By Rahul Jandial
Embarking at the first medical rotation in a clinic is a frightening event for clinicians, as textbook wisdom doesn't inevitably correlate with the information that's helpful ''''in the trenches'''' on the hospital.Whether you're a nurse tending to a critical venous line or an intern putting that line, Code Blue is an integral addition on your arsenal of emergency care wisdom. positioned this guide in your lab coat pocket and position the next details at your fingertips: fundamentals on physique structures, ailments, and drugsCritical in. Read more...
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Extra info for Code Blue: Bedside Procedures and Critical Information
Rotate a flexed finger tip circumferentially to free up any adhesions. Fig. 11-3 Fig. 11-4 11_Jandial-r5_045-050:Layout 1 48 8/2/12 3:20 PM Page 48 Cardiothoracic • • • • • Place one Kelly clamp on the distal end of the chest tube. Insert both through the subcutaneous tract into the pleural cavity (Fig. 11-5). Direct the tube posteriorly for fluid drainage or anteriorly for air drainage. Open the clamp and insert the tube farther to the premeasured length. Place two vertical mattress sutures on each side of the chest tube.
See Appendix C for additional helpful information. 10_Jandial-r6_039-044:Layout 1 8/2/12 3:22 PM Page 39 10 THORACENTESIS A 61-year-old female smoker with a right pulmonary nodule presents with dyspnea and orthopnea. A chest radiograph reveals opacification of the right costophrenic recess. INDICATIONS • Pleural effusion leading to dyspnea (Fig. 10-1) • Diagnostic removal of pleural fluid to determine cause of pleural effusion A B Fig. 10-1 A, Chest radiograph showing right pleural effusion. B, Chest radiograph with patient in the left lateral decubitus position reveals left pleural effusion layering on the lateral chest wall.
4-1 Abdominal CT scan showing ascites. 035-inch J-wire IV tubing Three-way stopcock 18- and 20-gauge IV catheter 16-gauge single-lumen central line catheter and dilator POSITIONING • Supine TECHNIQUE • Sites in which needle entry is safe take into consideration the course of the inferior epigastric vessels (Fig. 4-2). • The bladder should be catheterized. Fig. 4-2 04_Jandial-r4_015-018:Layout 1 8/2/12 3:34 PM Page 17 Paracentesis 17 • The insertion site should be free from infection. • The insertion site should not be through or near any previous incision sites.