Ward Procedures,
Edition 7Editors: By M B Patel, MBBS, MS, FRSH (LONDON), FICS (USA) and Mukesh S Suvera, MBBS, MS, FIAGES, FMAS, FICS (USA)
Publication Date:
10 Jan 2023
No accessibility information available.
First published in 1989, this book has become the standard text on the subject. It is a skills manual which explains the various preoperative and postoperative procedures and the related diagnostic and therapeutic processes used in clinical practice. The book also describes the basics of correctly handling medical/surgical appliance and highlights their working principles. The text is presented in a simple, clear and succinct manner and makes the content comprehensible for readers. The earlier editions of the book have had several reprints owing to its huge popularity.
This book is targeted primarily to meet the needs of undergraduate and postgraduate medical, nursing and paramedical students as well as trainee and practicing surgeons, physicians and nurses.
New to this edition
The seventh edition is a considerably revised version with inclusion of new chapters, topics and procedures:- Patient monitoring in ICU wards: A comprehensive chapter on basic care along with monitoring the patient in an ICU ward for management includes monitoring by multipara monitors and ventilator support with different modes of ventilator for management as well as analysis of arterial blood gases (ABGs) and interpretation beneficial to patient for better management.
- Several chapters from the previous edition are merged and rearranged and new content is added to match specific clinical procedures with the system.
- Several new topics/clinical procedures are added:
- Percutaneous nephrostomy (PCN), pericardiocentesis, parenteral nutrition
- Sample collection for various medical laboratory tests including COVID-19
- Various types of dressing including VAC dressing; ERG and VEP in ophthalmology
- Various types of radiology procedures including interventional radiology, enteroclysis, MRCP, mammography, etc.
- Cervical biopsy, cryotherapy in gynaecology and exchange transfusion in neonates
- Endoscopy procedures like ERCP, thoracoscopy, bronchoscopy, cystoscopy, flexible ureteroscopy, etc.
- Around 150 clinical photos have been added, besides tables, flow charts and illustrations, to facilitate easy and clear understanding of instruments or devices and their purpose.
- The book comes in a 4-color format to enhance visual appeal, which makes reading easier and interesting.
- Text is compact and concise to avoid redundancy.
Key Features
The seventh edition is a considerably revised version with inclusion of new chapters, topics and procedures:- Patient monitoring in ICU wards: A comprehensive chapter on basic care along with monitoring the patient in an ICU ward for management includes monitoring by multipara monitors and ventilator support with different modes of ventilator for management as well as analysis of arterial blood gases (ABGs) and interpretation beneficial to patient for better management.
- Several chapters from the previous edition are merged and rearranged and new content is added to match specific clinical procedures with the system.
- Several new topics/clinical procedures are added:
- Percutaneous nephrostomy (PCN), pericardiocentesis, parenteral nutrition
- Sample collection for various medical laboratory tests including COVID-19
- Various types of dressing including VAC dressing; ERG and VEP in ophthalmology
- Various types of radiology procedures including interventional radiology, enteroclysis, MRCP, mammography, etc.
- Cervical biopsy, cryotherapy in gynaecology and exchange transfusion in neonates
- Endoscopy procedures like ERCP, thoracoscopy, bronchoscopy, cystoscopy, flexible ureteroscopy, etc.
- Around 150 clinical photos have been added, besides tables, flow charts and illustrations, to facilitate easy and clear understanding of instruments or devices and their purpose.
- The book comes in a 4-color format to enhance visual appeal, which makes reading easier and interesting.
- Text is compact and concise to avoid redundancy.
About the author
By M B Patel, MBBS, MS, FRSH (LONDON), FICS (USA), Former Professor and Head of the General Surgery Department and currently Visiting Surgeon, Smt. Sharadaben Municipal General Hospital, Ahmedabad, India; Former Professor and Head of Surgery Department, Smt. NHL Municipal Medical College, Vadilal General Hospital, Ahmedabad, India, and Sardar Vallabhbhai Patel Institute of Medical Science and Research (SVPIMSR), Ahmedabad, India; General and Thoracic Surgeon, Nandanvan Hospital, Ahmedabad, India and Mukesh S Suvera, MBBS, MS, FIAGES, FMAS, FICS (USA)
Foreword, xvii
Preface, xix
Acknowledgements, xxi
Reviewers, xxiii
1 Sterilization, Surgical Drapes and
Scrubbing, 1
Sterilization, 1
Introduction, 1
Careful Thoughts Before the Sterilization
Process, 1
Physical Methods, 1
Chemical Methods, 5
Summary, 7
Surgical Drapes – Adhesive Ionized Drapes
Containing Chlorhexidine, 7
Advantages, 7
Indications, 7
Contraindications, 7
Sterilization, 8
Availability, 8
Scrubbing, 8
Definition, 8
Solutions, 8
Technique, 8
Glove Wearing, 8
CSSD (Central Sterile Supply Department), 8
2 Antiseptic Solutions, 11
Introduction and Definitions, 11
Mechanism of Action of Antiseptic and
Disinfection, 11
Care of Antiseptic Solutions, 12
Classifications, 12
Lysol – Concentrated Cresol Solution, 12
Weak Iodine (I2) Solution, 12
Ethicon, 13
Phenol, 13
Hydrogen Peroxide (H2O2), 14
Spirit, 14
Formalin Solution, 14
Eusol – Edinburgh University Solution (BP), 14
Cidex, 14
Glycerine Magsulf Solution, 15
Turpentine, 15
Ether, 15
Gentian Violet, 15
Acriflavine, 15
Potassium Permanganate (KMnO4), 15
Mercurochrome, 15
Silver Nitrate (AgNO3), 15
Hibitane Concentrate, 16
Cetavlon, 16
Povidone-Iodine – Betadine, 16
Dettol, 17
Torcilocid Concentrate, 17
3 Sutures in Surgery, 19
Suture Materials, 19
Introduction, 19
Descriptions on Various Types of Suture
Materials, 22
Catgut, 22
Polyglycolic Acid (Dexon), 23
Vicryl – Polyglactin 910, 23
Polydioxinone Suture (PDS), 25
Cotton Thread, 25
Linen, 25
Silk, 25
Nylon – Undyed Ethilon, 26
Prolene – Polypropylene, 26
Stainless Steel Wire, 27
Polyamide – Ethilon, 27
Fascia Lata Suture, 27
Skin Ribbon Suture, 28
Sutupak, 28
Expanded PTFE (Polytetrafluoroethylene) –
Gore-Tex, 28
Newer Nonabsorbable Synthetic Suture
Materials, 28
Newer Absorbable Synthetic Suture
Materials, 28
Needles, 29
Introduction, 29
Suturing, 32
Goals of Wound Closure or Suturing, 32
Principles of Wound Closure, 32
Different Types of Suturing Technique, 33
Remarks, 35
Removal of Sutures, 35
Mesh, 35
Introduction, 35
General Principles Guiding Use of Mesh, 35
Contraindications, 35
Properties of Ideal Mesh, 35
Physical or Mechanical Properties of Mesh
Materials, 36
Types of Mesh, 36
Nonabsorbable Mesh, 36
Absorbable Mesh, 38
Combined Nonabsorbable and Absorbable –
Lightweight Composite Meshes Without
Adhesion Prevention ‘Barrier’, 38
Composite Meshes With ‘Barrier’ to Prevent
Adhesion, 38
Complications, 39
Mesh Placement, 39
Current Trends/Future Perspectives, 39
4 Wound and Dressings, 41
Wound, 41
Introduction, 41
Wound Classification, 41
Types of Wound Drainage, 43
Complications of Wound, 43
Components of Wound, 43
Treatment of Wounds, 44
Treatment of Minor (Small) Burns, 44
Care of Infected Wounds, 45
Instructions for Wound Dressing, 45
Topical Agents, 45
Characteristics of Ideal Topical Agent, 45
Lotion, 45
Ointment, 45
Creams, 45
Powder, 46
Routinely Used Topical Agents, 46
Surgical Dressing, 47
Introduction, 47
Aim of Wound Dressing, 47
Indications of Wound Dressing, 47
Purpose of Wound Dressings, 48
General Rules of Dressing Care, 48
Ideal Dressing, 48
Types of Dressing, 48
Layers of Dressing, 49
Dressing Materials, 49
Adhesive Dressing Materials, 49
Plaster of Paris, 51
Wound Coverings, 53
Basic Surgical Materials, 54
Different Types of Dressing Materials, 54
Dressing Bag, 60
Stitch-Removal Bag, 60
Elastocrepe Bandage, 60
Lower Limb Stockings, 61
Wound Dressing With Different Products, 62
Wound Healing With Negative Pressure Wound
Therapy, 64
5 Emergency Drugs, 67
Introduction, 67
Purpose, 67
Discription on Various Types of Emergency
Drugs, 67
Inj. Adrenaline, 67
Inj. Noradrenaline, 68
Inj. Dopamine, 69
Inj. Propranolol, 69
Inj. Atropine Sulphate, 69
Inj. Neostigmine, 70
Inj. Hydrocortisone, 70
Inj. Aminophylline, 70
Inj. Morphine, 71
Inj. Pethidine _ Meperidine, 71
Inj. Diazepam, 71
Inj. Diphenylhydantoin, 71
Inj. Avil _ Chlorpheniramine Maleate, 72
Inj. Promethazine Hydrochloride _
Phenergan, 72
Inj. Insulin, 72
Inj. Sodium Bicarbonate, 72
Inj. Lasix _ Frusemide, 72
Inj. Mannitol, 73
Inj. Mephentine, 73
Sodium Nitroprusside _ Nitropress, 74
Inj. Potassium Chloride _ KCl, 74
Inj. Lignocaine Hydrochloride, 74
Inj. Calcium Gluconate, 75
Buprenorphine _ Norphin, 75
Bupivacaine Hydrochloride _ Sensorcaine, 75
Amiodarone, 76
Magnesium Sulphate, 76
Heparin, 76
Dextrose 50%, 77
Streptokinase, 77
6 Local Anaesthesia, 79
Introduction, 79
Mechanism of Action, 79
Properties Desirable in a Local Anaesthetic, 79
What Types of Local Anaesthetics are There?, 79
Topical, 80
Parenteral, 80
Drugs and Preparation, 80
Availability in Various Forms for Routine Use, 80
Jelly, 80
Viscous, 82
Injection, 82
Infiltration Anaesthesia, 82
7 Basic Nursing Care, 85
Nursing, 85
Definition, 85
Basic Nursing Care/Skill, 85
Bed Making, 85
Mouth Care, 86
Bed Bath, 86
Back Care, 86
Hair Washing, 88
Care for Fingernails/Toenails, 88
Perineal Care, 88
Taking Vital Signs, 88
Performing Physical Examination, 92
Care for Nasogastric Tube, 92
Administering Nasogastric Tube Feeding, 92
Cleaning a Wound and Applying a Sterile
Dressing, 92
Supplying Oxygen Inhalation, 93
Respiratory Care _ Inhalations, 93
Cold and Hot Applications, 95
Administration of Medications, 98
Principle, 98
Various Routes to Give Medications, 98
Specimen Collection, 100
Blood, 100
Urine, 101
Stool, 101
Sputum, 101
Biopsy, 102
Semen, 102
Nursing Care in HIV-Infected Patients, 102
General, 102
Inpatient and Outpatient Departments, 102
In Ward Patients, 102
In Operation Theatre, 102
Personal Universal Precaution, 102
Procedure in the Event of Contamination With
the Infected Blood, 102
Perioperative Nursing Care, 103
Preoperative, 103
Operating Room _ Intraoperative, 104
Recovery Room _ Postanaesthetic Room/
Postanaesthesia Care Unit, 104
Postoperative, 106
Nursing Care for Body Systems of a
Postoperative Patient, 107
Ambulatory Surgery Discharge, 107
8 Traction, Tourniquets and
Prosthesis, 109
Traction, 109
Introduction, 109
Objectives of Tractions, 109
General Principle, 109
Mechanism, 109
Types of Tractions, 110
Tourniquets, 112
Introduction, 112
Types of Tourniquets, 112
Sites of Applying a Tourniquet, 112
Width of Cuff, 112
Tourniquet Pressure, 112
Tourniquet Time, 112
Complications, 113
Contraindications, 113
Prosthesis, 113
Purpose, 113
Component of Prosthesis, 114
Classification of Artificial Limbs, 114
Prosthesis for Lower Extremity, 114
Prosthesis for Upper Extremity _ Categorized
Into Four Systems, 117
9 Oxygen Therapy, 119
Introduction, 119
Clinical Goals of O2 Therapy, 119
Purpose, 119
Indications, 119
Sources of Oxygen, 120
Different Types of Oxygen Therapy
Devices, 121
Selection of Method of O2 Therapy, 123
Precautions, Assessment and Complications
of O2 Therapy, 124
Hyperbaric Oxygen Therapy (HBO), 125
Endotracheal Intubation, 126
10 Procedures for Venous Access, 129
Introduction, 129
Types of Venous Access, 129
Vein Dilation Technique, 130
Criteria of Vein for Venous Access, 130
Considerations, 130
Indications, 130
Peripheral Venous System _ Peripheral
Angiocatheters, 130
Central Venous System _ Vascular
Catheters, 130
Types of Central Venous Catheters, 131
Site (Location) – Advantage and
Disadvantage Based On Where Central
Venous Catheters Inserted, 131
Descriptions of Various Types of Central Venous
Catheters, 133
Nontunnelled Central Catheters, 133
Tunnelled Catheters, 134
Peripherally Inserted Central Catheters, 134
Introduction, 134
Advantages, 134
Disadvantages, 134
Implantable Venous Access Device (IVAD), 134
Introduction, 134
Advantages, 134
Disadvantages, 134
Complication of Central Venous Catheter
Placement, 135
Venipuncture, 135
Drip Set and Infusion, 137
Infusion Bottle, 137
Infusion Set, 137
Common Indications for Intravenous
Infusions, 139
Method of Administration of Intravenous
Fluid, 139
Complications, 140
Irrigation Solutions, 141
Venesection, 141
Definition, 141
Indications, 141
Contraindications, 141
Sites, 141
Necessary Reagents and Equipment, 141
Procedure, 141
Care of the Venesection, 142
Procedure Failure, 142
Treatment of Thrombophlebitis, 142
Complications, 142
Special Remarks, 143
Arterial Puncture, 143
Indications, 143
Methods, 143
Complications, 144
11 Routes of Drug and Fluid
Administration, 145
Introduction, 145
Classification of Routes of Drug
Administration, 145
Factors Governing Choice of Route, 146
Systemic Routes of Drug Administrations, 146
Common Enteral Routes for Drug
Administration, 146
Common Routes for Parenteral Drug
Administrations, 147
Topical/Local Routes of Drug
Administration, 154
Routes of Fluid Administration, 155
Intravenous Fluid administration, 155
Intravenous Infusion, 155
Purpose of Infusion, 155
Types of Solutions Used, 155
Factors Affecting the Procedure, 155
Solution, 155
Volume Burette Set, 155
General Observations for Infusion, 156
Causes for Failure of Infusion, 156
After Care, 156
Subcutaneous Infusions or Hypodermoclysis or
Interstitial Infusion, 156
Introduction, 156
Indications, 156
Contraindications, 157
Sites, 157
Equipment, 157
Method or Technique of
Hypodermoclysis, 157
Fluid or Solutions, 157
Types of Fluids According to Use or
Function, 157
Types of Fluids According to Molecules, 158
Isotonic Solutions, 158
Electrolyte Solutions, 161
Indications of Isolyte Solutions, 161
Contraindications, 162
Hypotonic Solution Indications –
_250 mOsm/L, 162
Plasma Expanders, 162
12 Knives and Scalpels, 165
Scalpels, 165
Introduction, 165
Parts of Scalpels, 165
Handles, 165
Blades, 165
Types of Scalpels, 165
Sterilization, 165
Installing Surgical Blades on Handles, 166
Types of Grips on a Scalpel, 166
Methods of Cutting With a Scalpel, 166
Requirements of a Good Scalpel, 167
Removal of Blade From Handle, 167
Tenotomy Knife, 167
Indications, 167
Bistouries, 167
13 Syringes and Needles, 169
Syringes, 169
Introduction, 169
Parts of a Syringe, 169
Classification, 169
Care of the Syringe, 170
Qualities of an Ideal Syringe, 170
Description on Various Types of
Syringes, 170
Needles, 173
Parts, 173
Material, 173
Size, 173
Qualities of an Ideal Needle, 174
Descriptions of Various Types of Needles, 174
14 Procedures in Radiology: Diagnostic
and Interventional, 179
Introduction, 180
Diagnostic Radiology, 180
Interventional Radiology, 180
Nuclear Medicine, 180
X-Rays, 180
Introduction, 180
Properties, 180
Uses, 181
Points to Keep in Mind While Doing
X-ray, 181
Role of X-ray, 181
Some Normal Views for X-ray, 181
Relative Densities Seen in X-ray, 181
General Principles Before Interpreting or
Reading the X-ray, 182
Mammography, 183
Introduction, 183
Indications, 183
Advantages, 183
Disadvantages, 183
Fluoroscopy, 184
Introduction, 184
Types of Fluoroscopy, 184
Genitourinary Tract, 184
Gastrointestinal Tract, 186
Hepatobiliary, 189
Miscellaneous, 191
Ultrasonography (USG), 191
Introduction, 191
Endoscopic Ultrasound (EUS), 193
Layers of GI Wall as Seen at EUS, 193
Focused Abdominal Sonogram in Trauma
(FAST), 194
Doppler Effect, 195
Indications, 196
Computed Tomography (CT or CAT Scan), 196
Introduction, 196
Principle, 196
Advantages, 196
Computed Tomography Angiography (CTA), 197
Introduction, 197
Technique, 197
Clinical Applications, 198
Benefits and Risks, 198
CT Urography (CTU), 200
Introduction, 200
Indications, 200
Contraindications, 200
Patient Preparation, 200
CTU Phases, 200
Newer Advances in CT Scan, 202
4D CT, 202
Dual Energy CT, 202
Magnetic Resonance Imaging (MRI), 202
Principle, 202
Basic MRI Components, 202
Advantages, 203
Disadvantages, 204
Uses, 204
Magnetic Resonance Angiography (MRA), 204
Introduction, 204
Clinical Use, 204
Advantages, 204
Disadvantages, 204
Newer Advance in MRI, 205
In Angiography, 205
Magnetic Resonance Spectroscopy
(MRS), 205
Diffusion-Weighted Imaging (DWI), 205
Magnetic Resonance
Choloangiopancreatography (MRCP), 205
Nuclear Medicine, 207
Positron Emission Tomography (PET), 208
Primary Functions of the PET Scanner, 208
Stages of Evaluating an Abnormality, 208
15 Blood Transfusion and Parenteral
Nutrition, 209
Blood Transfusion, 209
Definition, 209
Purposes, 209
Types of Blood Transfusion, 209
Pre-Transfusion Testing, 210
Homologous Blood Transfusion, 210
Autologous Blood Transfusion, 213
Transfusion of Blood Components and
Plasma Expanders, 214
Whole Blood (CPD-Adenine-1), 214
Red Cell Concentrate (Packed Red Cells,
Plasma-Reduced Blood), 215
Red Cell Suspension, 216
Leucocyte-Depleted Red Cells, 216
Platelet Concentrates (Prepared From Whole
Blood Donations), 216
Platelet Concentrates (Collected by
Plateletpheresis), 217
Fresh Frozen Plasma, 217
Cryoprecipitate, 217
Human Albumin Solutions, 218
Coagulation Factors, 218
Plasma Derivatives Containing Factor IX, 218
Immunoglobulins, 219
Parenteral Nutrition, 219
Introduction, 219
Basic Principle of Nutrition, 219
Goals of Parenteral Nutrition, 219
Indication for Parenteral Nutrition, 219
Selection of Macronutrients, 220
Only Dextrose, 220
Dextrose Plus Amino Acids, 220
Dextrose Plus Amino Acids Plus Lipids, 220
Route of Nutrients Delivery, 220
Peripheral Parenteral Nutrition (PPN), 220
Central Parenteral Nutrition, 220
System of Delivering Parenteral Nutrition, 221
Multiple Bottle System, 221
Three-in-One System or Single Bottle
System, 221
Duration of Delivering Parenteral Nutrition, 221
Continuous Parenteral Nutrition, 221
Cyclic Parenteral Nutrition, 222
16 Ward Instruments, 225
Introduction, 225
Descriptions on Various Types of Ward
Instruments, 225
17 Drains, 245
Definition, 245
Principle, 245
Advantages, 245
Disadvantages, 245
Indication of Drain Placement, 245
Therapeutic, 245
Diagnostic, 246
Prophylactic, 246
Monitoring, 246
Palliative, 246
Types of Drains, 246
Advantages of Active Drains over Passive
Drains, 246
Drain Placement, 247
Procedures or Methods, 247
Precautions, 248
Drain Removal, 248
Inadvertent Removal or Drain
Dislodgement, 248
Time and Procedures, 248
Post Removal, 248
Complication of Drain, 248
Different Types of Drains, 249
Cotton Gauze, 249
Wicks, 249
Glove Rubber Drain, 249
Corrugated Drain (Sheet Drain), 249
Tube Drain, 250
Different Types of Tube Drains, 250
Mechanism of Action, 253
Pigtail Catheter Drain, 256
Davol Drain, 257
18 Catheters, 259
Definition, 259
Size, 259
Different Types of Catheters Used in the
Body, 259
Urethral and Suprapubic Catheters, 259
Description on Various Types of Non–Self-
Retaining Catheters, 260
Descriptions on Various Types of Self-
Retaining Catheters, 262
Availability, Durability and Change of
Catheters, 263
The Procedure of Urethral
Catheterization, 265
19 Gastric Aspiration Tubes, 269
Introduction, 269
General Instructions, 269
Purpose, 269
Types of Tubes, 269
Description on Various Types of Gastric
Aspiration or Feeding Tubes, 270
Stomach Tube, 270
Ryle Tube (Nasogastric Tube), 270
Sengstaken–Blakemore Tube, 273
Triple Lumen Tube (Red Rubber/Latex), 273
Infant Feeding Tube, 275
Availability, 275
Freka Transnasal Feeding Tube, 275
Levin Tube (Gastroduodenal Feeding Tube), 276
Feeding Bag, 277
20 Enemas and Suppositories, 279
Enemas, 279
Definition, 279
Procedures and Prerequisites, 279
Purpose, 279
Classification of Enemas, 280
Types of Enemas, 280
Nursing Responsibilities, 282
Description on Various Types of
Enemas, 282
Bowel Preparation for Colonoscopy or
Surgery, 283
Colon Wash, 283
Total Gut Irrigation (TGI), 284
Suppositories, 285
Introduction, 285
Advantages, 285
Disadvantages, 285
Types of Suppositories, 285
Rectal Suppositories, 286
Flatus Tube, 286
21 Procedures in Thorax, 287
Thoracocentesis, 287
Introduction, 287
Indications, 287
Diagnostic, 287
Therapeutic, 287
Purpose, 287
Contraindications, 288
Pre-Procedure Checklist, 288
Assessment, 288
Equipment and Preparation, 288
Skin Preparation, 288
Sterile Field, 288
Local Anaesthetic, 288
Thoracocentesis Specifics, 288
Dressing, 288
Premedication, 288
Procedure, 288
Position, 288
Selection of Site, 288
Technique, 288
When to Stop Aspiration and Removal of
Needle, 289
Post-Procedure Management, 289
Complications, 290
Pericardiocentesis, 290
Introduction, 290
Purpose, 290
Contraindications, 290
Pre-Procedure Checklist, 290
Equipment and Preparation, 290
Post-Procedure Management, 291
Intercostal Tube Drainage, 291
Introduction, 291
Definition, 291
Indications, 291
Contraindications, 291
Equipments and Preparation, 292
Components of Pleural Drainage
System, 292
Types of Chest Tube, 292
Selection of Chest Tube, 292
Procedures, 292
Position of the Patient, 292
Cleansing and Draping, 293
Choosing the Site of Insertion, 293
Local Anaesthesia, 293
Triangle of Safety, 293
Incision, 293
Insertion of a Tube, 293
Direction of Tube, 293
Underwater Seal Drainage System, 293
Post-Procedure Management, 293
Removal of Chest Tube, 294
Post Removal Care, 295
22 Procedures in Abdomen, 297
Liver Abscess Aspiration, 297
Liver Abscess, 297
Description on Percutaneous Drainage, 298
Needle Aspiration (Percutaneous
Drainage), 298
Catheter Drainage (Percutaneous), 300
Surgical Drainage, 300
Indications, 300
Peritoneal Lavage, 300
Introduction, 300
Indications, 300
Equipment, 301
Procedure, 301
Different Methods for Peritoneal
Lavage, 301
Complications of Peritoneal Lavage, 302
Peritoneal Dialysis, 302
Introduction, 302
Goals, 302
Principles, 302
Indications, 302
Contraindications, 303
Types of Catheters, 303
Insertion Techniques, 303
Types of Peritoneal Dialysis, 303
Method, 303
Complications, 304
Advantages of Peritoneal Dialysis (PD) over
Haemodialysis (HD), 304
Abdominal Paracentesis, 304
Introduction, 304
Types, 304
Indications, 304
Contraindications, 304
Procedure or Methods, 305
Complications, 305
Percutaneous Suprapubic Puncture, 305
Introduction, 305
Indications, 305
Contraindication, 305
Types, 306
Techniques, 306
Pre-Op Preparation or Pre-Procedure
Checklist, 306
Method or Procedure, 306
Complications, 306
Suprapubic Aspiration, 306
Introduction, 306
Indications, 307
Contraindications, 307
Equipment, 307
Technique, 307
Complications, 307
23 Procedures in Head and Neck, 309
Central Venous Pressure (CVP), 309
Introduction, 309
Indications, 309
Material and Types of Central Venous
Catheter, 310
Materials, 310
Types, 310
Indications for Central Venous Cannulation, 310
Sites for Catheter Insertion, 310
Pre-Procedure Checklist, 310
Techniques of Cannulation, 311
Measurement of CVP, 312
Post-Procedure Care, 313
Complications, 313
Tracheostomy, 313
Introduction, 313
Types of Tracheostomy Tube, 314
Types of Tracheostomy, 314
Indications, 315
Procedures, 315
Complications, 316
Tracheostomy Care (Post-Procedure
Care), 316
Emergency Tracheostomy, 316
Mucus Extractors, 316
Endotracheal Intubation, 316
Introduction, 316
When to Intubate, 317
Indications, 317
Different Types of Tubes for Endotracheal
Intubation, 317
Pre-Procedure Checklist, 318
Procedure for Oral Intubation, 318
Post-Procedure Sign for Confirmation of
Tube Placement, 319
Complications, 319
Supraglottic Airway Device – LMA, 319
Introduction, 319
Classification of LMA, 320
Indications, 321
Contraindications, 321
Methods of Insertion, 321
Advantages, 321
Disadvantages, 321
24 Procedures in Back and Spine, 323
Lumbar Puncture, 323
Definition, 323
Indications, 323
Contraindications, 324
Equipment (Spinal Set), 324
Procedure or Methods, 324
Method or Technique, 325
Pressure and Dynamics, 326
Problems (Comments on Conditions), 326
Complications, 326
Lumbar Puncture in Children, 327
Percutaneous Nephrostomy (PCN), 327
Introduction, 327
Indications, 327
Contraindications, 327
Methods for Gaining Access, 327
Equipment, 327
Procedures, 327
25 Procedures in Ophthalmology, 329
Basic Diagnostic Procedures, 329
Visual Acuity Testing, 329
Measuring Intraocular Pressure, 329
Basic Therapeutic Procedures, 329
Instillation of Eye Drops and Ointments, 329
Lacrimal Sac Syringing, 329
Foreign Body Removal, 329
Epilation for Trichiasis, 329
Specific Diagnostic Procedures, 330
Electroretinogram, 330
Visual Evoked Potential, 331
26 Procedures in ENT, 333
Procedures of Ear, 333
Ear Foreign Body (FB) Removal, 333
Ear Swab, 333
Suction Clearance of Ear, 334
Microscopic Examination of Ear, 334
Procedures of Nose, 334
Nasal FB Removal, 334
Anterior Nasal Packing, 335
Nasal Endoscopic Examination, 335
Procedures of Throat, 336
Indirect Laryngoscopy, 336
Direct Laryngoscopic Examination, 337
Throat Swab, 337
27 Procedure in Gynaecology, 339
Colposcopy, 339
Definition, 339
Indications, 339
Precaution, 339
Instruments or Equipment, 339
Pre-Procedure Preparation, 340
Procedure, 340
Aftercare or Post-Procedure Care, 340
Risks/Complications, 340
Normal Results, 340
Abnormal Results, 341
Pap Smear, 341
Introduction, 341
Indications, 341
Contraindications, 341
Instruments or Equipment, 341
Pre-Preparation, 341
Procedure, 341
Risk or Complications, 341
Results, 341
Placement of the Intrauterine Contraceptive
Device, 342
Definition, 342
Pre-Procedure Examination and
Counselling, 342
Indications, 343
Contraindications, 343
Pre-Procedure Preparation, 343
Instruments or Equipment, 343
Procedure, 343
Technique, 343
Post-Procedure Care and Advice, 344
Risk and Complications, 344
Removal of the IUCD, 344
Vaginal Douche, 344
Introduction, 344
Advantages, 344
Disadvantages, 344
Should a Woman Douche?, 344
When to Douche?, 344
Cervical Biopsy, 344
Introduction, 344
Types, 344
Indications, 345
Contraindications, 345
Complications, 345
Cryotherapy, 345
Introduction, 345
Methods, 345
Mechanism of Action, 345
Complications of Cryosurgery, 345
Advantages of Cryosurgery, 345
28 Procedures in Paediatrics and
Devices, 347
Introduction, 347
Basic Procedures, 347
Specific Procedures, 347
Umbilical Vein Catheterization, 347
Renal Biopsy, 348
Ultrasonography (USG) Machine, 349
Exchange Transfusion, 349
Definition, 349
Choice of Donor Blood, 350
Pre-Procedure Checklist, 350
Procedures, 350
Devices Used Specifically in Neonatal
Unit, 351
Dry Powder Inhaler, 353
29 Procedures in Medical Laboratories
for Investigation and Diagnosis, 357
Specimen Collection, 357
Introduction, 357
Blood Sample Collection, 357
Vacutainer Tube, 358
Urine Specimens, 359
Sputum Specimen Collection, 361
Stool Specimen Collection, 361
Semen Specimen Collection, 362
Specimen Collection for Microbiology
Studies, 362
Introduction, 362
Blood Culture, 362
Urine Culture, 362
Stool Culture, 363
Sputum Culture, 363
Wound Culture, 363
Throat Culture, 363
Sample Collections in COVID-19, 363
Biopsy, 364
Introduction, 364
Indications for Biopsy, 365
Characteristics of Lesions That Raise the
Suspicion of Malignancy, 365
Contraindications, 365
Technique or Procedures Through Which
Biopsy is Obtained, 365
Complications, 365
Common Errors and Omissions, 366
Management of the Specimen, 366
Clinical Data Needed by the Pathologist, 366
Fixatives for Biopsy Specimen, 366
General Principles of Gross or Macroscopic
Examination, 367
Method or Procedures by which
Tissue or Part of Tissue Obtained
for Biopsy, 367
Description on Various Types of Biopsy, 368
Bony Biopsy, 368
Skin Biopsy, 368
Soft Tissue Needle Biopsy, 371
Cytology, 372
Bone Marrow Aspiration, 374
Liver Biopsy, 375
Prostate Biopsy, 378
Scissors Biopsy, 379
Image-Guided Biopsy, 379
Recent Advance in Tissue or Part of Tissue
Collection for Biopsy, 380
Core Needle Biopsy, 380
Stereotactic Biopsy, 380
Vacuum-Assisted Breast Biopsy (VABB), 380
Frozen Section, 380
30 Endoscopies: Minimal Invasive
Visual Diagnostic and Therapeutic
Procedures, 383
Introduction, 384
Types of Endoscopy, 384
Description on Various Types of
Endoscopy, 384
Sigmoidoscopy, 384
Proctoscopy, 385
Rhinoscopy, 385
Otoscopy, 386
Indirect Laryngoscopy, 386
Fundoscopy, 387
Oesophagoscopy, 387
Fibreoptic Oesophagogastroduodenoscop, 389
Colonoscopy, 390
Endoscopic Retrograde
Cholangiopancreatography, 392
Introduction, 392
Indications, 392
Contraindications, 393
Pre-Procedure Preparation, 393
Procedure, 393
Postprocedures, 394
Advantages, 394
Disadvantages, 394
Complications, 394
Cystoscopy, 394
Introduction, 394
Indication, 394
Contraindications, 394
Pre-Procedure Preparation, 394
Procedure, 395
Postprocedures, 395
Advantages, 395
Disadvantage, 395
Complications, 395
Transurethral Resection Set, 395
RIRS (Retrograde Intrarenal Surgery) or Flexible
URS (Ureteroscopy), 395
Introduction, 395
Indications, 395
Contraindications, 396
Instruments, 396
Advantage, 396
Disadvantages, 396
Complications, 396
Capsule Endoscopy System, 396
Introduction, 396
Component of Capsule Endoscopy
System, 396
Indications, 397
Contraindications, 397
Preprocedure Preparations, 397
Advantages, 397
Disadvantages, 397
Bronchoscopy, 397
Introduction, 397
Types, 397
Indications, 397
Contraindications, 398
Pre-Procedure Preparations, 398
Procedure, 398
Technique or Methods, 398
Postprocedure Care, 398
Complications, 398
Advantages, 398
Disadvantages, 398
Thoracoscopy, 398
Introduction, 398
Indications, 398
Contraindications, 398
Advantages, 399
Complications, 399
31 Patient Monitoring in ICU Wards, 401
Introduction, 401
Multiparameter Monitor, 401
Introduction, 401
Electrocardiogram Monitoring, 402
Types of ECG Lead System, 402
Factors Affect on ECG, 402
SpO2 Monitoring _ Pulse Oximeter, 409
Blood Pressure Monitoring, 410
Respiratory Monitoring, 410
Body Temperature, 410
Pulse Rate, 410
ETCO2 _ Capnography, 410
Arterial Blood Gas Analysis, 413
Introduction, 413
Indications for Arterial Blood Gas
Analysis, 413
Collection of Sample (Site and Care), 413
Contraindications for Radial Artery
Puncture, 414
Results of ABGA, 414
Primary Acid – Base Disorders, 414
Metabolic Acidosis, 414
Metabolic Alkalosis, 415
Respiratory Acidosis, 415
Respiratory Alkalosis, 415
Future Trends in Patient Monitoring System, 416
INDEX, 417
Preface, xix
Acknowledgements, xxi
Reviewers, xxiii
1 Sterilization, Surgical Drapes and
Scrubbing, 1
Sterilization, 1
Introduction, 1
Careful Thoughts Before the Sterilization
Process, 1
Physical Methods, 1
Chemical Methods, 5
Summary, 7
Surgical Drapes – Adhesive Ionized Drapes
Containing Chlorhexidine, 7
Advantages, 7
Indications, 7
Contraindications, 7
Sterilization, 8
Availability, 8
Scrubbing, 8
Definition, 8
Solutions, 8
Technique, 8
Glove Wearing, 8
CSSD (Central Sterile Supply Department), 8
2 Antiseptic Solutions, 11
Introduction and Definitions, 11
Mechanism of Action of Antiseptic and
Disinfection, 11
Care of Antiseptic Solutions, 12
Classifications, 12
Lysol – Concentrated Cresol Solution, 12
Weak Iodine (I2) Solution, 12
Ethicon, 13
Phenol, 13
Hydrogen Peroxide (H2O2), 14
Spirit, 14
Formalin Solution, 14
Eusol – Edinburgh University Solution (BP), 14
Cidex, 14
Glycerine Magsulf Solution, 15
Turpentine, 15
Ether, 15
Gentian Violet, 15
Acriflavine, 15
Potassium Permanganate (KMnO4), 15
Mercurochrome, 15
Silver Nitrate (AgNO3), 15
Hibitane Concentrate, 16
Cetavlon, 16
Povidone-Iodine – Betadine, 16
Dettol, 17
Torcilocid Concentrate, 17
3 Sutures in Surgery, 19
Suture Materials, 19
Introduction, 19
Descriptions on Various Types of Suture
Materials, 22
Catgut, 22
Polyglycolic Acid (Dexon), 23
Vicryl – Polyglactin 910, 23
Polydioxinone Suture (PDS), 25
Cotton Thread, 25
Linen, 25
Silk, 25
Nylon – Undyed Ethilon, 26
Prolene – Polypropylene, 26
Stainless Steel Wire, 27
Polyamide – Ethilon, 27
Fascia Lata Suture, 27
Skin Ribbon Suture, 28
Sutupak, 28
Expanded PTFE (Polytetrafluoroethylene) –
Gore-Tex, 28
Newer Nonabsorbable Synthetic Suture
Materials, 28
Newer Absorbable Synthetic Suture
Materials, 28
Needles, 29
Introduction, 29
Suturing, 32
Goals of Wound Closure or Suturing, 32
Principles of Wound Closure, 32
Different Types of Suturing Technique, 33
Remarks, 35
Removal of Sutures, 35
Mesh, 35
Introduction, 35
General Principles Guiding Use of Mesh, 35
Contraindications, 35
Properties of Ideal Mesh, 35
Physical or Mechanical Properties of Mesh
Materials, 36
Types of Mesh, 36
Nonabsorbable Mesh, 36
Absorbable Mesh, 38
Combined Nonabsorbable and Absorbable –
Lightweight Composite Meshes Without
Adhesion Prevention ‘Barrier’, 38
Composite Meshes With ‘Barrier’ to Prevent
Adhesion, 38
Complications, 39
Mesh Placement, 39
Current Trends/Future Perspectives, 39
4 Wound and Dressings, 41
Wound, 41
Introduction, 41
Wound Classification, 41
Types of Wound Drainage, 43
Complications of Wound, 43
Components of Wound, 43
Treatment of Wounds, 44
Treatment of Minor (Small) Burns, 44
Care of Infected Wounds, 45
Instructions for Wound Dressing, 45
Topical Agents, 45
Characteristics of Ideal Topical Agent, 45
Lotion, 45
Ointment, 45
Creams, 45
Powder, 46
Routinely Used Topical Agents, 46
Surgical Dressing, 47
Introduction, 47
Aim of Wound Dressing, 47
Indications of Wound Dressing, 47
Purpose of Wound Dressings, 48
General Rules of Dressing Care, 48
Ideal Dressing, 48
Types of Dressing, 48
Layers of Dressing, 49
Dressing Materials, 49
Adhesive Dressing Materials, 49
Plaster of Paris, 51
Wound Coverings, 53
Basic Surgical Materials, 54
Different Types of Dressing Materials, 54
Dressing Bag, 60
Stitch-Removal Bag, 60
Elastocrepe Bandage, 60
Lower Limb Stockings, 61
Wound Dressing With Different Products, 62
Wound Healing With Negative Pressure Wound
Therapy, 64
5 Emergency Drugs, 67
Introduction, 67
Purpose, 67
Discription on Various Types of Emergency
Drugs, 67
Inj. Adrenaline, 67
Inj. Noradrenaline, 68
Inj. Dopamine, 69
Inj. Propranolol, 69
Inj. Atropine Sulphate, 69
Inj. Neostigmine, 70
Inj. Hydrocortisone, 70
Inj. Aminophylline, 70
Inj. Morphine, 71
Inj. Pethidine _ Meperidine, 71
Inj. Diazepam, 71
Inj. Diphenylhydantoin, 71
Inj. Avil _ Chlorpheniramine Maleate, 72
Inj. Promethazine Hydrochloride _
Phenergan, 72
Inj. Insulin, 72
Inj. Sodium Bicarbonate, 72
Inj. Lasix _ Frusemide, 72
Inj. Mannitol, 73
Inj. Mephentine, 73
Sodium Nitroprusside _ Nitropress, 74
Inj. Potassium Chloride _ KCl, 74
Inj. Lignocaine Hydrochloride, 74
Inj. Calcium Gluconate, 75
Buprenorphine _ Norphin, 75
Bupivacaine Hydrochloride _ Sensorcaine, 75
Amiodarone, 76
Magnesium Sulphate, 76
Heparin, 76
Dextrose 50%, 77
Streptokinase, 77
6 Local Anaesthesia, 79
Introduction, 79
Mechanism of Action, 79
Properties Desirable in a Local Anaesthetic, 79
What Types of Local Anaesthetics are There?, 79
Topical, 80
Parenteral, 80
Drugs and Preparation, 80
Availability in Various Forms for Routine Use, 80
Jelly, 80
Viscous, 82
Injection, 82
Infiltration Anaesthesia, 82
7 Basic Nursing Care, 85
Nursing, 85
Definition, 85
Basic Nursing Care/Skill, 85
Bed Making, 85
Mouth Care, 86
Bed Bath, 86
Back Care, 86
Hair Washing, 88
Care for Fingernails/Toenails, 88
Perineal Care, 88
Taking Vital Signs, 88
Performing Physical Examination, 92
Care for Nasogastric Tube, 92
Administering Nasogastric Tube Feeding, 92
Cleaning a Wound and Applying a Sterile
Dressing, 92
Supplying Oxygen Inhalation, 93
Respiratory Care _ Inhalations, 93
Cold and Hot Applications, 95
Administration of Medications, 98
Principle, 98
Various Routes to Give Medications, 98
Specimen Collection, 100
Blood, 100
Urine, 101
Stool, 101
Sputum, 101
Biopsy, 102
Semen, 102
Nursing Care in HIV-Infected Patients, 102
General, 102
Inpatient and Outpatient Departments, 102
In Ward Patients, 102
In Operation Theatre, 102
Personal Universal Precaution, 102
Procedure in the Event of Contamination With
the Infected Blood, 102
Perioperative Nursing Care, 103
Preoperative, 103
Operating Room _ Intraoperative, 104
Recovery Room _ Postanaesthetic Room/
Postanaesthesia Care Unit, 104
Postoperative, 106
Nursing Care for Body Systems of a
Postoperative Patient, 107
Ambulatory Surgery Discharge, 107
8 Traction, Tourniquets and
Prosthesis, 109
Traction, 109
Introduction, 109
Objectives of Tractions, 109
General Principle, 109
Mechanism, 109
Types of Tractions, 110
Tourniquets, 112
Introduction, 112
Types of Tourniquets, 112
Sites of Applying a Tourniquet, 112
Width of Cuff, 112
Tourniquet Pressure, 112
Tourniquet Time, 112
Complications, 113
Contraindications, 113
Prosthesis, 113
Purpose, 113
Component of Prosthesis, 114
Classification of Artificial Limbs, 114
Prosthesis for Lower Extremity, 114
Prosthesis for Upper Extremity _ Categorized
Into Four Systems, 117
9 Oxygen Therapy, 119
Introduction, 119
Clinical Goals of O2 Therapy, 119
Purpose, 119
Indications, 119
Sources of Oxygen, 120
Different Types of Oxygen Therapy
Devices, 121
Selection of Method of O2 Therapy, 123
Precautions, Assessment and Complications
of O2 Therapy, 124
Hyperbaric Oxygen Therapy (HBO), 125
Endotracheal Intubation, 126
10 Procedures for Venous Access, 129
Introduction, 129
Types of Venous Access, 129
Vein Dilation Technique, 130
Criteria of Vein for Venous Access, 130
Considerations, 130
Indications, 130
Peripheral Venous System _ Peripheral
Angiocatheters, 130
Central Venous System _ Vascular
Catheters, 130
Types of Central Venous Catheters, 131
Site (Location) – Advantage and
Disadvantage Based On Where Central
Venous Catheters Inserted, 131
Descriptions of Various Types of Central Venous
Catheters, 133
Nontunnelled Central Catheters, 133
Tunnelled Catheters, 134
Peripherally Inserted Central Catheters, 134
Introduction, 134
Advantages, 134
Disadvantages, 134
Implantable Venous Access Device (IVAD), 134
Introduction, 134
Advantages, 134
Disadvantages, 134
Complication of Central Venous Catheter
Placement, 135
Venipuncture, 135
Drip Set and Infusion, 137
Infusion Bottle, 137
Infusion Set, 137
Common Indications for Intravenous
Infusions, 139
Method of Administration of Intravenous
Fluid, 139
Complications, 140
Irrigation Solutions, 141
Venesection, 141
Definition, 141
Indications, 141
Contraindications, 141
Sites, 141
Necessary Reagents and Equipment, 141
Procedure, 141
Care of the Venesection, 142
Procedure Failure, 142
Treatment of Thrombophlebitis, 142
Complications, 142
Special Remarks, 143
Arterial Puncture, 143
Indications, 143
Methods, 143
Complications, 144
11 Routes of Drug and Fluid
Administration, 145
Introduction, 145
Classification of Routes of Drug
Administration, 145
Factors Governing Choice of Route, 146
Systemic Routes of Drug Administrations, 146
Common Enteral Routes for Drug
Administration, 146
Common Routes for Parenteral Drug
Administrations, 147
Topical/Local Routes of Drug
Administration, 154
Routes of Fluid Administration, 155
Intravenous Fluid administration, 155
Intravenous Infusion, 155
Purpose of Infusion, 155
Types of Solutions Used, 155
Factors Affecting the Procedure, 155
Solution, 155
Volume Burette Set, 155
General Observations for Infusion, 156
Causes for Failure of Infusion, 156
After Care, 156
Subcutaneous Infusions or Hypodermoclysis or
Interstitial Infusion, 156
Introduction, 156
Indications, 156
Contraindications, 157
Sites, 157
Equipment, 157
Method or Technique of
Hypodermoclysis, 157
Fluid or Solutions, 157
Types of Fluids According to Use or
Function, 157
Types of Fluids According to Molecules, 158
Isotonic Solutions, 158
Electrolyte Solutions, 161
Indications of Isolyte Solutions, 161
Contraindications, 162
Hypotonic Solution Indications –
_250 mOsm/L, 162
Plasma Expanders, 162
12 Knives and Scalpels, 165
Scalpels, 165
Introduction, 165
Parts of Scalpels, 165
Handles, 165
Blades, 165
Types of Scalpels, 165
Sterilization, 165
Installing Surgical Blades on Handles, 166
Types of Grips on a Scalpel, 166
Methods of Cutting With a Scalpel, 166
Requirements of a Good Scalpel, 167
Removal of Blade From Handle, 167
Tenotomy Knife, 167
Indications, 167
Bistouries, 167
13 Syringes and Needles, 169
Syringes, 169
Introduction, 169
Parts of a Syringe, 169
Classification, 169
Care of the Syringe, 170
Qualities of an Ideal Syringe, 170
Description on Various Types of
Syringes, 170
Needles, 173
Parts, 173
Material, 173
Size, 173
Qualities of an Ideal Needle, 174
Descriptions of Various Types of Needles, 174
14 Procedures in Radiology: Diagnostic
and Interventional, 179
Introduction, 180
Diagnostic Radiology, 180
Interventional Radiology, 180
Nuclear Medicine, 180
X-Rays, 180
Introduction, 180
Properties, 180
Uses, 181
Points to Keep in Mind While Doing
X-ray, 181
Role of X-ray, 181
Some Normal Views for X-ray, 181
Relative Densities Seen in X-ray, 181
General Principles Before Interpreting or
Reading the X-ray, 182
Mammography, 183
Introduction, 183
Indications, 183
Advantages, 183
Disadvantages, 183
Fluoroscopy, 184
Introduction, 184
Types of Fluoroscopy, 184
Genitourinary Tract, 184
Gastrointestinal Tract, 186
Hepatobiliary, 189
Miscellaneous, 191
Ultrasonography (USG), 191
Introduction, 191
Endoscopic Ultrasound (EUS), 193
Layers of GI Wall as Seen at EUS, 193
Focused Abdominal Sonogram in Trauma
(FAST), 194
Doppler Effect, 195
Indications, 196
Computed Tomography (CT or CAT Scan), 196
Introduction, 196
Principle, 196
Advantages, 196
Computed Tomography Angiography (CTA), 197
Introduction, 197
Technique, 197
Clinical Applications, 198
Benefits and Risks, 198
CT Urography (CTU), 200
Introduction, 200
Indications, 200
Contraindications, 200
Patient Preparation, 200
CTU Phases, 200
Newer Advances in CT Scan, 202
4D CT, 202
Dual Energy CT, 202
Magnetic Resonance Imaging (MRI), 202
Principle, 202
Basic MRI Components, 202
Advantages, 203
Disadvantages, 204
Uses, 204
Magnetic Resonance Angiography (MRA), 204
Introduction, 204
Clinical Use, 204
Advantages, 204
Disadvantages, 204
Newer Advance in MRI, 205
In Angiography, 205
Magnetic Resonance Spectroscopy
(MRS), 205
Diffusion-Weighted Imaging (DWI), 205
Magnetic Resonance
Choloangiopancreatography (MRCP), 205
Nuclear Medicine, 207
Positron Emission Tomography (PET), 208
Primary Functions of the PET Scanner, 208
Stages of Evaluating an Abnormality, 208
15 Blood Transfusion and Parenteral
Nutrition, 209
Blood Transfusion, 209
Definition, 209
Purposes, 209
Types of Blood Transfusion, 209
Pre-Transfusion Testing, 210
Homologous Blood Transfusion, 210
Autologous Blood Transfusion, 213
Transfusion of Blood Components and
Plasma Expanders, 214
Whole Blood (CPD-Adenine-1), 214
Red Cell Concentrate (Packed Red Cells,
Plasma-Reduced Blood), 215
Red Cell Suspension, 216
Leucocyte-Depleted Red Cells, 216
Platelet Concentrates (Prepared From Whole
Blood Donations), 216
Platelet Concentrates (Collected by
Plateletpheresis), 217
Fresh Frozen Plasma, 217
Cryoprecipitate, 217
Human Albumin Solutions, 218
Coagulation Factors, 218
Plasma Derivatives Containing Factor IX, 218
Immunoglobulins, 219
Parenteral Nutrition, 219
Introduction, 219
Basic Principle of Nutrition, 219
Goals of Parenteral Nutrition, 219
Indication for Parenteral Nutrition, 219
Selection of Macronutrients, 220
Only Dextrose, 220
Dextrose Plus Amino Acids, 220
Dextrose Plus Amino Acids Plus Lipids, 220
Route of Nutrients Delivery, 220
Peripheral Parenteral Nutrition (PPN), 220
Central Parenteral Nutrition, 220
System of Delivering Parenteral Nutrition, 221
Multiple Bottle System, 221
Three-in-One System or Single Bottle
System, 221
Duration of Delivering Parenteral Nutrition, 221
Continuous Parenteral Nutrition, 221
Cyclic Parenteral Nutrition, 222
16 Ward Instruments, 225
Introduction, 225
Descriptions on Various Types of Ward
Instruments, 225
17 Drains, 245
Definition, 245
Principle, 245
Advantages, 245
Disadvantages, 245
Indication of Drain Placement, 245
Therapeutic, 245
Diagnostic, 246
Prophylactic, 246
Monitoring, 246
Palliative, 246
Types of Drains, 246
Advantages of Active Drains over Passive
Drains, 246
Drain Placement, 247
Procedures or Methods, 247
Precautions, 248
Drain Removal, 248
Inadvertent Removal or Drain
Dislodgement, 248
Time and Procedures, 248
Post Removal, 248
Complication of Drain, 248
Different Types of Drains, 249
Cotton Gauze, 249
Wicks, 249
Glove Rubber Drain, 249
Corrugated Drain (Sheet Drain), 249
Tube Drain, 250
Different Types of Tube Drains, 250
Mechanism of Action, 253
Pigtail Catheter Drain, 256
Davol Drain, 257
18 Catheters, 259
Definition, 259
Size, 259
Different Types of Catheters Used in the
Body, 259
Urethral and Suprapubic Catheters, 259
Description on Various Types of Non–Self-
Retaining Catheters, 260
Descriptions on Various Types of Self-
Retaining Catheters, 262
Availability, Durability and Change of
Catheters, 263
The Procedure of Urethral
Catheterization, 265
19 Gastric Aspiration Tubes, 269
Introduction, 269
General Instructions, 269
Purpose, 269
Types of Tubes, 269
Description on Various Types of Gastric
Aspiration or Feeding Tubes, 270
Stomach Tube, 270
Ryle Tube (Nasogastric Tube), 270
Sengstaken–Blakemore Tube, 273
Triple Lumen Tube (Red Rubber/Latex), 273
Infant Feeding Tube, 275
Availability, 275
Freka Transnasal Feeding Tube, 275
Levin Tube (Gastroduodenal Feeding Tube), 276
Feeding Bag, 277
20 Enemas and Suppositories, 279
Enemas, 279
Definition, 279
Procedures and Prerequisites, 279
Purpose, 279
Classification of Enemas, 280
Types of Enemas, 280
Nursing Responsibilities, 282
Description on Various Types of
Enemas, 282
Bowel Preparation for Colonoscopy or
Surgery, 283
Colon Wash, 283
Total Gut Irrigation (TGI), 284
Suppositories, 285
Introduction, 285
Advantages, 285
Disadvantages, 285
Types of Suppositories, 285
Rectal Suppositories, 286
Flatus Tube, 286
21 Procedures in Thorax, 287
Thoracocentesis, 287
Introduction, 287
Indications, 287
Diagnostic, 287
Therapeutic, 287
Purpose, 287
Contraindications, 288
Pre-Procedure Checklist, 288
Assessment, 288
Equipment and Preparation, 288
Skin Preparation, 288
Sterile Field, 288
Local Anaesthetic, 288
Thoracocentesis Specifics, 288
Dressing, 288
Premedication, 288
Procedure, 288
Position, 288
Selection of Site, 288
Technique, 288
When to Stop Aspiration and Removal of
Needle, 289
Post-Procedure Management, 289
Complications, 290
Pericardiocentesis, 290
Introduction, 290
Purpose, 290
Contraindications, 290
Pre-Procedure Checklist, 290
Equipment and Preparation, 290
Post-Procedure Management, 291
Intercostal Tube Drainage, 291
Introduction, 291
Definition, 291
Indications, 291
Contraindications, 291
Equipments and Preparation, 292
Components of Pleural Drainage
System, 292
Types of Chest Tube, 292
Selection of Chest Tube, 292
Procedures, 292
Position of the Patient, 292
Cleansing and Draping, 293
Choosing the Site of Insertion, 293
Local Anaesthesia, 293
Triangle of Safety, 293
Incision, 293
Insertion of a Tube, 293
Direction of Tube, 293
Underwater Seal Drainage System, 293
Post-Procedure Management, 293
Removal of Chest Tube, 294
Post Removal Care, 295
22 Procedures in Abdomen, 297
Liver Abscess Aspiration, 297
Liver Abscess, 297
Description on Percutaneous Drainage, 298
Needle Aspiration (Percutaneous
Drainage), 298
Catheter Drainage (Percutaneous), 300
Surgical Drainage, 300
Indications, 300
Peritoneal Lavage, 300
Introduction, 300
Indications, 300
Equipment, 301
Procedure, 301
Different Methods for Peritoneal
Lavage, 301
Complications of Peritoneal Lavage, 302
Peritoneal Dialysis, 302
Introduction, 302
Goals, 302
Principles, 302
Indications, 302
Contraindications, 303
Types of Catheters, 303
Insertion Techniques, 303
Types of Peritoneal Dialysis, 303
Method, 303
Complications, 304
Advantages of Peritoneal Dialysis (PD) over
Haemodialysis (HD), 304
Abdominal Paracentesis, 304
Introduction, 304
Types, 304
Indications, 304
Contraindications, 304
Procedure or Methods, 305
Complications, 305
Percutaneous Suprapubic Puncture, 305
Introduction, 305
Indications, 305
Contraindication, 305
Types, 306
Techniques, 306
Pre-Op Preparation or Pre-Procedure
Checklist, 306
Method or Procedure, 306
Complications, 306
Suprapubic Aspiration, 306
Introduction, 306
Indications, 307
Contraindications, 307
Equipment, 307
Technique, 307
Complications, 307
23 Procedures in Head and Neck, 309
Central Venous Pressure (CVP), 309
Introduction, 309
Indications, 309
Material and Types of Central Venous
Catheter, 310
Materials, 310
Types, 310
Indications for Central Venous Cannulation, 310
Sites for Catheter Insertion, 310
Pre-Procedure Checklist, 310
Techniques of Cannulation, 311
Measurement of CVP, 312
Post-Procedure Care, 313
Complications, 313
Tracheostomy, 313
Introduction, 313
Types of Tracheostomy Tube, 314
Types of Tracheostomy, 314
Indications, 315
Procedures, 315
Complications, 316
Tracheostomy Care (Post-Procedure
Care), 316
Emergency Tracheostomy, 316
Mucus Extractors, 316
Endotracheal Intubation, 316
Introduction, 316
When to Intubate, 317
Indications, 317
Different Types of Tubes for Endotracheal
Intubation, 317
Pre-Procedure Checklist, 318
Procedure for Oral Intubation, 318
Post-Procedure Sign for Confirmation of
Tube Placement, 319
Complications, 319
Supraglottic Airway Device – LMA, 319
Introduction, 319
Classification of LMA, 320
Indications, 321
Contraindications, 321
Methods of Insertion, 321
Advantages, 321
Disadvantages, 321
24 Procedures in Back and Spine, 323
Lumbar Puncture, 323
Definition, 323
Indications, 323
Contraindications, 324
Equipment (Spinal Set), 324
Procedure or Methods, 324
Method or Technique, 325
Pressure and Dynamics, 326
Problems (Comments on Conditions), 326
Complications, 326
Lumbar Puncture in Children, 327
Percutaneous Nephrostomy (PCN), 327
Introduction, 327
Indications, 327
Contraindications, 327
Methods for Gaining Access, 327
Equipment, 327
Procedures, 327
25 Procedures in Ophthalmology, 329
Basic Diagnostic Procedures, 329
Visual Acuity Testing, 329
Measuring Intraocular Pressure, 329
Basic Therapeutic Procedures, 329
Instillation of Eye Drops and Ointments, 329
Lacrimal Sac Syringing, 329
Foreign Body Removal, 329
Epilation for Trichiasis, 329
Specific Diagnostic Procedures, 330
Electroretinogram, 330
Visual Evoked Potential, 331
26 Procedures in ENT, 333
Procedures of Ear, 333
Ear Foreign Body (FB) Removal, 333
Ear Swab, 333
Suction Clearance of Ear, 334
Microscopic Examination of Ear, 334
Procedures of Nose, 334
Nasal FB Removal, 334
Anterior Nasal Packing, 335
Nasal Endoscopic Examination, 335
Procedures of Throat, 336
Indirect Laryngoscopy, 336
Direct Laryngoscopic Examination, 337
Throat Swab, 337
27 Procedure in Gynaecology, 339
Colposcopy, 339
Definition, 339
Indications, 339
Precaution, 339
Instruments or Equipment, 339
Pre-Procedure Preparation, 340
Procedure, 340
Aftercare or Post-Procedure Care, 340
Risks/Complications, 340
Normal Results, 340
Abnormal Results, 341
Pap Smear, 341
Introduction, 341
Indications, 341
Contraindications, 341
Instruments or Equipment, 341
Pre-Preparation, 341
Procedure, 341
Risk or Complications, 341
Results, 341
Placement of the Intrauterine Contraceptive
Device, 342
Definition, 342
Pre-Procedure Examination and
Counselling, 342
Indications, 343
Contraindications, 343
Pre-Procedure Preparation, 343
Instruments or Equipment, 343
Procedure, 343
Technique, 343
Post-Procedure Care and Advice, 344
Risk and Complications, 344
Removal of the IUCD, 344
Vaginal Douche, 344
Introduction, 344
Advantages, 344
Disadvantages, 344
Should a Woman Douche?, 344
When to Douche?, 344
Cervical Biopsy, 344
Introduction, 344
Types, 344
Indications, 345
Contraindications, 345
Complications, 345
Cryotherapy, 345
Introduction, 345
Methods, 345
Mechanism of Action, 345
Complications of Cryosurgery, 345
Advantages of Cryosurgery, 345
28 Procedures in Paediatrics and
Devices, 347
Introduction, 347
Basic Procedures, 347
Specific Procedures, 347
Umbilical Vein Catheterization, 347
Renal Biopsy, 348
Ultrasonography (USG) Machine, 349
Exchange Transfusion, 349
Definition, 349
Choice of Donor Blood, 350
Pre-Procedure Checklist, 350
Procedures, 350
Devices Used Specifically in Neonatal
Unit, 351
Dry Powder Inhaler, 353
29 Procedures in Medical Laboratories
for Investigation and Diagnosis, 357
Specimen Collection, 357
Introduction, 357
Blood Sample Collection, 357
Vacutainer Tube, 358
Urine Specimens, 359
Sputum Specimen Collection, 361
Stool Specimen Collection, 361
Semen Specimen Collection, 362
Specimen Collection for Microbiology
Studies, 362
Introduction, 362
Blood Culture, 362
Urine Culture, 362
Stool Culture, 363
Sputum Culture, 363
Wound Culture, 363
Throat Culture, 363
Sample Collections in COVID-19, 363
Biopsy, 364
Introduction, 364
Indications for Biopsy, 365
Characteristics of Lesions That Raise the
Suspicion of Malignancy, 365
Contraindications, 365
Technique or Procedures Through Which
Biopsy is Obtained, 365
Complications, 365
Common Errors and Omissions, 366
Management of the Specimen, 366
Clinical Data Needed by the Pathologist, 366
Fixatives for Biopsy Specimen, 366
General Principles of Gross or Macroscopic
Examination, 367
Method or Procedures by which
Tissue or Part of Tissue Obtained
for Biopsy, 367
Description on Various Types of Biopsy, 368
Bony Biopsy, 368
Skin Biopsy, 368
Soft Tissue Needle Biopsy, 371
Cytology, 372
Bone Marrow Aspiration, 374
Liver Biopsy, 375
Prostate Biopsy, 378
Scissors Biopsy, 379
Image-Guided Biopsy, 379
Recent Advance in Tissue or Part of Tissue
Collection for Biopsy, 380
Core Needle Biopsy, 380
Stereotactic Biopsy, 380
Vacuum-Assisted Breast Biopsy (VABB), 380
Frozen Section, 380
30 Endoscopies: Minimal Invasive
Visual Diagnostic and Therapeutic
Procedures, 383
Introduction, 384
Types of Endoscopy, 384
Description on Various Types of
Endoscopy, 384
Sigmoidoscopy, 384
Proctoscopy, 385
Rhinoscopy, 385
Otoscopy, 386
Indirect Laryngoscopy, 386
Fundoscopy, 387
Oesophagoscopy, 387
Fibreoptic Oesophagogastroduodenoscop, 389
Colonoscopy, 390
Endoscopic Retrograde
Cholangiopancreatography, 392
Introduction, 392
Indications, 392
Contraindications, 393
Pre-Procedure Preparation, 393
Procedure, 393
Postprocedures, 394
Advantages, 394
Disadvantages, 394
Complications, 394
Cystoscopy, 394
Introduction, 394
Indication, 394
Contraindications, 394
Pre-Procedure Preparation, 394
Procedure, 395
Postprocedures, 395
Advantages, 395
Disadvantage, 395
Complications, 395
Transurethral Resection Set, 395
RIRS (Retrograde Intrarenal Surgery) or Flexible
URS (Ureteroscopy), 395
Introduction, 395
Indications, 395
Contraindications, 396
Instruments, 396
Advantage, 396
Disadvantages, 396
Complications, 396
Capsule Endoscopy System, 396
Introduction, 396
Component of Capsule Endoscopy
System, 396
Indications, 397
Contraindications, 397
Preprocedure Preparations, 397
Advantages, 397
Disadvantages, 397
Bronchoscopy, 397
Introduction, 397
Types, 397
Indications, 397
Contraindications, 398
Pre-Procedure Preparations, 398
Procedure, 398
Technique or Methods, 398
Postprocedure Care, 398
Complications, 398
Advantages, 398
Disadvantages, 398
Thoracoscopy, 398
Introduction, 398
Indications, 398
Contraindications, 398
Advantages, 399
Complications, 399
31 Patient Monitoring in ICU Wards, 401
Introduction, 401
Multiparameter Monitor, 401
Introduction, 401
Electrocardiogram Monitoring, 402
Types of ECG Lead System, 402
Factors Affect on ECG, 402
SpO2 Monitoring _ Pulse Oximeter, 409
Blood Pressure Monitoring, 410
Respiratory Monitoring, 410
Body Temperature, 410
Pulse Rate, 410
ETCO2 _ Capnography, 410
Arterial Blood Gas Analysis, 413
Introduction, 413
Indications for Arterial Blood Gas
Analysis, 413
Collection of Sample (Site and Care), 413
Contraindications for Radial Artery
Puncture, 414
Results of ABGA, 414
Primary Acid – Base Disorders, 414
Metabolic Acidosis, 414
Metabolic Alkalosis, 415
Respiratory Acidosis, 415
Respiratory Alkalosis, 415
Future Trends in Patient Monitoring System, 416
INDEX, 417
ISBN:
9788131264492
Page Count:
530
Retail Price (USD)
:
