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NG Tubes:

Indications:

Diagnostic1. Evaluation of upper gastrointestinal (GI) bleed (ie, presence, volume)2. Aspiration of gastric fluid content3. Identification of the esophagus and stomach on a chest radiograph4. Administration of radiographic contrast to the GI tract Therapeutic1. Gastric decompression, including maintenance of a decompressed state afterendotracheal

intubation,often via the oropharynx2. Relief of symptoms and bowel rest in the setting of small-bowel obstruction3. Aspiration of gastric content from recent ingestion of toxic material4. Administration of medication5. Feeding6. Bowel irrigation

Contraindications:

Severe midface trauma Recent nasal surgery Coagulation abnormality Esophageal varices or stricture

Recent banding or cautery of esophageal varices Alkaline ingestionCatheters:

Indications:

Diagnostic1. Collection of uncontaminated urine specimen for diagnostic purposes2. Monitoring of urine output3. Imaging of the urinary tract4. Can be used to diagnose hematuria Therapeutic:

1. Acute urinary retention (eg,benign prostatic hypertrophy,blood clots)2. Chronic obstruction that causeshydronephrosis3. Initiation of continuous bladder irrigation4. Intermittent decompression forneurogenic bladder

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5. Hygienic care of bedridden patients6. Used to administer medication eg chemotherapy, antibiotics for cystitis

Contraindications:

Lower urinary tract trauma which is suspected when there is pelvic or straddle-type injuries or

clinical suspicion such as a boggy or high-riding prostate on DRE, perineal hematoma orblood at the meatus.

Types of catheters classified based on: Size in French gauge eg. 12-small 16-large 20-very large Materiallatex, silastic (silicone) Shape- foley, coude (elbow), teeman, 3 way catheters

Chest Tube Insertion:Indications:

Pneumothorax- opened or closed Hemothorax Hemopneumothorax Hydrothorax Chylothorax Empyema Pleural effusions Post operatively- thoracotomy, cardiothoracic surgery

Contraindications:

Coagulopathy Pulmonary bullae Pulmonary, pleural, or thoracic adhesions Loculated pleural effusion or empyema Skin infection over the chest tube insertion site

Types of surgical drain

Drains can be:

Open or closed: Open drains (Including corrugated rubber or plastic sheets) drain fluid on to a

gauze pad or into a stoma bag. They are likely to increase the risk of infection. Closed drains are formed by tubes draining into a bag or bottle. Examples include

chest, abdominal and orthopaedic drains. Generally, the risk of infection is

reduced.

Active or passive: Active drains are maintained under suction (which may be low or high pressure) eg J-

Vac

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Passive drains have no suction and work according to the differential pressurebetween body cavities and the exterior eg catheter bags

Silastic or rubber: Silastic drains are relatively inert and induce minimal tissue reaction. Red rubber drains can induce an intense tissue reaction, sometimes allowing a tract to

form (this may be considered useful - for example, with biliary T-tubes).

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Damn nuisance