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Part Three

- The amount of blood lost and the thoracic prosthesis with an underwater system

Weighing Sponges for Blood Lost During Surgery

Necessary equipment:

- A balance in grams .

- Paper for weight notation .

Notable :

 The gauze used during the operations should be weighed, especially in large surgical operations, pediatric and neonatal operations-to find out the amount of blood and fluid lost to compensate for it by giving the patient a similar amount in size .

Procedure:

1.    Place the scale on top of a level surface.

2.    Before using the scale, make sure that the indicator is on zero .

3.    The nursing handler picks up the used gauze with a peat or a glove and puts it on the scale .

4.    All gauze used in surgery should be weighed .

 (More than one monitor can be weighed at a time if the amount of blood is low .)

5.    Before reading the weight should make sure that the indicator is constant.   

(To make sure the reading is correct)

6.    Record the reading each time the gauze is weighed and add the new weight to the previous one to find out the total total .

(Weight is equal to the amount of blood lost 1 g = 1square CM)

7.    Gauze is placed on its own trellis .

       (Because there is no confusion in the weight)

8.    Before putting gauze on the scale make sure that there is no gauze on it.

9.    The balance should be checked regularly during surgery .

       (To make sure the reading is correct during the operation)

Water Seal Chest Draining System

Necessary tools:

◾sterile bottles for thoracocentesis and we deliver them complete (Atrium) .

◾ (The suit system can be installed by a sterile nurse or a second nurse who must put a sterile sleeve and maintain the sterilization system)

◾ Adhesive tape.

◾ Distilled water.

◾ Rubber tube.

Procedure:

1.   Single bottle system:

Place the distilled water inside the bottle until it reaches about 5 cm, the exact amount of water should be recorded on a piece of blaster and placed at a level i.e. after the device is completed and connected to the patient's chest tube .

A long glass tube entered through one hole and a short one from the other hole .

(The long pipe should be about 2 cm below the water level)

 Put a rubber cap on the top of the bottle .

Because a long pipe must be installed so that its end is below the water level.

 (This is to prevent air from entering the chest cavity)

The second tube acts as a breath of air and is the shortest of the two tubes .

(Considered a breath of air that comes out of the lungs)

Make sure that it is not below the water level and that it is open to the air.

Place a valve around the top of the connections around the inlet of the wetsuit tube inside the rubber cap so that it goes into the bottle.

(To prevent air from entering the device)

 The rubber Valve is next to this tube and can be with the patient all the time .

      (Valve to close the tubes while emptying the bottles, moving the device or when the patient is moving)

 Put adhesive tape on the bottle this can be used to record the puncture level and the number of times .

2.   Two-bottle system:

We put the device in the same way as we put one bottle by a tube connected to the patient's chest tube 2 cm below the water level .

The second tube is connected to the first tube in the rubber cap of the second tube .

The rubber valve in the bottle has three holes, the middle hole is for the gauge that controls the pressure .

The third hole is for the tube and the tubes that are connected to the suction if the surgeon indicated it .

The second bottle should contain at least 5..Water poison (glass tube should be from 1.Cm-2.Poison in the water)

Place a blaster around the connections .

Place a rubber tube inside one of the two bottles.

 Place a piece of plastic along the length of the bottle to record the level of effort and time.

  (The amount of external suction from the chest is determined by the length of the tube on the surface of the water)

The thoracic prosthesis is usually about 1.Cm-2.Poison .

We fix the rubber tube with a blaster on the side of the first bottle to record the level of effort and time .

3.   The three-bottle system :

 The first bottle is delivered to the patient by a chest tube and does not contain water and is only for collecting the suit from the patient.

 The rubber cover has two holes .            

  (This is to maintain the underwater system ).

A tube passing through the rubber cap and connected to the chest tube and the other hole has a conductive tube and is underwater.

We measure the amount of distilled water inside the second bottle, which should contain enough water for the pipe connected to it to be covered with water 2 cm below the level .

The rubber cap of the second bottle has two holes :

One is for the tube that is underwater and the second is connected on the second tube .

The third bottle is filled with about 5..At least poison sterile water.

The rubber cap of the third bottle has three openings of the first tube: it comes out of the bottle and is connected to the second bottle and the second hole has a pressure control gauge .