Common Ward

Procedures
Dr Florence Bakon
• Airway Access
Endotracheal intubation
• Blood Sampling & Vascular Access
Venepuncture & Peripheral venous cannulation
umbilical vessels cannullation
• Body Fluid Sampling
CSF
Chest tube
Abdomen
Bone marrow
 Airway Access
endotracheal intubation
• Indication
• - to maintain /
protect airway

laryngoscope
ETT
Ambubagging
Suction
Laryngoscopes sizes
 Blood sampling&vascular access
Venepuncture
• Indication:

• Blood sampling (investigations)

• Intravenous fluid / medication
administration
• Equipments:

• Alcohol swab
• Tourniquet
• Topical
anaesthesia ( ie
EMLA,lignocaine)
• Needle/ branulla
• Heparinised saline
• Complications

• Hematoma or bleeding
• Thrombophebilits
• extravasation
 Arterial blood sampling
arterial line cannulation
• Indication

• Arterial blood gas

• Invasive Blood pressure monitoring
• Frequent bloodtaking

• Contraindication
• Presence of potential limbs ischaemia
 Intra osseous access
• Indications:
• Emergency access when vascular access fail
• in severe shock; vasocontriction

• Contraindication
• Fractures; crush injuries near access site
• Infection on overlying skin
Intra osseous site
 Neonate
Umbilical artery catherization
• Indication

• Bloodtaking
( frequent)
• BP monitoring
 Body Fluid Sampling
• Lumbar Puncture

• Chest tube insertion

• Gastric lavage
• Abdominal paracentesis
• Suprapubic tap
• Bladder catheterization
• Bone marrow aspiration
 Lumbar Puncture
• Indication:
-diagnostic for meningitis / encephalitis
-administration of medication/
chemotherapy

Contraindication:
-increased intra cranial pressure
-platelet< 50 000/mm or coagulopathy
-skin infection at LP site
LP • Sedation
• Child in lateral
recumbent position
(neck, body, hip,knees
flexed)
• Visualize vertical line
at level of iliac
crest.midline of spine.
• Level L3-4
• Clean the area /
sterile procedure
• Gentle puncture skin
with spinal needle.
 Chest tube
• Indications

Pneumothorax
Pleural effusion
Empyema
 Bone Marrow Aspiration
• Indications

Examination of bone marrow for diagnostic of hematology /

oncology disorder

• Contraindication
Bleeding tendency
Platelet low ( may transfuse platelet before procedure)
• Sedate
• Position –prone position
• Identify site- posterior superior iliac spine
• Aseptic technique –clean with povidone
• Local anaesthesia
• Small nick at site, hold trocar gently ,enter the cortex, by
twisting action.
• Withdraw marrow, gently remove trocar.
• Compress, tight gauze.
 Suprapubic aspiration
• Indication

• Diagnostic urine investigation

Other methods for urine collection;

-bladder catheterization
-clean catch / mid stream urine
Symphysis
pubis
• The end

• Questions