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 your lab coat pocket and position the subsequent info at your fingertips: fundamentals on physique structures, ailments, and drugsCritical in. Read more...
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Extra info for Code Blue: Bedside Procedures and Critical Information
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.