Instruments In Pediatrics 6h5k4v

PARTS pointed cannula with hub & stillete SITE – L3 & L4 OR L4 & L5 subarachnoid space POSITION – lateral decubitus sitting position

USES DIAGNOSTIC Infection- Brain & spinal cord Bleeding- subarachnoid , stroke hemorrhage Tumors – Lymphoma Autoimmune disorders - MS THERAPEUTIC- Intrathecal Injection methotrexate- Leukemia amphotericin – Fungal infection CONTRAINDICATIONS Skin infection at puncture site Raised ICT, papilloedema Hydrocephalous Intracranial Space occupying lesions COMPLICATIONS- Local Back pain Headache, Infection Brainstem herniation

PARTS – Stillete ,Thick body Nail, Needle with guard SITE Posterior Iliac Crest Sternum Tibia ( upto 2 yrs)

USES

Diagnostic Aplatic Anaemia Leukemia, PUO Megaloblastic anaemia Storage disorders- Gaucher’s, Nieman pick’s

Therapeutic Intraosseous infusion Bone marrow transplantation

JAMSHIDI’S BIOPSY NEEDLE

PARTS – Sharp pointed needle , notch sleeve SITE

- Ant to Rt mid-axillary line tenth intercostal space

Local anaesthesia INDICATIONS Chronic Hepatitis Conjugated Hyperbilirubinemia in Infancy Investigation Portal HT , Wilson’s Disease Metabolic or storage disorders CONTRAINDICATIONS

Increase PT/ PTT Platelet count < 40000 mm3 Hydatid disease of liver, Pyogenic Abscess COMPLICATIONS- Local pain , Infection, capsular bleeding, subcapsular & intrahepatic hematoma

Metal depressors –commonly used, Spatula – disposable

USES  Examine Throat, Oral Cavity, tonsil, palatal movement, posterior pharynx, Uvula,..  Visualise foreign body if aspirated  Open mouth in a unconscious patient , suctioning  Test for spasms of masseter in a suspected case of Tetanus

OR SELF INFLATING BAG PARTS  Patient outlet  Pressure release valve set to release at pressure 30-35cm water  One way valve unit  Oxygen inlet  Air inlet( with reservoir FiO2 to be around 90 – 100%)  Bag size ranges from 450ml to 1500ml

INDICATIONS  Respiratory failure/arrest  Neonatal resuscitation CONTRAINDICATION: Diaphragmatic hernia Meconium Aspiration Syndrome What is EC clamp?

OXYGEN RESERVOIR A reservoir bag One end connected to air inlet of self inflating bag Used to increase the FiO2 of the oxygen delivered to patient from 40 % to 90%

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Handle with 2 batteries Blade with light source Curved ( Macintosh) / Straight (miller) Younger children – straight blade is useful Size of the blade- 0,1,2&3

USES  For intubation under direct vision  Direct laryngoscopy- Vocal Cord Palsy For detecting foreign body in Larynx COMPLICATION Mechanical injury Stimulation of posterior pharyngeal wall – vasovagal episode Hyperextension of neck- damage to cervical spine

PARTS  Plastic tube with blunt tip & opening on lateral Side close to tip.  Blunt tube prevents damage to structures while inserting the tube  Marked line - for proper placement  Radio opaque marker  No. 5 to No. 12 commonly used for paediatric patients

PROCEDURE Size measured  From nose to tragus +  Tragus to xiphoid USES Diagnostic use  To detect internal bleeding in stomach  For performing gastric lavage for AFB  To detect tracheo-esophageal fistula  Poisoning ( for chemical analysis of gastric content)  Gastric analysis Therapeutic use NG feeds istration of drugs To decompress the stomach – as preoperative procedure Oxygen catheter For nasal, endotracheal and tracheostomy suction

Clean the area with antiseptic

SITE- Antero-lateral part of thigh Deltoid Upper & Outer quadrant of Gluteal region Needle is inserted at 45 or 90 degree

Mantoux or Tuberculin skin test Subcutaneous route

PARTS  Thin plastic sheath  Metallic stillete for guiding the vein  Metallic sheath is removed once plastic sheath is placed in the vein  Color coded for sizes  Pediatric size ranges from No. 22 to No.24

USES For infusion of iv fluids, drugs, blood products

INHALERS 4 groups

MDI Inhaler with Dry spacer devices powder Nebuliser Inhaler

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