Nota Exam - Procedures

1.Feeding tube

Purpose
-feeding (dysphagia)
-gastric aspiration ( intestinal obs, unconcious)
Cx-
aspiration pneumonia
trauma
sophagitis

2. Endotracheal tube

indication- apnea, airway obs, resp failure, coma, stridor
criteria b4 doing - suction, airway, laryngoscope,
cx- trauma, perforation, pneumothorax, aspiration pneumonia esophageal intubation

3. Lumbar puncture

indication -suspected meningitis/encephalitis,
contraindication - increased icp(raised bp, papilloedema), bleeding tendency, skin infection at site
technique-
1.sedate
2.place child in recumbant position (flexed neck, body, hip and knee)
3. identiy area (L3-L4)
4. clean using standard aseptic techniques
5.gently puncture the skin using spinal needle , toward umbilicus
6.gently advanced few mm until outflow of csf. collect
7.withdraw needle, spray n cover with gauze and bandage
8. take random blood sugar
9. ensure child in supine postion 4-6 hrs,
cx- headache, brain herniation
DONOT PERFORM IN HYPERTENSIVE ENCEPALOPATHY

4.chest tube

ind- pneumothorax +resp distress, pleural effusion, empyema
equipment - suture set, chest tube, suction pump (optional), local anas, underwater seal+sterile h2o
site- up rib 4th ics,aal/midaxillary line
cx- bleeding, nerve injury, infection
5. bone marrow aspiration
indication - hematology/oncology disorder
c/i - bleeding tendency,

p/s -esok last exam. doakan saya pass! dan doakan saya selamat sampai ke kampung.
Salah silap saya mintak maaf. ^_^