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Disinfection of medical instruments is important for preventing the spread of disease. Cleaning and disinfecting reusable equipment after it comes into contact with patients can be expensive, both in the cost of the disinfection procedure, but also in terms of time away from the patients themselves. Not all medical instruments can be fully sterilized after each use. Thankfully, not all reusable instruments need the highest level of disinfection. But how to determine the minimum level of disinfection in a given situation? Earle H. Spaulding devised a rational approach to disinfection and sterilization of patient-care items and equipment Spaulding believed the nature of disinfection could be understood readily if instruments and items for patient care were categorized as critical, semi-critical, and non-critical according to the degree of risk for infection involved in use of the items. Spaulding recognized that the need for disinfection of equipment in medical settings ranged from non-critical to semi-critical to critical, depending on the likelihood of spreading disease. For example, sterilization is necessary for equipment that comes into contact with a patient’s bloodstream or sterile tissue. This category of equipment, such as surgical knives, is designated “critical” because it presents a high risk of disease transmission from patient to patient. Equipment that only touches healthy, unbroken skin presents a low risk of contamination because intact skin acts as an effective barrier to most microorganisms. Examples in this “non-critical” category include bedpans, blood-pressure cuffs, and bedrails. In between those two scenarios, a “semi-critical” level of disinfection presents a medium risk of contamination. This would include equipment such as endoscopes used on mucous membranes or areas of broken skin.

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Catheterization of the bladder involves introducing a latex or plastic tube through the urethra and into the bladder. The catheter provides a continuous flow of urine in patients unable to control micturition or those with obstructions. It also provides a means of assessing urine output in hemodynamically unstable patients. Because bladder catheterization carries the risk of UTI, blockage, and trauma to the urethra, it is preferable to rely on other measures for either specimen collection or management of incontinence. Types of Catheterization. Intermittent and indwelling retention catheterizations are the two forms of catheter insertion INTERMITTENT CATHETERIZATION introduce a straight single-use catheter long enough to drain the bladder (5 to 10 minutes When the bladder is empty, you immediately withdraw the catheter. COMPLICATION- increases risk of trauma and infection. INDICATION- It is common for people with spinal cord injury or other neurological problems such as multiple sclerosis to perform self– intermittent catheterization up to every 4 hours daily for months or years. UTI rate is lower than for patients with long-term indwelling catheters. INDWELLING CATHETERIZATION- remains in place for a longer period, until a patient is able to void voluntarily or continuous accurate urine measurements are no longer needed The straight single-use catheter has a single lumen with a small opening about 1.3 cm ( 1 2 inch) from the tip. . Urine drains from the tip, through the lumen, and to a receptacle. An indwelling Foley catheter has a small inflatable balloon that encircles the catheter just above the tip. When inflated the balloon rests against the bladder outlet to anchor the catheter in place. The indwelling retention catheter often has two or three lumens within the body of the catheter . One lumen drains urine through the catheter to a collecting tube. A second lumen carries sterile water to and from the balloon when it is inflated or deflated. A third (optional) lumen is sometimes used to instill fluids or medications into the bladder. It is easy to determine the number of lumens by the number of drainage and injection ports at the end of the catheter A second type of intermittent catheter has a curved tip A Coudé catheter is used on male patients who may have enlarged prostates that partly obstruct the urethra. It is less traumatic during insertion because it is stiffer and easier to control than the straight-tip catheter Plastic catheters are suitable only for intermittent use because of their inflexibility Latex catheters are recommended for use up to 3 weeks. Be aware of allergies. Pure silicon or Teflon catheters are best suited for long-term use (2 to 3 months) because of less encrustation at the urethral meatus Balloon sizes range from 3 mL (pediatric) to large postoperative volumes (75 mL). In adults the 5-mL and 30-mL sizes are the most common: The 5-mL size allows for optimal drainage, whereas the 30-mL size is used after pros

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LFT stands for liver function test, which is a blood test that measures the levels of proteins and enzymes in the blood to provide information about the state of the liver. LFTs are also known as hepatic panels. LFT stands for liver function test, which is a blood test that measures the levels of proteins and enzymes in the blood to provide information about the state of the liver. LFTs are also known as hepatic panels. Contents Overview Test Details Results and Follow-Up Contents Overview Test Details Results and Follow-Up Overview What are liver function tests? Liver function tests are blood tests that measure different substances produced by your liver. These measurements give your healthcare provider important information about the overall health of your liver and how well it’s working. A liver panel will often measure several substances in one blood sample. It may include various enzymes, proteins and byproducts. What are the five primary liver function tests? The most common liver tests include: Liver enzymes test. Your liver enzymes include alkaline phosphatase (ALP), alanine transaminase (ALT), aspartate aminotransferase (AST) and gamma-glutamyl transferase (GGT). These are elevated when there’s liver injury. Total protein test.A total protein test measures levels of protein in your blood. Your liver makes protein, and low protein levels may indicate that your liver isn’t functioning optimally. Bilirubin test. Bilirubin is a waste product that your liver deposits in bile. LDH test. Lactate dehydrogenase (LDH) is an enzyme found in many of your body’s tissues, including your liver. Prothrombin Time (PT) test. This test measures how long it takes for a sample of your blood to clot, a process that involves proteins that your liver produces. These tests are all part of a routine blood panel called a comprehensive metabolic panel. When are tests done to check liver function? Your healthcare provider might want to check these values to screen you for possible hepatitis or other liver diseases. If they already know that you have liver disease, they might want to check how it’s progressing or whether a treatment is working. You may also have a liver test to monitor the side effects of certain medications that are known to affect your liver. What kinds of things can a liver panel tell you? Different values and ratios of different substances may tell your healthcare provider: If you have liver inflammation (hepatitis). Whether the inflammation is alcohol-related or nonalcoholic (metabolic). Whether you have a problem in your liver itself or in your bile ducts. If your liver function is impaired, and if so, how much. If your bile flow is impaired, and if so, how much. Whether your medications are affecting your liver, and if so, how much. Test Details How do liver function tests work? A healthcare provider draws a small amount of blood from a vein in your arm to test in the lab. They’ll look for abnormally high or low levels of different subs

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