6 liters of O2 per minute

Oronasal mask

A facepiece designed to cover the nose and mouth with small vent holes to expel exhaled air along with a breathing tube and connector

• Used most often for O2 therapy, but can also be used to give meds, mucolytic detergents, or humidity by the use of an accessory nebulizer

Tent

A canopy placed over the head and shoulders or the entire body for the purpose of deliver O2 at a higher lvl than normal

Tracheostomy mask

A mask placed over a stoma or tracheostomy for the purpose of giving supplemental O2

Balanced suspension traction

Surgically inserted pins, screws, and wires that apply traction force

• Commonly used for comminuted femur fractures and requires prolonged immobilization (and therefore risks skin breakdown)

External fixation

A surgical procedure were holes are drilled into uninjured areas of bone surrounding a fracture to insert wires, pins, bolts, and screws so that the bone fragments can be aligned

• Allows for earlier mobility for complex fractures

Internal fixation

A surgical procedure that uses metal plates, rods, wires, etc., and attempts to promote the healing process of bone without any external applications being applied to the skin

• Commonly used for comminuted or displaced fractures

Urinary catheter types

• External - applied over the shaft of the male genital

• Foley - indwelling that has a balloon attachment at the end

• Suprapubic - surgically inserted into the bladder

Chest tube

A flexible plastic tube that is inserted through an incision into the side of the chest so suction can be used to remove air, fluid, or pus from the intrathoracic space

Mechanical ventilator

Produces a controlled flow of gas into a patient’s airways that causes positive pressure the the inflation of the lungs for those that cannot breathe on their own

• Volume cycled = delivers a predetermined amount of gas based on the patients need during the inspiratory phase

• Pressure cycled = delivers a predetermined max pressure of gas during respiration

Ostomy device

A method for collection of waste from a surgically produced opening in the abdomen

• Removal occurs through a stoma extending into the SI

Arteriography

An invasive procedure that uses X-ray and injects contrast dye to visualize blood vessels and identify arteriosclerosis, aneurysms, vascular malformations, tumors, and blockages

• Pros: Useful for dx of vascular abnormalities

• Cons: Invasive, potential allergy to contrast dye

Athrography

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