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Manual of Surgical Equipment
Rajendra Singh Sewta
1:
Care of Instruments
CAUSES OF DAMAGE OF INSTRUMENTS
Specifications for Buying
Storing of Instruments
Usage
Preparation for Disinfection and Cleaning
Re-using the Instruments
Pre-disinfection
Washing
Drying
Care of Instruments
Maintenance of Instruments
Conditions for Sterilization
Sterilization
2:
Electrosurgery (Diathermy)
PRINCIPLES OF ELECTRICITY
Tissue Effects by Electrosurgery
Variables Affecting Tissue Effect
Types of Circuit
Precautions
CAUSES OF DIATHERMY INJURY
Safety Measures
If Diathermy is not Working Look For
Patient Plate Electrode
Placement of Plate
Foot Switch (Fig. 2.4)
Different Modes of Current
Patient with Pacemaker
Metallic Prosthesis
Safe Use of Diathermy in Minimal Invasive Surgery
ARGON BEAM COAGULATION
Advantages
Disadvantages
Use
ULTRASONIC DEVICES (FIG. 2.5)
Ultrasonic Scalpels and Clamps
Advantages
Disadvantages
CUSA
Uses
Limitations CUSA
LASERS
3:
Sterilization
DEFINITIONS
Antiseptic Agents
Asepsis
Bacteremia
Septicemia
Toxemia
Slough
Antiseptic
Bacteria
Bacteriostat
Bioburden (Bioload, Microbial Load)
Biological Indicator
Chemosterilizer (Chemical Sterilant)
Cleaning
Contamination
Decontamination
Disinfectant
Disinfection
Disposable
Fungicide
Germicide
Mechanical Control (Physical) Monitors
Microbiocidal Process
Microbiocide
Nosocomial
Sanitization
Sanitizer
Spore
Sterilant/Disinfection
Sterile/Sterility
Sterilization
Viricide
Pasteurization
Methods of Sterilization
Physical Methods
Autoclaving (Figs 3.1A to C)
Control Measures
Autoclave Labels
While Autoclaving Following Points Must be Remembered
“Actual time Starts when the Pressure and Temperature at 15 PSI and 120°C Respectively”
Uses
HOT AIR OVEN
BOILING (MOIST HEAT)
Advantages
Disadvantages
Sterilizer
FILTRATION
CHEMICAL METHODS
Formaldehyde
Glutaraldehyde
Formaldehyde + Absolute Alcohol + Sodium Nitrate (Ethicon)
Formalin Solution
Uses
Quaternary Ammonium Compounds
Phenolic Compounds
PHENOL
Carbolic Acid
Recommended Concentration and Time
Other Uses
Lysol
Recommended Time and Concentration
Hospital Concentrate (Savlon Aseptic HC)
Uses
Bacilocid Special
Special Features
Uses
Precautions
Mode of Use
Ethanol + 1 and 2 Propanol Solution (Bacillol 25)
NICU/ICU
OT
Others
Precautions
Alcohol (Spirits)
Uses
Iodophors
Para-acetic Acid
Advantages
Disadvantages
Chlorine and Chlorine Products
Hydrogen Peroxide
Advantages
Disadvantage
GAS STERILIZATION
Formalin Sterilization
Fumigation of Operation Theater
Recommended Formaline Dosages
Disinfection Procedure
Disadvantages
EO Gas Sterilization
Preparation for Ethylene Oxide
Indicators
Complications of Ethylene Oxide Sterilization
Personnel Complications
Recommendations to Reduce Exposure
Advantages
Disadvantages
RADIATION
Ionizing Radiation Method
Advantages
Disadvantages
Non-ionizing Radiation Method
Disadvantages
Indicator
Gas Plasma Sterilization
Plasmalyte System
Conclusion of Sterilization and Disinfection
4:
Suture Material
TYPES OF SUTURES
Absorbable Sutures
Non-absorbable Sutures
Monofilament
Polyfilament
Classification of Sutures
Absorbable
Nonabsorbable
Catgut
Uses
POLYGLACTIN
Advantages
Uses
POLYGLYCOLIC ACID
Advantages
Uses
POLIGLECAPRONE SUTURE (MONOCRYL)
Advantages
Disadvantages
Uses
POLYDIOXINONE SUTURE (PDS)
SILK
Advantages
Disadvantages
Uses
NYLON
Advantages
Disadvantages
Use
POLYPROPYLENE
Advantages
Uses
POLYAMIDE (ETHILON)
Advantages
Uses
POLYTETRA FLUOROETHYLENE
Expanded PTFE
SUTUPACK
POLYBUTYLATE
Advantages
Uses
METAL CLIPS
Ligature
Suture
Advantages
ADHESIVE SKIN CLOSURE TAPE
CYNOACRYLATE LOTION
Disadvantage
STAPLES (Figs 4.2 to 4.4)
Available in Different Names
Advantages
MESH
Absorbable
Advantages
Uses
Non-absorbable
Polypropylene Mesh (Fig. 4.5)
Uses
5:
Syringes and Needles
SYRINGES
DIFFERENT TYPES OF SYRINGES
Glass Syringe – B D type
Plastic Syringe (Fig. 5.2)
Insulin Syringe (Fig. 5.3)
Asepto Syringe (plastic/glass) (Fig. 5.4)
Gabriel's Syringe (Fig. 5.5)
Higginson's Syringe
Tuberculin Syringe (Fig. 5.6)
NEEDLES
Parts of Needle
DIFFERENT TYPES OF NEEDLES
BD Needle (Becton and Dickinson)
Scalp Vein Set or Butterfly (Fig. 5.7)
Venepuncture Needle
Method
LP Needle (Lumbar Puncture Needle)
Uses
Epidural Needle (Fig. 5.8)
Tru-cut Needle (Fig. 5.9)
6:
Sterile Precautions and Operation Theater Safety
STERILE PRECAUTIONS AND OPERATION THEATER SAFETY ENVIRONMENT OF OPERATION THEATER
FUMIGATION OF OPERATION THEATER
OPERATION THEATER SET UP
Scrub Room
Mask and Caps (Fig. 6.1)
SCRUBBING
GOWNING (TO WEAR GOWN)
GLOVES (GLOVING) (Figs 6.3A to C)
PREOPERATIVE PREPARATION OF PATIENT
THE PATIENT IN THE OT
Position of the Patient
Protection of Nerves
Painting and Scrubbing the Operative Site
Drapping of the Patient
During Procedure
ELECTROSURGERY (DIATHERMY)
Precautions
FOR ENDO-SURGERY
WHEN IITV (IMAGE INTENSIFIER TELEVISION) IS USED
SPECIMENS
CARE OF INSTRUMENTS AFTER OPERATION
CARE OF LINEN
CARE OF OT TABLE MATTRESS AND PILLOWS
TRANSFER OF THE PATIENT TO RECOVERY ROOM
MANAGEMENT OF PATIENTS IN RECOVERY ROOM
TRANSFER OF THE PATIENT TO THE WARD
7:
Position of the Patient for Surgery
PRECAUTIONS
DIFFERENT POSITIONS ARE (Figs 7.1 to 7.7)
Knee-Chest Position
Sims Position (Lateral Recumbent)
Mayo-Robson Position
Prone Position
Fowler's Position
Lithotomy Position
Supine Position
Trendelenburg's Position (head down)
Kidney Position
Anatomical Position
Neck Position
Supine Hip Position
8:
Hospital Furniture
9:
Common Disposable Surgical Items
PEDIA DRIP™
Features
Features
Features
Features
Features
Features
Features
Features
Complete Kit Consist of
10:
Instruments for Preparing the Patient for Surgery
CHEATLE'S FORCEPS (Fig. 10.1)
SPONGE HOLDING FORCEPS (Fig. 10.2)
TOWEL CLIP (Fig. 10.3)
Mayo's Towel Clip
Uses
Moynihan's Tetra-Towel Clip
TOURNIQUET
Simple Tourniquet (Fig. 10.4)
Pneumatic Tourniquet (Fig. 10.5)
Method of Use
For bloodless field it is used along with Esmarch's Bandage
Uses
Contraindications to its use
Esmarch's Bandage (Fig. 10.6)
Uses
Method of Use
11:
Operative Room Equipment
EPIDURAL CATHETER
EPIDURAL/TUOHY NEEDLE
LOR SYRINGE
THREADING ASSIST GUIDE
DETACHABLE CONNECTOR
HYDROPHOBIC FILTER
Features
Kit consist of
12:
Surgical Needle and Needle Holder
SURGICAL NEEDLES
Types
Aneurysm Needle
Uses
How it is Used
Specific Uses of Various Types of Needle
NEEDLE HOLDERS (FIG. 12.11)
How to Use a Needle Holder (Fig. 12.12)
13:
Scissors
TYPES OF SCISSORS
Straight Scissors
Curved Scissors
Uses
Gauze Cutting Scissor (Fig. 13.4)
Stitch Cutting Scissor (Fig. 13.5)
How to Remove Stitches
14:
Retractors
TYPES
Plain Retractors
Langenbeck's Retractor (Fig. 14.1)
Czerny's Retractor (Fig. 14.2)
Volkmann's Retractor (Fig. 14.3)
Morris Retractor (Fig. 14.4)
Deaver's Retractor (Fig. 14.5)
Doyen's Retractor (Fig. 14.6)
Skin Hook Retractor (Fig. 14.7)
Self Retaining Retractor (Figs 14.9A to E)
15:
Dissecting Forceps
PLAIN FORCEPS (Fig. 15.1)
Uses
TOOTHED DISSECTING FORCEPS (Figs 15.2 to 15.4)
Uses
16:
Hemostatic Forceps
17:
Tissue Holding Forceps
BABCOCK'S FORCEP
Uses
ALLIS TISSUE FORCEP
Uses
LANE'S TISSUE FORCEP
Uses
OTHER TISSUE HOLDING FORCEPS
18:
Instruments for Minor Operation
SURGICAL TRAYS FOR MINOR OPERATIONS/PROCEDURES
Incision and Drainage (Abscess Drain)
ICDT insertion (Intercostal Drainage Tube Insertion)(Figs 18.1 and 18.2)
Stitching of any Wound
Features
Sizes
Cyst/Lipoma Excision or Biopsy (Figs 18.3 and 18.4)
For Biopsy
Ear Lobule Repair
Venesection (cut down of vein) (Figs 18.5A and B)
Suprapubic Cystostomy (SPC) (Figs 18.6 and 18.7)
Features
Pleural Fluid Aspiration/Tapping (Fig. 18.8)
Abdominocentesis/Ascitic Fluid Tapping/Aspiration (Fig 18.9)
Urethrocystoscopy
Disarticulation/Amputation of finger/limb
Paronychia
Lumbar Puncture
Skeletal Traction
Skull Traction
Application of Plasters
Nonsterile equipment
Removing Plaster (Figs 18.10 A to F)
Nonsterile equipment
Cervical Cauterization
Skin Traction
Nonsterile Equipment
Curettes (Figs 18.11 and 18.12)
19:
Instruments for General Operation
SURGICAL TRAYS FOR GENERAL OPERATIONS
KOCHER'S THYROID DISSECTOR (Fig. 19.7)
KOCHER'S THYROID RETRACTOR (Fig. 19.8)
STRAP MUSCLE CLAMP (Fig. 19.9)
20:
Instruments for Abdominal Operation
ABDOMINAL OPERATIONS
Instruments for Bowel Surgery
Bowel Clamps
DIFFERENCE BETWEEN CRUSHING AND NON-CRUSHING CLAMPS
GASTRIC CLAMPS
Moynihan's Gastric Clamp
Payrs Gastric Crushing Clamp
INTESTINAL CLAMPS
Payrs Intestinal Crushing Clamp (Fig. 20.2)
Doyen's intestinal Clamp (Fig. 20.3)
CHOLECYSTECTOMY FORCEPS
Uses
DESJARDIN CHOLEDOCHOLITHOTOMY FORCEP
Bake's Dilator
1. General Set
2. Laparotomy Set
3. Appendicectomy/Appendectomy
4. Herniotomy Set
5. Herniorrhaphy/ Hernioplasty
6. Cholecystostomy/Cholecystectomy
7. Choledochotomy Set (Incision into the CBD)
8. Choledocho-duodenostomy
9. Cholecysto-gastrostomy
10. Cholecysto-jejunostomy
11. Pseudocyst-Gastrostomy
12. Pancreatico-Duodenectomy Set (Whipple operation)
13. Vagotomy Set
14. Pyloroplasty Set
15. Gastrojejunostomy Set
16. Gastrectomy Set
17. Splenectomy Set
18. Ileostomy set/ Colostomy Set
19. Set for Colostomy Closure
20. Hemicolectomy Set
21. Bowel Anastosmosis Set (Fig. 20.4)
22. APR Set (Abdominoperineal resection)
For Abdominal Surgeon
For Perineal Surgeon
23. Lumbar Sympathectomy
21:
Instruments for Anorectal Surgery
SURGICAL TRAY FOR ANORECTAL OPERATIONS
Proctoscope (Fig. 21.1)
Uses
Anal Retractor (Fig. 21.2)
Rectal Biopsy Forcep
RECTAL DILATOR
Use
FISTULA DIRECTOR
Uses
GHOBRIEL'S SYRINGE (FIG. 21.3)
Uses
HEMORRHOIDED LIGATING FORCEP GUN (FIGS 21.4 AND 21.5)
22:
Instruments for Genitourinary Surgery
SURGICAL TRAY FOR GENITOURINARY OPERATIONS
Foley's Catheter
Plain Catheter
Foley's Catheter (Foley-American Urologist)
Urethral Dilator (Fig. 22.1)
Uses
Canny-Ryall Bougie
Cystolithotomy Forceps (Fig. 22.2)
Randall's Forcep (Fig. 22.3)
Use
CIRCUMCISION
Vasectomy
Non-Scalpel Vasectomy (NSV)
Hydrocele (Hydro means Water)
Varicocele
Orchidectomy – (Removal of Testis)
Orchidopexy
Suprapubic Cystostomy
Suprapubic Cystolithotomy (Fig. 22.4)
Prostatectomy (Suprapubic)
Cystourethroscopy
Litholapaxy
Pyelolithotomy, Nephrolithotomy, Ureterolithotomy (Fig. 22.5)
Nephrectomy – Removal of Kidney
Renal Transplantation
Percutaneous Nephrolithotomy (PCNL) (Figs 22.6 to 22.11B)
Nephrostomy
Transurethral Resection of the Prostate (TUR-P) (Figs 22.13 to 22.15)
Urethroscopy and Removal of Ureteric Stone (URS) (Figs 22.16 and 22.17B)
Franuloplasty, Meatoplasty, Meatotomy
Urethrotomy (Fig. 22.18)
Stent Removal
23:
Instrument for Gynecological and Obstetric Operations
SURGICAL TRAYS FOR GYNECOLOGICAL AND OBSTETRIC OPERATIONS
Perineorrhaphy Set
Dilatation and Curettage Set (D & C) (Figs 23.2, 23.3, 23.8, 23.10, 23.11, 23.15 and 23.20)
Hysterosalpingography (Hsg)– (Hystera Means Uterus)
Tubectomy (Conventional)
Recanalization/Tubal Reconstructive Surgery
Laparoscopic Sterilization (LS)
Hysterectomy (Abdominal) (Figs 23.13, 23.14, 23.17 and 23.22)
Vaginal Hysterectomy (Figs 23.1, 23.4 to 23.7, 23.17, 23.19 to 23.22)
Fothergill's/Manchester's Operation
Wertheim's Hysterectomy
Cesarean Section (Figs 23.25 and 23.26)
Myomectomy
For Delivery of a Child (Figs 23.26 and 23.28)
For Medical Termination of Pregnancy (Mtp) (Figs 23.15, 23.16, 23.18, 23.27 and 23.29)
EPISIOTOMY
Vulval Biopsy
24:
Instruments for Cardiovascular Surgery
MEDIASTINOSCOPY
THORACOTOMY (Figs 24.1 to 24.4)
PNEUMONECTOMY/LOBECTOMY (Figs 24.5 and 24.6)
DIAPHRAGMATIC HERNIA REPAIR
VALVE REPLACEMENT
VALVOTOMY/VALVOPLASTY (Figs 24.7 and 24.8)
OPERATIONS ON THE VESSELS/ GRAFT/ EXCISION/EMBOLECTOMY
CABG (CORONARY ARTERY BYPASS GRAFT)
25:
Instruments for Orthopedic Surgery
SURGICAL TRAYS FOR ORTHOPEDIC OPERATIONS
OSTEOTOME (Fig. 25.1)
Use
CHISEL (Fig. 25.2)
Uses
MALLET (Figs 25.3 and 25.4)
Uses
BONE CUTTER (Fig. 25.5)
Uses
BONE NIBBLER
Uses
PERIOSTEUM ELEVATOR (Fig. 25.6)
Use
DOYEN'S RIB RASPATORY (Figs 25.7)
Use
RIB SHEAR
Use
VOLKMANN'S SCOOP (Fig. 25.8)
Uses
AMPUTATION SAW (Figs 25.9 and 25.10)
GIGLI'S WIRE SAW
Uses
KUNTSCHER'S INTRAMEDULLARY NAIL
HIP PROSTHESIS (Fig. 25.11)
TENDON SUTURE
BONE GRAFTING (Fig. 25.12)
PATELLECTOMY (Figs 25.13 and 25.14)
MENISCECTOMY/REMOVAL OF LOOSE BODIES (FROM KNEE/ELBOW)
OSTEOTOMY
SYNOVECTOMY
AMPUTATION (Fig. 25.9)
PLATING AND SCREWING (Figs 25.13, 25.14, 25.17 and 25.18)
WIRING
OPEN REDUCTION OF FRACTURE
INTRAMEDULLARY (NAILING) FIXATION
INTRAMEDULLARY FIXATION IN FRACTURE SHAFT
INTERNAL FIXATION OF FRACTURE NECK FEMUR
DYNAMIC HIP SCREW (DHS)
ARTHROSCOPY
ARTHROCENTESIS
ARTHRODESIS
26:
Instruments for Plastic Surgery
SURGICAL TRAYS FOR PLASTIC SURGERY OPERATIONS
Skin Grafting (Figs 26.1 to 26.5)
Cleft Lip and Cleft Palate Repair Set
Reduction Mammoplasty
Fasciectomy
Denis Browne Operation for Reconstruction of Urethra
Rhinoplasty
27:
Instruments for Neurosurgical Operations
SURGICAL TRAYS FOR NEUROSURGICAL OPERATIONS
Cysternal Puncture
Burr Hole
Craniotomy (Figs 27.1 to 27.6)
Ventriculo-peritoneal Shunt (VP Shunt)
Meningomyelocele, Meningocele, Repair of Spina Bifida
Laminectomy
Stereotactic Surgery
Nerve (Peripheral) Anastomosis (Fig. 27.7)
28:
Laparoscopic Instruments and Equipment
RESOLUTION
CONTRAST
MAGNIFICATION
DEPTH OF FIELD
FOGGING
IMAGING SYSTEM EQUIPMENT
LAPAROSCOPE (Figs 28.1 and 28.2)
LIGHT CABLE
LIGHT SOURCE (Fig. 28.3)
CAMERA (Fig. 28.4)
MONITOR (Fig. 28.5)
INSUFFLATORS (Fig. 28.6)
ENERGY SOURCES
HAND INSTRUMENTS (Figs 28.7 and 28.8)
Verres Needle (Fig. 28.9)
Trocars and Cannulas (Fig. 28.10)
SUCTION AND IRRIGATION APPARATUS
DISSECTORS (Fig. 28.11)
SCISSORS (Fig. 28.12)
HOOKS AND SPATULAS (Figs 28.13 and 28.14)
CLIP APPLIERS (Fig. 28.15)
RETRACTORS (Fig. 28.16)
HERNIA STAPLER
TACKER
NEEDLE HOLDER (DRIVER) (Fig. 28.17)
DIAGNOSTIC LAPAROSCOPIC SET
LAPAROSCOPIC CHOLECYSTECTOMY SET
LAPAROSCOPIC APPENDECTOMY SET
LAPAROSCOPIC CHOLEDOCHOLITHOTOMY SET
LAPAROSCOPIC GROIN HERNIA REPAIR SET
LAPAROSCOPIC FUNDOPLICATION SET
OTHER ADVANCED LAPAROSCOPIC PROCEDURES
WHY LAPAROSCOPIC SURGERY
Conclusion
ROOM LAYOUT (Fig. 28.28)
Operative Room Setup
Optimum Position of Equipment and Team
Checklist
Optional
Basic Room Setup
Before Starting the Operation
TROUBLE SHOOTING
STERILIZATION OF LAPAROSCOPIC INSTRUMENTS
Disinfection
Sterilization
Ethylene Oxide
Glutaraldehyde
Paracetic Acid (Acetone)
Autoclave (Steam sterilization)
Care of Laparoscopic Instruments after their Use
29:
Instruments for ENT Operations
SURGICAL TRAYS FOR ENT OPERATIONS
Head Mirror (Fig. 29.1)
King's College Hospital Model Headlight (Fig. 29.2)
Otoscope (Figs 29.3 to 29.5)
Uses
AURAL SYRINGE (Figs 29.7 and 29.8)
Uses
Mastoid Retractor (Fig. 29.9)
Mastoid Cell Seeker With Scoop
Thudichum's Nasal Speculum (Fig. 29.10)
Posterior Rhinoscopy Mirror
Nasal Packing Forceps (Fig. 29.11)
Nasal Foreign Body Hook
Luc's Forceps (Fig. 29.12)
Krause's Nasal Snare (Fig. 29.13)
Frer's Septal Knife (Fig. 29.14)
Lack's Spatula (Fig. 29.15)
Laryngeal Mirror
Fiberoptic Bronchoscope (Fig. 29.16)
Boyle-Davis Mouth Gag (Fig. 29.17)
Denis-Brown Tonsil Holding Forceps (Fig. 29.18)
Eve's Tonsillar Snare (Fig. 29.19)
Ballenger's Guillotine (Fig. 29.20)
Tonsillar Dissector
Peritonsillar Abscess Drainage Forceps (Fig. 29.21)
Tracheostomy Tubes
NASAL PACKING
NASAL POLYPECTOMY AND TURBINECTOMY/ TURBINOTOMY
SUBMUCOUS RESECTION OF NASAL SEPTUM (SMR)
SEPTOPLASTY
NASAL BONE FRACTURE REDUCTION
CAUTERIZATION/CRYOSURGERY
ANTROSTOMY OR CALD WELL LUC OPERATION
ETHMOIDECTOMY
MYRINGOTOMY/TYMPANOTOMY
TYMPANOPLASTY
MASTOIDECTOMY
STAPEDECTOMY
30:
Instruments for Ophthalmology Operations
INSTRUMENTS USED IN OPHTHALMIC SURGERY
Eyelid Retractor (Figs 30.1A to D)
Use
Ophthalmic Loupe
Uses
Ophthalmoscope
Trial Frame
Schiotz Tonometer
Eye Speculum
Strabismus Hook
Enucleation Spoon With Optic Nerve Guide (Fig. 30.2)
Enucleation Scissor (Fig. 30.3)
Evisceration Scoop (Fig. 30.4)
Fixation Forcep (Fig. 30.5)
Conjunctival Forceps (Fig. 30.6)
Lim's Forceps
Iris Forceps (Fig. 30.7)
Pierse Hoskin's Forceps (Fig. 30.8)
Capsula Forcep (Arruga's) (Fig. 30.9)
Lens Spatula (Fig. 30.10)
Superior Rectus Forceps
Irrigation – Aspiration Cannula (Fig. 30.11)
De Wecker's Scissor (Fig. 30.12)
Spring Scissor (Figs 30.13A and B)
Vannas Scissor (Fig. 30.14)
Needle Holder
von Graffe's Knife (Fig. 30.15)
Capsulotomy Knife
Clayman Lens Holding Forceps (Fig. 30.16)
Mc Pherson Micro Forcep
Sinskey Shearing Lens Hook and Manipulator (Fig. 30.17)
Barkan Goniotomy Knife
Chalazion Clamp (Fig. 30.18)
Punctum Dilator (Fig. 30.19)
Lacrimal Syringe and Cannula (Figs 30.20A and B)
Bone Punch
Pigtail Probe (Fig. 30.21)
Foreign Body Spud and Spoon (Fig. 30.22)
Instrument for Conventional Cataract Operation
Instruments for IOL (Intraocular Lens) Implants
Intraocular Lens
Glaucoma Surgery
DCR (Dacryo Cysto Rhionostomy) Operation
Instruments for Lid Surgery
Instruments for Lacrimal Sac Surgery
31:
Microsurgical Instruments
32:
Endoscopy
FIBEROPTIC ENDOSCOPES
VIDEO ENDOSCOPY (Fig. 32.2)
EQUIPMENT SETUP (Figs 32.3 to 32.4)
TROUBLE SHOOTING
EQUIPMENT CARE
ROOM SETUP
MANIPULATION OF ENDOSCOPE
DOCUMENTATION OF FINDINGS
MONITORING
CONSCIOUS SEDATION
Characteristics of Conscious Sedation
RECOVERY
INDICATIONS
PATIENT PREPARATION
ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP)
Indications
ERCP requires following Equipment
PATIENT PREPARATION
FLEXIBLE SIGMOIDOSCOPY
Instrumentation
Patient Preparation
COLONOSCOPY
Contraindications
Preparation and Positioning of the Patient and Room Setup
General Principles of Colonoscopy
33:
Human Immunodeficiency Virus
NATURAL HISTORY OF HIV DISEASE
The Centers for Disease Control (CDC) Classification of HIV Disease
Transmission
Serologic Events
Risks of Transmission of HIV disease/Presentation to the Surgeon
Precautions
Additional Precautions for Invasive Procedures
Procedure in the Event of Contamination with Infected Blood
Infection of the Patient by Surgeon
Surgery and HIV Infection
Management of Health Care Workers Exposed to Patients' Blood and Other Body Fluids
Transmission of Blood-borne Pathogens from Health Care Workers to Patients
34:
Drains
TYPES OF DRAIN
Corrugated Drainage Sheet (Fig. 34.4)
Features
Indications
CORRUGATED DRAIN
Disadvantage
CLOSED DRAIN (Fig. 34.1)
Advantages
SUMP DRAIN (Figs 34.2 and 34.3)
Advantages
CAUTIONS WHEN YOU PUT A DRAIN
35:
Incision
INCISION
DIFFERENT TYPES OF INCISIONS (Figs 35.1 to 35.3)
MIDLINE INCISION
Steps
Advantages
Disadvantage
PARAMEDIAN INCISION
Steps
Closure
SUBCOSTAL INCISION (RIGHT OR LEFT)
Advantages
Steps
TRANSVERSE INCISION
Steps
PFANNENSTIEL INCISION
GRID IRON INCISION
RUTHERFORD MORRISON INCISION
LANZ INCISION
Advantage
INGUINAL INCISION
CURVED SUBUMBILICAL OR SUPRAUMBILICAL INCISION
MIDLINE SUPRAUMBILICAL INCISION
LUMBAR SUBCOSTAL INCISION
INSTRUMENTS FOR INCISION (Figs 35.5 and 35.6)
Scalpel
DIFFERENT METHODS OF HOLDING A SCALPEL
36:
Oxygen Therapy
INDICATION OF OXYGEN THERAPY
Hypoxemia
Hypoxia
Hypercapnia
METHODS OF OXYGENATION OR OXYGEN THERAPY (Fig. 36.3)
Nasal Prongs
Face Masks (Fig. 36.2)
Venturi Masks
Nonbreathing Masks
CPAP Mask (Continuous Positive Airway Pressure)
Bilevel Positive Airway Pressure (BiPAP)
Nonbreathing Masks
OTHER OXYGEN THERAPY DEVICE WHICH ARE USEFUL IN PEDIATRIC PATIENT
Oxygen Tent
Oxygen Hood
Oxygen in Incubator
Caution
Disadvantages
Oxygen Supply
Oxygen Cylinder
Parts of Cylinder (Figs 36.4 and 36.5)
Humidification of Oxygen (Fig. 36.6)
Precautions
Untoward Effects of Oxygen Therapy
HYPERBARIC OXYGENATION
Hazards of Hyperbaric Oxygen
Indications of Hyperbaric Oxygen
How it is Given?
Bibliography
INDEX
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