L3 - Non-Aseptic Techniques

8/12/2019 L3 - Non-Aseptic Techniques

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Patient Care II Non-aseptic Technique


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OUTLINE

Nasogastric tube

Insertion

Removal

Transferring patients ithnasogastric tube

Urinals

!e"pans

Enemas

Cleansing enema

Other aspect ofpreparation

!arium enema

Post-proce"uralinstructions

Colostomies


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INTRO#UCTION

Un"erstan"ing non-aseptic technique is important tothe professional practice of a ra"iographers$

%ost of these techniques are performe" ith patients

ho are ver& sic' or in great "iscomfort$

Ra"iographers nee" to "evelop abilities ofcompassion( caring( an" competenc& to be able an

e)cellent practitioner


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N*+O,*+TRIC TU!E

Nasogastric tube are plastic or rubber tubes inserte"through the nasophar&n) into the stomach$

Primar& use

#ecompression or removal of flatus an" flui"s fromthe stomach

.ee"ing the patient


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N*+O,*+TRIC TU!E

%ost common t&pes use"

Levin tube - single lumen tube ith several hole nearthe tip

+alem-sump tube - "ouble lumen( ra"iopaque tube$One of the lumina provi"es air vent( the other is forremoval of the gastric contents$


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N*+O,*+TRIC TU!E

Patients ith nasogastric tube usuall& suffers from"iscomfort$

/eep the patient reassure" an" informe" is ver&

important so that the proce"ure is smooth an"complications can be avoi"e"$


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N*+O,*+TRIC TU!E - IN+ERTION

Usuall& the "octor or nurse is responsible for inserting the nasogastrictube$

The proce"ures of inserting are as follos

i$ I"entif& the patient an" e)plain the proce"ure$

ii$ Place the patient in high .oler0s position$ +upport patient ithpillos$

iii$Lubricate the tube at the "istal en" ith ater-soluble lubricating1ell& 1ust before insertion$

iv$Instruct the patient to sallo ater through a stra as theproce"ure begins$ If unable to ta'e flui"s( then as' patient tosallo air$

v$ The tube shoul" go "on easil& ith little force$


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2I#EO #E%ON+TR*TION


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N*+O,*+TRIC TU!E - +ECURIN,

The tube is usuall& secure" using butterfl& metho"$

The proce"ures of inserting are as follos

i$ Cut to pieces of tape appro)imatel& 3 inches longan" tear one lengthise$ Leave the other intact$

ii$ 4rap the intact piece aroun" the tubing$

iii$ Crisscross the to pieces of tape at the front of the

tubing( an" place them over the bri"ge of the nose$


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N*+O,*+TRIC TU!E - RE%O2*L

The proce"ure to remove a nasogastric tube is as follos

i$ I"entif& the patient an" e)plain the proce"ure$

ii$ 4ash han"s an" the turn off an" "isconnect the suction

apparatusiii$,entl& remove the tape from the patient0s nose( an" ma'e

certain that the tubing is free from the patient0s facial s'in

iv$Put on clean gloves an" as' the patient to ta'e in "eep

breath as the tube is gentl& ith"ran$


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TR*N+.ERRIN, P*TIENT+

4hen use" as a gastric "ecompression( nasogastrictube is often connecte" to an intermittent gastricsuctioning "evice$

4hen transferring patient( ma'e sure the "octor isinforme" an" give permission for the patient to betransferre"$


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If the "evice coul" be "etache"( fin" out the e)actlength of time that the "evice can be interrupte"$

If it is onl& for a short time( the "evice must be

reattache" to the suctioning "evice available in thera"iolog& "epartment$


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!efore patient is transferre"( the amount of suctionpressure require" must be "etermine"$

The amount of pressure is varie" an" can be

obtaine" b& rea"ing the "octor0s chart or as'ing thenurse-in-charge$


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URIN*L+

Urinals is use" for male patients for urination$

If the patient is able to help himself( ra"iographer can give theurinal to him an" leave( thus provi"ing privac&$

If patient require assistance( ra"iographer shoul"4ear gloves an" raise the sheet a"equatel& to permitvisibilit& hile protecting patient0s privac&

+prea" the patient0s leg an" place the urinal beteen it$

Place the penis into the urinal far enough that it "oesn0t slipout$

*fter urination( empt& the urinal( ash ith col" ater( an"put it in the soile" supplies to be resterilise"$


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URIN*L+


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!E#P*N+

!e"pans are for non-ambulator& patient for"efecation an" urination purpose$

3 t&pes are available5 the stan"ar" an" fracturebe"pans$

Usuall& ma"e from metal or plastic5 noa"a&smost commonl& plastic( out of concern for

infectious "isease$


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!E#P*N+


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2I#EO !RE*/


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!E#P*N+

6an" ashing is important an" shoul" be performe"before an" after assisting the patient ith a be"pan$

If the be"pan is col"( run arm ater over it( then "r&

it$

Patient0s privac& must be secure" an" respecte"$*la&s place a sheet over the patient$


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!E#P*N+ - Placement

Remove the be"pan cover an" place it at the en" of the table$

If the patient able to move( place one han" un"er the loer bac'(

as'ing the patient to raise his7her hips$ Place the pan un"er the hips$

If the patient is able to sit up( then this is the i"eal position$ If

possible( the patient0s hea" shoul" be elevate" 89 "egrees$

#o not leave patient for too long hen on be"pan$ 4hen leaving is

necessar&( please provi"e patient ith a a& to call for help in case

an&thing happens$


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!E#P*N+ - Placement

4hen finishe"( ear clean "isposable gloves( an"

remove the be"pan from patient b& instructing

him7her to raise the hips$

Plastic be"pans can be "iscar"e"( hile metal be"pans

must be emptie" in "esignate" area( run through col"

ater( an" place" in use" equipment area$

Offer patient a et cloth to ash up$ Then provi"e

clean toel$


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2I#EO #E%ON+TR*TION


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ENE%*+

Enema is a proce"ure of in1ecting a liqui" into therectum$

There are to t&pes of enema in ra"iolog&

"epartment

Cleansing enema

!arium enema


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CLE*N+IN, ENE%*

Cleansing enema is use" to promote "efecation$ .lui"sill brea' "on the fecal matter( stretches the rectalall( an" initiate "efecation refle)$

There are : t&pes of cleansing enemaTap ater

6&pertonic solution

Normal saline

+oapsu" solution

Oil retention


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CLE*N+IN, ENE%* - %etho"

I"entif& the patient an" obtain consent$ E)plain theproce"ure to the patient$

Prepare the enema solution$

Put an un"erpa" an" put patient in +im0s position ;leftanterior oblique


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CLE*N+IN, ENE%* - %etho"

The the patient that the proce"ure is about to start$

Lift the patient0s right buttoc' ith &our palm an"gentl& insert the tip of the tube( hile patient

breathing slol&$ If problem happens( as' for helpfrom others$

Let patient 'no that the enema is about to start$Cramping ma& occur ( so instruct patient to breatherapi"l& through mouth$

Tell patient to retain the flui"s as long as possible$


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Cleansing Enema - %etho"

*fter all flui"s have been inserte"( as' patient to liesupine then roll to right si"e to clean the transversean" ascen"ing colon$

,entl& remove the enema tip( rap it in paper then"ispose in appropriate container$

Patient shoul" rest quietl& for =9 minutes before as'e"to go to toilet$


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OT6ER *+PECT O. PREP*R*TION

!oel preparation aspect shoul" also be consi"ere" inbarium enema e)amination$

%ost preparation consist of the folloing

#ietar& restriction

Purgation ;la)ative inta'e

L3 - Non-Aseptic Techniques

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