Instruments and Procedures cannula/lumber puncture

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INTRACATH / INTRAVENOUS CANNULA It is used for giving IV fluids and drugs—

CANNULA

It consists of a long metallic: needle and a plastic cannula or sheath over it.
The bevelled tip of the needle goes inside the vein and at the other end the blood leaking out can be seen.
The needle may then be withdrawn and the plastic cannula or sheath left in place for many days.

· To withdraw CSF in cases of meningitis for diagnosisHyperglycemic Hyperosmolar State (HHS) Acute Complication Of DM. Read more ... » of etiology.
· Subarachnoid haemorrhage.
· GB syndromeMetabolic,Insulin Resistance Syndrome X Causes Symptoms. Read more ... » – albumin cytological dissociation.
· Queckenstedt test for CSF block.
· For myelogram – for diagnosis of spinal tumors, disc prolapsed etc.
· Therapeutic use – Intrathecal administration of steroids, immunoglobulin’s, methotrexate etc.
· For Spinal anaesthesia.

· It is a sharp needle with a short bevel (slanting tip), with a stilette fitting inside the needle.
· It is made of steel.

· The patient may sit up and bend forwards or lie in a lateral decubitus position with the knees drawn up on the abdomen and head fully flexed.
· In this position the back arches backwards and the intervertebral spaces are increased.
· The LP need Ie is inserted between the 3^rd and 4^t^h lumbar vertebra i.e. on a line joining the highest points of the two iliac crests.
· The patient is sedated, positioned, cleaned, draped and local anaesthetic xylocaine is injected subcutaneously at the site. LP needle is inserted with the stilette with the bevel of needle pointing upwards, direct into the space till loss of resistance is felt when the needle passes through the dura. The stillete is removed and CSF is seen to trickle out. CSF is collected in 3 bottles about 2 ml each for biochemical test, culture sensitivity and cytological examinationHow to take good medical history & examination. Read more ... ».
· The needle is taken out after replacing the stilette and the site is sealed with tincture benzoin.
· The head end is lowered by raising the foot end.

· Dry tap – no CSF comes out.
· Traumatic LP
· HypotensionHyperglycemic Hyperosmolar State (HHS) Acute Complication Of DM. Read more ... »
· HeadacheHeadache. Read more ... »
· Brain stem herniation
· Introduction of infection
· Backache.

· Raised intracranial tensionAshwagandha Withania somnifera Ayurvedic Drug of Impotency, Spermatorrhoea, Nervous Tonic and Tension. Read more ... » and papilledema
· Skin infection at the site of puncture
· Spinal cord compression
· Bleeding disorders
· Septicemia.

Indications —-

It is also called a sternal puncture needle.
The Salah’s needle consists of stout wide bore short bevelled needle With a stilette. On the side it has a screw guard which can be tightened at a particular distance from the tip to avoid over- penetration.

· Sternal puncture
· Patient is mildly sedated. The sternum is cleaned and punctured opposite the second and third
intercostal spaces and ~ocal anaesthetic Xylocaig.e injected so as to infiltrate the periosteum whiCh is very sensitive to pain.

>· The aspiration needle is inserted vertically half cm. into the sternum. On entering the bone marrow loss of resistance is felt, stilette is removed and suction applied with a syringe to draw out 0.2 ml of marrow. The needle is withdrawn and puncture site is pressed and sealed with tincture ben?:oin.
· Films are prepared from aspirate immediately.
· For posterior iliac crest puncture, the patient is in lateral decubitus position and the needle is introduced perpendicularly into the ilium at the posterior superior iliac spine.
Cutting fork

This is short description about some spatial processors’ in medicalFatigue diagnosis medicine and treatment. Read more ... » field, general practice.