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2. Venipuncture: the processes of obtaining IV accesses for purpose of IV-therapy
or blood sampling of a venous blood.
IV injection: the parenteral route of administration of medications to be injected
directly into the venous circulation.
Questions:
‫ال‬sites‫بالترتيب‬
‫دكتور‬x‫ال‬ ‫نقول‬5
‫حد‬ ‫اي‬‫تاني‬‫اول‬ ‫يبقا‬
‫تالته‬
 If the vein is not apparent?
1- hold down his arm
2- ask the patient clench and unclench his wrist to increase the Venous
return
3- Gently tap the venipuncture site with two fingers.
4- warm compress to the site of IV
5- Apply a tourniquet (wrapped proximal to the site of injection ‫االول‬ ‫هتشده‬
) ‫واحدة‬ ‫بأيد‬ ‫تفكة‬ ‫تعرف‬ ‫عشان‬ ‫كدا‬ ‫فيونكة‬ ‫نص‬ ‫وهتربطة‬
6- Do not cause undue pain to the patient by trying over and over again
call a more experienced colleague instead.
7- Use femoral stab as a last resort.
‫(في‬femoral triangle‫ال‬vein &artery‫احس‬ ‫هقدر‬ ‫فبالتالي‬ ‫بعض‬ ‫جنب‬‫ال‬pulse
‫بال‬ ‫هدخل‬syringe←a finger breadth medial to the pulse)

3.  Why do we inject slowly?
1- To minimize the vein injury.
2- To lower the overdose risk.
3- To minimize the irritant effect of the blood .
 In the event of needle stick injury:
- Encourage bleeding, wash with soap and running water.
- Immediately report the injury to the local Public Health Consultant.
- If there is a significant risk of HIV, post-exposure prophylaxis should be
started as soon as possible.
- Fill out an incident form.
Procedures:
1- great the patient
2- Introduce yourself to the patient
3- Confirm the patient identity
‫ال‬ ‫هو‬ ‫دا‬ ‫ان‬ ‫تتأكد‬patient( ‫واسمه‬double check)
4- Explain what u will do
5- Obtain consent (the patient agrees)
6- equipments:
Collect equipment needed (sterile syringe –sterile alcohol swab- dry cotton
ball-adhesive tab-prescribed drug)

4. 7- position of the patient in the recombinant position (the best position)
or siting upright
not while standing : to avoiding shock
‫لو‬‫ابدأ‬ ‫قال‬‫ال‬ ‫اول‬ ‫من‬procedures‫من‬ ‫نبدأ‬8
8- choose the arm (non-dominant arm )
9- choose the site of vein puncture
 (ventral aspect of the forearm&dorsum……………..)
 Select the vein
(palpable – run straight for few cm –away from joints)
10- Washing of the hands with soap and water
→ dry with dry cloth
11- Wear gloves
“sterile gloves optional ”
12- withdraw the medications inside the syringe
13- enhance the engorgement of the vein:
 hold down his arm
 ask the patient clench and unclench his wrist to increase the
Veins return
 Gently tap the venipuncture site with two fingers.
 warm compress to the site of IV
 finally Apply a tourniquet
(Wrapped proximal to the site of injection ‫االول‬ ‫هتشده‬‫وهتربطة‬
‫واحدة‬ ‫بأيد‬ ‫تفكة‬ ‫تعرف‬ ‫عشان‬ ‫كدا‬ ‫فيونكة‬ ‫نص‬)

5. 14- disinfect the skin (Swab around the entry site with one downward
sweep
‫نستخدم‬ ‫نكرر‬ ‫ولوعايزين‬ ‫لتحت‬ ‫واحدة‬ ‫(مرة‬new strile swab)*
15- Streach the skin by your thumb of the non dominant hand (to
immobilize the vein) distal to the puncture site
61-‫بزاوية‬ ‫هندخل‬03‫هتمسك‬‫ال‬syringe‫وال‬ ‫تحت‬ ‫صوابع‬ ‫اربع‬thumb‫ان‬ ‫ونتاكد‬ ‫فوق‬‫ال‬
level‫لفوق‬)‫ال‬ ‫فتحة‬needle)..‫ب‬ ‫بتحس‬resistance‫هتختفي‬ ‫بعدين‬ ‫االول‬ ‫في‬←‫هنا‬ ‫اثبت‬
‫اكتر‬ ‫متدخلش‬"‫بيدخل‬ ‫السن‬ ‫كل‬ ‫مش‬← "(one swift maneuver
*one pouch to puncture the skin
and vein
- observe the flash back of blood
61-‫ال‬ ‫ثبت‬syringe‫بال‬thumb&index
of non-dominant hand

6. ‫احمر‬ ‫لون‬ ‫هتشوف‬ ‫لورا‬ ‫هتسحب‬(‫ابيض‬ ‫االمتحان‬ ‫في‬ ‫طبعا‬ ‫بس‬)
←‫ال‬ ‫في‬ ‫احنا‬ ‫يبقا‬vein
‫هتعمل‬flattening‫لل‬syringe)‫ال‬ ‫على‬ ‫نايمة‬ ‫هتبقا‬skin)
61-‫ال‬ ‫فك‬tourniquet‫هتمسك‬‫الطرف‬‫وتشدة‬ ‫الفيونكة‬ ‫نص‬ ‫فيه‬ ‫اللي‬‫ما‬ ‫قبل‬ ‫تفكه‬ ‫الزم‬
‫ال‬ ‫تحقن‬drug
19- Inject slowly with the blood flow towards the heart
20- Remove the needle too slowly as not to collapse the vein
16-‫قطن‬ ‫وتجهز‬‫ة‬(to apply pressure )‫ال‬ ‫تطلع‬ ‫ما‬ ‫اول‬ ‫هتحطها‬syringe
11-‫ال‬syringe‫ا‬‫نرميها‬ ‫لمفروض‬‫في‬sharp
box‫ومنعملش‬recapping
‫مفيش‬ ‫لو‬box←‫هنستخدم‬single hand technique
23- ensure the patient he is comfortable
Discard all of the blood contaminated items & your gloves .
24- Washing of the hands with soap and water →dry with dry cloth
25- Thank the patient

7. Blood sample:
‫الخطوات‬ ‫نقس‬..‫ال‬ ‫فك‬ ‫بس‬ ‫االختالف‬tourniquet‫العينة‬ ‫اسحب‬ ‫اما‬ ‫بعد‬
‫بال‬ ‫اخرج‬ ‫ما‬ ‫وقبل‬syringe

9. Nasogastric tube insertion
‫ال‬nasogastric tube‫عن‬ ‫عباره‬ ‫هى‬ ‫و‬ ‫المعده‬ ‫انبوبه‬ ‫هى‬ ‫اللى‬tube‫بين‬ ‫بتوصل‬
‫ال‬nose‫ال‬ ‫و‬stomach‫اسمها‬ ‫اللى‬ ‫بردوا‬ ‫دى‬ ‫وهي‬gastric
lavage.‫المعده‬ ‫غسيل‬
‫؟‬ ‫ايه‬ ‫حاالت‬ ‫ف‬ ‫بنستخدمها‬
6-‫نعمل‬ ‫عايزين‬ ‫فاحنا‬ ‫معوى‬ ‫تسمم‬ ‫اوجاله‬ ‫بالغلط‬ ‫دوا‬ ‫خد‬ ‫حد‬withdrawal
‫دي‬ ‫للحاجات‬
1-‫ال‬ ‫حاالت‬hematemesis‫لسه‬ ‫ف‬ ‫نتاكد‬ ‫علشان‬active bleeding‫او‬
‫منها‬ ‫ونعمل‬ ‫ال‬lavage‫و‬ ‫بيطلع‬ ‫دم‬ ‫ف‬ ‫لسه‬ ‫هنشوف‬ ‫باننا‬‫او‬ ‫قديم‬ ‫دم‬ ‫بتطلع‬ ‫ال‬
clots‫كدا‬ ‫او‬
0-‫علشان‬ ‫تكون‬ ‫ممكن‬feeding
4-‫اعالج‬ ‫ممكن‬ ‫خاللها‬ ‫من‬gastric immobility, and bowel obstruction
Steps:
‫عالعيان‬ ‫تدخل‬ ‫ما‬ ‫اول‬
-‫ايه‬ ‫هتعمل‬ ‫وتشرحله‬ ‫نفسك‬ ‫وهتقدم‬ ‫العيان‬ ‫على‬ ‫هتسلم‬
-‫ال‬ ‫هيتعمله‬ ‫المفروض‬ ‫اللى‬ ‫الشخص‬ ‫هو‬ ‫؟وانه‬ ‫الفالنى‬ ‫فالن‬ ‫حضرتك‬ ‫هو‬ ‫اسمه‬ ‫من‬ ‫تتاكد‬procedure
-‫موافقته‬ ‫تاخد‬
‫لحضرتك‬ ‫هركب‬ ‫سايدكيك‬ ‫د‬ ‫انا‬ ‫حاج‬ ‫يا‬ ‫عليكم‬ ‫"سالم‬nasogastric tube‫معدتك‬ ‫لغايه‬ ‫مناخيرك‬ ‫من‬ ‫هتدخل‬
‫وم‬ ......‫علشان‬" ‫شويه‬ ‫تساعدنى‬ ‫حضرتك‬ ‫عايز‬ ‫بس‬ ‫هللا‬ ‫شاء‬ ‫ان‬ ‫بحاجه‬ ‫هتحس‬ ‫ش‬
-‫وتلبس‬ ‫ايدك‬ ‫تغسل‬glove‫هنا‬ ‫ونوعه‬non sterile‫العادى‬ ‫هو‬ ‫اللى‬
-‫ادواتك‬ ‫تجهز‬
Prepare equipments:
1) A pair of non-sterile gloves.
2) A NG tube of appropriate size.
3) K-Y jelly.
4) Xylocaine spray.
5) A glass of water (if appropriate).
6) Tape.

10. 7) Stethoscope.
8) A 20 ml syringe and some pH paper.
9) A catheter bag.
10) A vomit bowel.
‫حاجه؟‬ ‫كل‬ ‫جهزنا‬ ‫ما‬ ‫بعد‬ ‫ايه‬ ‫هنعمل‬
1. Examine nostrils
‫ليه؟‬ ‫كدا‬ ‫بتعمل‬ ‫هيسالك‬
:‫هتقوله‬
- To determine which one is more patent or suitable for nasogastric tube
insertion
‫مش‬ ‫هيخليها‬ ‫اللى‬ ‫ايه‬ ‫وهى‬ ‫قايلك‬ ‫هيقوم‬patent‫؟‬
- Foreign body or deformity/obstructions,
polyps, septal deviation
How?
 Ask the patient to close one of the nostrils
and to take deep inspiration
 To repeat this with the other on to compare between them and to see which
one is more patent.
‫ال‬ ‫من‬ ‫واحده‬ ‫من‬ ‫نفس‬ ‫ياخد‬ ‫للعيان‬ ‫**هتقول‬nostrils‫و‬ ‫التانيه‬ ‫الناحيه‬ ‫مع‬ ‫دى‬ ‫الحركه‬ ‫يكرر‬ ‫و‬ ‫التانيه‬ ‫يقفل‬ ‫ما‬ ‫بعد‬
‫فيها‬ ‫تركب‬ ‫احسن‬ ‫منها‬ ‫نفسه‬ ‫بياخد‬ ‫اللي‬ ‫واحده‬ ‫اى‬ ‫يحدد‬ ‫اللى‬ ‫وهو‬ ‫بعض‬ ‫مع‬ ‫الناحيتين‬ ‫تقارن‬
‫حته‬‫العيان‬ ‫لو‬ :‫مهمه‬comatosed:‫ازاى‬ ‫هاعرف‬
‫ف‬‫ي‬:‫طريقتين‬
6-‫حركتها‬ ‫وهاالحظ‬ ‫قطنه‬ ‫شبه‬ ‫حاجه‬ ‫هاحط‬
1-‫هاشوف‬ ‫او‬‫ف‬ ‫لو‬ ‫بكشاف‬‫ي‬deformity/obstructions, polyps, septal deviation

11. 2. Measure the tube size:
How?
6)‫ال‬ ‫بتسك‬ ‫االول‬tube‫ال‬ ‫من‬ ‫وتحطها‬tip‫ال‬ ‫عند‬ ‫لتاعها‬ala of the nose‫طلعت‬ ‫اللى‬ ‫الناحيه‬ ‫من‬
‫يعنى‬ ‫مناسبه‬more patent
1)‫ال‬ ‫عند‬ ‫مثبتها‬ ‫لسه‬ ‫ماسكها‬ ‫وانت‬ala of nose‫التانيه‬ ‫بايدك‬
‫ال‬ ‫ورا‬ ‫من‬ ‫هتعديها‬auricle‫الناحيه‬ ‫نفس‬ ‫على‬ ‫اللى‬
0)‫ال‬ ‫عند‬ ‫اللى‬ ‫ايدك‬ ‫تسيب‬ ‫خالص‬ala‫هى‬ ‫ما‬ ‫زى‬ ‫التانيه‬ ‫و‬
behind the auricle‫وتوصلها‬ ‫دى‬ ‫سبتها‬ ‫اللى‬ ‫بايدك‬ ‫وتمسك‬
in front of the neck at the midline(Dr.X)
‫ال‬ ‫عند‬sternal notch
4)‫ال‬ ‫قدام‬ ‫اللى‬ ‫ايدك‬ ‫تثبت‬ ‫كدا‬ ‫بعد‬neck‫ال‬ ‫ورا‬ ‫اللى‬ ‫ايدك‬ ‫وتشيل‬auricle‫ال‬ ‫طول‬ ‫على‬ ‫بيها‬ ‫تكمل‬ ‫و‬
midline‫لغايه‬2 fingers above the umbilicus
5)‫هتحدد‬ ‫كدا‬ ‫بعد‬‫ال‬size‫حاجه‬ ‫اى‬ ‫او‬ ‫قلم‬ ‫او‬ ‫ماركر‬ ‫ب‬ ‫ده‬ ‫قسته‬ ‫انت‬ ‫اللى‬
1)‫مفيهاش‬ ‫مانيكانات‬ ‫ف‬umbilicus‫ال‬ ‫هو‬ ‫المانيكان‬ ‫ال‬ ‫اخر‬ ‫ان‬ ‫هنعتبر‬ ‫وقتها؟؟‬ ‫ايه‬ ‫هنعمل‬umbilicus
‫ونقيس‬2 fingers above
3. Insertion of the tube:
***( ‫بالك‬ ‫خد‬ ...‫بحاجتين‬ ‫المكان‬ ‫هنخدر‬ ‫االول‬Dr. X)
- Lubricate the tip of the NG tube with K-Y jelly.
‫شويه‬ ‫ايدك‬ ‫على‬ ‫بتحط‬ ‫**هنا‬K.Y jell‫ال‬ ‫تاخد‬ ‫وبعدين‬tip‫ال‬ ‫بتاعه‬tube‫ما‬ ‫لغايه‬ ‫تلفها‬ ‫كلها‬ ‫فيها‬ ‫تحطها‬ ‫و‬
‫الجيل‬ ‫عليه‬ ‫كله‬ ‫طرفها‬ ‫تبقى‬
- Spray the back of the throat with xylocaine
‫ندخل‬‫بقى‬‫ال‬tube
How?
-‫يكون‬ ‫االمكان‬ ‫قدر‬ ‫انه‬ ‫العيان‬ ‫هتخلى‬ ‫االول‬upright position
‫ايدك‬ ‫ب‬ ‫وتعمله‬support‫تعمل‬ ‫علشان‬ ‫راسه‬ ‫على‬
reflection of neck‫واحد‬ ‫مستوى‬ ‫على‬ ‫كله‬ ‫يكون‬ ‫بحيث‬
‫ال‬ ‫تدخل‬ ‫وتقدر‬tube‫لل‬ ‫بسهوله‬stomach‫علشان‬ ‫وكمان‬
‫ورا‬ ‫ل‬ ‫راسه‬ ‫مرجع‬ ‫ويقوم‬ ‫منها‬ ‫يضايق‬ ‫ممكن‬ ‫هو‬

12. -‫تب‬ ‫كدا‬ ‫وبعد‬‫ال‬ ‫تدخل‬ ‫دا‬tube‫ال‬ ‫ف‬ ‫فيين؟؟‬the nosefloor of)Dr. X)‫ف‬ ‫هيكون‬ ‫بالراحه‬‫ي‬
resistance‫؟‬ ‫فيين‬back of Nasopharynx‫البدايه‬ ‫ف‬..‫هتعدى‬ ‫كدا‬ ‫بعد‬ ‫بس‬
-‫ال‬ ‫يقلل‬ ‫علشان‬ ‫معاك‬ ‫حاجه‬ ‫يبلع‬ ‫انه‬ ‫العيان‬ ‫من‬ ‫تطلب‬ ‫ممكن‬ ‫كمان‬
resistance‫هيعرف‬ ‫مش‬ ‫النه‬ ‫مثال‬ " ‫"شفاطه‬ ‫طريق‬ ‫عن‬ ‫دى‬
‫ال‬ ‫وضع‬ ‫ف‬ ‫وهو‬ ‫يشرب‬reflection‫ال‬ ‫وتوصل‬tube‫خالل‬
‫ال‬mouth‫و‬pharynx‫و‬esophagus‫توصل‬ ‫ما‬ ‫لغايه‬
‫ل‬stomach.‫علمته‬ ‫انت‬ ‫اللى‬ ‫الجزء‬ ‫لغايه‬
‫عمل‬ ‫العيان‬ ‫افرض‬ ‫كدا‬ ‫بتدخل‬ ‫وانت‬ ‫طب‬ **gag reflex: ‫ايه‬ ‫هتعمل‬
- If the patient coughs or gags, slightly withdraw the tube and leave him some
time to recover.
4. Make sure that the tube is already present in the Stomach:
How?
‫ف‬ ‫هتقوله‬0‫خطوات‬

-‫هاخد‬20 ml of air‫ف‬ ‫واحطهم‬tommy syringe
-‫هى‬ ‫اللى‬ ‫السماعه‬ ‫هاجيب‬(stethoscope)‫و‬‫متنساش‬
‫انها‬ ‫كمان‬ ‫واتاكد‬ ‫لبره‬ ‫مقوسه‬ ‫تحسها‬ ‫هى‬ ‫اللى‬ ‫صح‬ ‫تلبسها‬
‫بعدين‬ ‫و‬ ‫بيتلككوا‬ ‫دكاتره‬ ‫ف‬ ‫علشان‬ ‫مفتوحه‬‫ال‬ ‫ع‬ ‫هاحطها‬
epigastrium‫ال‬ ‫ما‬ ‫مكان‬ ‫هى‬ ‫اللى‬tube‫وخد‬ ‫وصلت‬
‫الكليه‬ ‫فيديو‬ ‫ف‬ ‫غلط‬ ‫معموله‬ ‫دى‬ ‫الحته‬ ‫بالك‬‫كدا‬ ‫الحمرا‬ ‫الدايره‬ ‫مكان‬ ‫شويه‬ ‫فوق‬ ‫يعنى‬ ‫الرسمه‬ ‫ف‬ ‫وكمان‬***‫ف‬
‫الهوا‬ ‫هافضى‬ ‫الوقت‬ ‫نفس‬ ‫وف‬ ‫المانيكان‬ ‫نص‬ ‫ف‬ ‫لجوه‬ ‫داخله‬ ‫كدا‬ ‫حته‬ ‫النص‬‫بسرعه‬ ‫و‬ ‫واحده‬ ‫مره‬ ‫ع‬‫اسمع‬ ‫اما‬
‫هو‬ ‫اللى‬ ‫الصوت‬gurgling sound‫ال‬ ‫ع‬ ‫بادخله‬ ‫اللى‬ ‫الهوا‬ ‫الشيشه‬ ‫صوت‬ ‫هو‬ ‫اللى‬fluid‫ال‬ ‫ف‬ ‫كدا‬ ‫انا‬
epigastrium
‫السرنجه‬ ‫بنفس‬(Dr.X‫ساحب‬ ‫)اقوم‬gastric contents‫ع‬ ‫واحطهم‬
litmus paper‫ال‬ ‫ان‬ ‫اساس‬ ‫ع‬ ‫الحمر‬ ‫بتحول‬ ‫لونها‬ ‫المفروض‬gastric
contents acidic (pH <6)

13. ‫ال‬ ‫يسألك‬ ‫ممكن‬ ‫هنا‬normal‫من‬ ‫طالع‬ ‫لسه‬ ‫واحد‬ ‫انت‬ ‫طبعا‬ .. ‫كام‬GIT... ‫ده‬ ‫الموضوع‬ ‫ف‬ ‫خبير‬ ‫و‬
pH=1-2
‫ها‬ask forRAY-X‫نوعها‬RAY-CHEST X‫هيبين‬ ‫اللى‬
"Radio- opaque white line extending from neck till
the stomach"
( ‫كدا‬ ‫تقول‬ ‫الزم‬Dr.X)
‫ال‬ ‫العيان‬ ‫ف‬COMATOSED‫هنعمله‬X-RAY‫طريق‬ ‫عن‬
Portable X-RAY
***‫ال‬ ‫لو‬ ‫بالك‬ ‫خد‬TUBE‫مخرومه‬‫حاجه‬ ‫هتسحب‬ ‫ما‬ ‫عمرها‬
‫بقى‬ ‫هنثبت‬ ‫تمام‬ ‫كله‬ ‫خالص‬
5. FIXATION
‫؟‬ ‫ازاى‬ ‫بنثبتها‬
-‫ال‬ ‫من‬ ‫جزى‬ ‫هناخد‬TAPE‫بعدين‬ ‫؟‬ ‫ماشى‬ ‫البنطلون‬ ‫شبه‬ ‫يبقى‬ ‫بحيث‬ ‫واحده‬ ‫ناحيه‬ ‫من‬ ‫حتتين‬ ‫هنقطعه‬ ‫وبعدين‬
‫ع‬ ‫وتحطها‬ ‫فوق‬ ‫من‬ ‫اللى‬ ‫مقطوعه‬ ‫مش‬ ‫هى‬ ‫اللى‬ ‫البنطلون‬ ‫حته‬ ‫هتاخد‬Tip of nose‫فرده‬ ‫هتاخد‬ ‫وبعدين‬
‫ال‬ ‫ع‬ ‫وتلفها‬ ‫بنطلون‬tube‫االتجا‬ ‫ف‬ ‫وتلفها‬ ‫التانيه‬ ‫الفرده‬ ‫وتاخد‬ ‫اتجاه‬ ‫اى‬ ‫ف‬‫ال‬ ‫ع‬ ‫ثبتها‬ ‫كدا‬ ‫عكسه‬ ‫اللى‬ ‫ه‬nose
-‫وبعدين‬ ‫العيان‬ ‫خد‬ ‫على‬ ‫ونمشيها‬ ‫التيوب‬ ‫هنجيب‬ ‫؟‬ ‫ايه‬ ‫نعمل‬ ‫متضايقهوش‬ ‫علشان‬ ‫العيان‬ ‫وش‬ ‫ع‬ ‫نثبتها‬ ‫بقى‬ ‫عايزين‬
‫زى‬ ‫شاش‬ ‫وعليها‬ ‫قطنه‬ ‫نحط‬ ‫باننا‬ ‫نثبتها‬tunnel‫يضايقش‬ ‫ما‬ ‫اتحركت‬ ‫لو‬ ‫علشان‬ ‫كدا‬
-‫ال‬ ‫هنركب‬ ‫كدا‬ ‫بعد‬catheter bag‫هاعمله‬ ‫لو‬ ‫حاله‬ ‫ف‬DRAINAGE‫هاعمله‬ ‫لو‬ ‫هتتركب‬ ‫ومش‬
FEEDING
‫كدا‬ ‫نمشى‬ ‫هااا‬‫؟؟‬
...‫طبعا‬ ‫ال‬
‫سؤال‬ ‫اى‬ ‫عنده‬ ‫لو‬ ‫او‬ ‫واجعاه‬ ‫او‬ ‫مضايقاه‬ ‫حاجه‬ ‫ف‬ ‫كان‬ ‫اذا‬ ‫العيان‬ ‫هنسال‬ ‫االول‬
‫العيان‬ ‫ع‬ ‫هنسلم‬
‫خطوه‬ ‫فاضل‬ ‫لسه‬ ‫ال‬ !!‫امشى‬ ‫بقى‬ ‫خالص‬ ‫عالعيان‬ ‫سلمت‬ ‫وهللا‬ ‫؟؟‬ ‫نمشى‬ ‫هااا‬
‫حاضر‬ ‫الزباله‬ ‫ف‬ ‫الحاجات‬ ‫هلم‬
‫م‬ ‫ال‬‫اصبر‬ ‫و‬ ‫بردوا‬ ‫الحاجات‬ ‫هتلم‬ ‫انت‬ ‫ما‬ ‫دى‬ ‫ش‬

14. 6. Documentation: VIP
‫ال‬ ‫ف‬ ‫بتبقى‬ ‫اللى‬ ‫الحاجات‬ ‫من‬ ‫تحديدا‬ ‫دى‬ ‫الخطوه‬list‫فيها‬ ‫بيتحط‬ ‫اللى‬ ‫ايوه‬XX‫منها‬ ‫باله‬ ‫بياخد‬ ‫ومحدش‬
‫باعمل‬ ‫طب‬Documentation‫اليه؟‬1‫بالك‬ ‫خد‬ ‫حاجات‬
1) The reason for the tube insertion,
2) Type & size of tube
3) The nature and amount of aspirate
4) The type of suction and pressure setting if for suction,
5) The nature and amount of drainage
6) The effectiveness of the intervention.
‫ال‬ ‫ايه‬ **complications‫؟؟‬
1) the main complications of NG tube insertion is tissue trauma
2) Placement of the catheter can induce gagging or vomiting (aspiration)
**‫ساعتها‬ ‫الحل‬ ‫ايه‬‫؟؟‬
- Therefore suction should always be ready to use in the case of this
happening
**‫استخدم‬ ‫مينفعش‬ ‫امتى‬NG tube‫؟؟‬‫مهم‬ ‫مهم‬ ‫مهم‬ ‫مهم‬ ‫مهم‬
- Severe facial trauma (cribriform plate disruption), due to the possibility of
inserting the tube intracranially.
- Bleeding tendency.
**‫ساعتها؟؟‬ ‫الحل‬ ‫ايه‬
In this instance, an orogastric tube may be inserted