1.2_COMMON CONTRAPTIONS

COMMON CONTRAPTIONS:

1. Jackson-Pratt drain (JP drain)

2. Nasogastric Tube (NGT)

3. Endotracheal Tube (EDT)

4. Tracheostomy Tube

5. Mechanical Ventilator

6. Intrajugular Catheter

7. Subclavian Catheter

8. Tenckhoff Catheter

9. Femoral Catheter

10. Intravenous Catheter

11. Arteriovenous (AV) Fistula

1. Jackson-Pratt drain (JP drain)

2. Nasogastric Tube (NGT)

3. Endotracheal Tube (EDT)

4. Tracheostomy Tube

5. Mechanical Ventilator

6. Intrajugular Catheter

7. Subclavian Catheter

8. Tenckhoff Catheter

9. Femoral Catheter

10. Intravenous Catheter

11. Arteriovenous (AV) Fistula

 Jackson-Pratt drain (JP drain)

Nasogastric Tube (NGT)

Endotracheal Tube (EDT)

Tracheostomy Tube

Mechanical Ventilator

Intrajugular Catheter

Subclavian Catheter

Tenckhoff Catheter

Femoral Catheter

Intravenous Catheter

Arteriovenous (AV) Fistula

INDICATION: Drains excess blood and fluid from under the skin and the incision site

Jackson-Pratt drain (JP drain)

INDICATION: Remove air or excess fluid out of the stomach

Nasogastric Tube (NGT)

INDICATION: To bring food, medicines, and other substances into the stomach

Nasogastric Tube (NGT)

INDICATION: For pts who cannot swallow

Nasogastric Tube (NGT)

INDICATION: Placed in trachea to maintain a patent airway

Endotracheal Tube (EDT)

INDICATION: Protection against aspiration and gastric insufflation

Endotracheal Tube (EDT)

INDICATION: More effective ventilation and oxygenation

Endotracheal Tube (EDT)

INDICATION: Facilitation of suctioning

Endotracheal Tube (EDT)

INDICATION: Delivery of anaesthetic and other drugs

Endotracheal Tube (EDT)

INDICATION: provides direct access by surgically making an opening in the neck

Tracheostomy Tube

INDICATION: Acute setting: used in emergencies to obtain an airway

Tracheostomy Tube

INDICATION: Acute setting: In ventilated patient who are having difficulty weaning off the ventilator

Tracheostomy Tube

INDICATION: Chronic setting: for pts to be ventilated for the longer term

Tracheostomy Tube

INDICATION: Measure to control ventilation in critical patients

Mechanical Ventilator

INDICATION: Prophylaxis for impending collapse of other physiologic functions

Mechanical Ventilator

INDICATION: Used for emergency HD (hemodialysis) access

Intrajugular Catheter

INDICATION: Provide dependable intravenous access

Subclavian Catheter

INDICATION: Used as a PD (peritoneal dialysis) access

Tenckhoff Catheter

INDICATION: HD (hemodialysis) access (if IJ is not accessible)

Femoral Catheter

INDICATION: Access for fluids and medications (can also be seen in the legs)

Intravenous Catheter

INDICATION: Permanent access for HD

Arteriovenous (AV) Fistula

PRECAUTIONS: JP Drain:

Pin to patient's clothing when sitting, standing, and ambulating the patient

Pin to patient's clothing when sitting, standing, and ambulating the patient

RISKS: JP Drain:

(+) ↑ redness, swelling, drainage around the area (notify the NIC/nursing in charge stat before starting tx)

(+) ↑ redness, swelling, drainage around the area (notify the NIC/nursing in charge stat before starting tx)

PRECAUTIONS: NGT:

• Secure tube at all times.

• Make sure it wont get pulled or tugged during bed mobility (ex. transitional movements, and standing)

• Secure tube at all times.

• Make sure it wont get pulled or tugged during bed mobility (ex. transitional movements, and standing)

RISKS: NGT:

• Bleeding, infection/ injury

• May enter the wrong place such as the lung

• May move = lung problems/ indigestion

• Bleeding, infection/ injury

• May enter the wrong place such as the lung

• May move = lung problems/ indigestion

PRECAUTIONS: Endotracheal Tube (EDT):

• Ensure that the tube is secured

• Make sure pt is receiving adequate ventilation (check  check the O2 levels all time)

• Keep tube attached to the ventilator (ventilator will make a sound if EDT is not attached properly)

• Ensure that the tube is secured

• Make sure pt is receiving adequate ventilation (check  check the O2 levels all time)

• Keep tube attached to the ventilator (ventilator will make a sound if EDT is not attached properly)

PRECAUTIONS: Tracheostomy Tube:

• Area should be clean

• Cuff's pressure should be between 15-20 mm

• Pts are unable to talk (pts c good cognition – need to find other ways to communicate; can use whiteboard)

• Area should be clean

• Cuff's pressure should be between 15-20 mm

• Pts are unable to talk (pts c good cognition – need to find other ways to communicate; can use whiteboard)

PRECAUTIONS: Mechanical Ventilator:

When it alarms:

• Look at the pt & monitor

• Try not to focus on the vent

• Determine hemodynamic stability (check VS: BP, HR, O2 Sat; stable? inc/dec?)

• How quickly is the pt deteriorating

• If out of hand, inform NIC STAT

• Look at the pt & monitor

• Try not to focus on the vent

• Determine hemodynamic stability (check VS: BP, HR, O2 Sat; stable? inc/dec?)

• How quickly is the pt deteriorating

• If out of hand, inform NIC STAT

PRECAUTIONS: Intrajugular Catheter:

No excessive neck and shoulder movements (avoid FULL ROM)

No excessive neck and shoulder movements (avoid FULL ROM)

PRECAUTIONS: Subclavian Catheter:

Secure line at all times esp during transitional movements

Secure line at all times esp during transitional movements

PRECAUTIONS: Tenckhoff Catheter:

No to minimal hip movements

No to minimal hip movements

PRECAUTIONS: Femoral Catheter:

No to minimal hip motions (may advise ankle pumping ex to avoid DVT)

No to minimal hip motions (may advise ankle pumping ex to avoid DVT)

PRECAUTIONS: Intravenous Catheter:

No movement at proximal joints

No movement at proximal joints

PRECAUTIONS: Arteriovenous (AV) Fistula:

• No movement at prox joints

• No BP taking in the laterality with AV Fistula

• No modalities

• No movement at prox joints

• No BP taking in the laterality with AV Fistula

• No modalities