Pocket Essential Medical Equipment

Norbert Banhidy, David Zhang

• Publisher: CRC Press
• Year: 2022
• ISBN:
  9781000514551
• Edition: 1
• Topic: Médecine
• Subtopic: Théorie, pratique et référence de la médecine

This genuinely pocket-sized guide to essential medical equipment is ideal for medical students, newly qualified junior doctors and other healthcare professionals seeking a convenient and concise handbook to refer to in busy clinical settings including emergency departments. Clear, concise and systematic, it provides a visual guide to enable readers to identify correctly common medical equipment and use it appropriately without overwhelming or extraneous information.

Key Features:

• Convenient – everything at your fingertips, for speedy access in the emergency department, on the ward and in the clinic

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• Portable – actually fits in a pocket???

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• Illustrated – plentiful photographs and explanatory line diagrams support and enhance the text

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• Tailored – written specifically with the less experienced practitioner in mind

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Providing guidance and answering questions when senior help is not readily available, with this book as your indispensable companion you will be equipped to identify and use equipment with confidence in order to provide safe and effective care for patients.

Section I

Resuscitation “ABCDE” equipment

DOI: 10.1201/9781003159179-P1

Airway

DOI: 10.1201/9781003159179-2

Nasopharyngeal airway

Description:

• A flexible rubber tube consisting of a smooth angled tip, curved body and flanged end which can be inserted into the nose and extends into the top of the oropharynx
• Sizes range from 2 to 9 (corresponding to diameter in mm) with male adults usually requiring size 7 to 8 and females 6 to 7

Indication:

• Airway adjunct used to provide an airway in patients with an intact gag reflex, trismus or oral trauma
• May be used instead of or in conjunction with an oropharyngeal airway (see Oropharyngeal airway)

Directions of use:

• Select appropriate nostril for insertion (typically right nostril) and apply local anaesthetic spray
• Apply lubricant to tube and insert with bevel facing the nasal septum
• Advance along the septum horizontally, following the natural curvature of the floor of the nasopharyngeal cavity and rotated 90 degrees to lie in the nasopharynx
• Safety pin may be placed behind flange to prevent the advancement of tube
• Correct position can be confirmed by visualising tube tip behind uvula

Cautions and contraindications:

• Major contraindication is base of skull fractures due to possible intracranial placement
• Main complications include epistaxis, ulceration, infection, blockage

Oropharyngeal airway

Description:

• Also known as “Guedel” airway
• Rigid plastic tube inserted into mouth, curved to sit along the roof of the oral cavity and end at the tongue base
• Sizes are colour coded for easy identification (children – 0, 1, 2; adults – 4, 5, 6)

Indication:

• Airway adjunct used to lift the tongue off the posterior pharyngeal wall to prevent airway obstruction in reduced GCS (≤8)
• Also allows for oropharyngeal suctioning

Directions of use:

• Identify the correct size by measuring from the centre of the mouth between the first incisors to the angle of the mandible in an adult
• Ensure no foreign bodies in the oral cavity
• Lubricate the oropharyngeal airway
• Insert into the mouth upside down (reduces risk of pushing tongue back)
• Once tip is around the hard-soft palate junction, rotate 180 degrees and advance until flange at mouth opening
• Confirm airway patency

Cautions and contraindications:

• The main contraindication is use in patients with intact gag reflex (GCS>8)
• Main complications include gagging, vomiting and aspiration; soft tissue trauma to the tongue, palate and pharynx and injury to the teeth

Laryngeal mask airway

Description:

• Supraglottic airway device consisting of flexible plastic tube with an inflatable circular cuff on end which sits above the larynx
• Sizes range from 0 (infant) to 6 (large adult), with typically size 3 or 4 being used for female and male adults, respectively

Indication:

• Ventilation during elective anaesthesia with low risk of aspiration
• Cardiac arrest pre-intubation
• Failed endotracheal tube insertion/lack of available trained staff

Directions of use:

• Select correct size LMA
• Deflate cuff using 20ml syringe
• Lubricate cuff
• Position patient with 15 degree neck flexion and full head extension
• Insert the LMA over the tongue until it reaches the posterior pharyn...