Download Code Blue: Bedside Procedures and Critical Information by Rahul Jandial PDF

By Rahul Jandial

Embarking at the first medical rotation in a health center is a frightening event for clinicians, as textbook wisdom doesn't unavoidably correlate with the information that's useful ''''in the trenches'''' on the hospital.Whether you're a nurse tending to a valuable venous line or an intern placing that line, Code Blue is an necessary addition in your arsenal of emergency care wisdom. positioned this guide in Read more...

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Extra info for Code Blue: Bedside Procedures and Critical Information

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9-5). • Continue to advance the needle past the pericardium; blood or effusion should be encountered. • If ST-segment elevation is seen, the tip of the needle is in the myocardium. ) Fig. 9-3 Fig. 9-4 Fig. 9-5 Negative deflection of the QRS complex. 09_Jandial-r5_033-038:Layout 1 38 8/2/12 3:24 PM Page 38 Cardiothoracic PEARLS • Pericardiocentesis should be performed in a monitored setting. • For continuous drainage of fluid, a 16-gauge catheter can be inserted into the pericardial space using the Seldinger technique.

The J-wire will be in the peritoneal space and the IV catheter can be removed. • Nick the skin adjacent to the entry point of the J-wire and dilate the skin, abdominal tissue, and peritoneum (do insert the dilator past the peritoneum) using the dilator over the J-wire. • Remove the dilator and place a 16-gauge central line catheter over the J-wire and into the peritoneal space. • Remove the J-wire and connect the central line catheter to IV tubing and to a vacuum or drainage bag. Fig. 4-3 04_Jandial-r4_015-018:Layout 1 18 8/2/12 3:34 PM Page 18 Abdominal PEARLS • Oblique needle entry allows the abdominal wall to collapse when the needle is removed.

Fig. 10-3 Fig. 10-4 10_Jandial-r6_039-044:Layout 1 42 8/2/12 3:22 PM Page 42 Cardiothoracic Fig. 10-5 • With the hand that removed the syringe, place a J-wire into the needle and direct it inferiorly into the pleural space using the Seldinger technique (Fig. 10-5) (see Chapter 9). • Remove the needle, leaving the wire in place. • Using the scalpel, nick the skin adjacent to the entry site of the J-wire and introduce the dilator over the wire into the subcutaneous tissue. • Remove the dilator and introduce the 16-gauge catheter over the wire into the pleural space.

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