INTRODUCTION about instruments in Pediatric

1. Instruments
Dr. SANDYA

2. 1. Identify the instrument
2. What is the principle on which
it works?
3. List 3 mandatory screening
tests prior to using this machine
4. List any 3 broad indications for
using this machine.

3. 1. Hemodialysis machine 0.5
2. Selective removal of molecules across a semipermeable membrane
0.5
3. HIV, HBsAg, Anti-HCV 0.5 x 3
4. Any 3 of : Acute renal failure ( hypervolemia, intractable
hypertension, hyperkalemia), endstage renal failure,
hyperphosphatemia, poisoning ( ethylene glycol, methanol etc)
0.5 x 3

4. 1. Identify the procedure
2. What is it used for ?
3. How does it work?
4. List 1 advantage of this
particular system. What is the
mechanism behind this?

5. 1. Transcutaneous bilirubinometry 1
2. Noninvasive screening for neonatal jaundice 1 ( must mention
noninvasive and screening; no marks for using word ‘diagnosis’)
3. Use spectrum of visible light reflected from the skin for assessment
of jaundice 1
4. Corrects for skin pigmentation. This is done by using multiple
wavelengths 0.5 x 2

6. 1. Identify the equipment giving
the treatment
2. What's the mechanism of action
3. Name few complications
enountered

7. • 1. biliblanket for providing phototherapy
• 2. structural isomerisation, photo isomerisation, photo oxidation
• 3. hypo/hyper thermia. Fluid imbalance, rash

8. 1. Identify the equipment
2. What is the principle on
which it works?
3. What is the major
disadvantage?
4. what would be the
saturations recorded in a case of
carbon monoxide poisoning?

9. 1. Finger Pulse oximeter 0.5
2. Difference in the pattern of absorption 1.5
of light by oxygenated and reduced Hb
3. Wide range in PaO2 at high levels of StcO2 1.5
4. 100 %, though the patient is severely hypoxemic, there is erroneous
recording as it records both the hb bound to oxygen and carbon
monoxide.

10. 1. What equipment support is the baby on?
2. What are the three main ways by which
the support is provided?
3. name 4 conditions where its used
4. name 2 complications
5. what is the interphase used. Name 2
more

11. • 1. baby is on C-PAP support
• 2. ventilator CPAP, bubble CPAP, variable flow CPAP
• 3. RDS, BPD,TTNB,Pneumonia
• 4. Nasal trauma, septal trauma, pneumothorax
• 5. Nasal mask, short binasal prongs, binasal nasopharyngeal canula.

12. 1. Identify the instrument used here.
2, what is the important difference in
hfnc and CPAP
3. what are the advantages of using
humidification

13. • 1. HFNC
• 2. CPAP is closed system, HFNC an open system
• 3. Advantages of humidification:
• protects respiratory epithelium
• maintains ciliary function of respiratory epithelium
• Improves lung compliance

14. 1. What is the equipment?
2. What is the use of POP up valve
3. how do you sterilise it?

15. • 1. self inflating ambu bag
• 3. wash with detergent and hot water. Dry thoroughly.
• If soiled with blood/body fluids clean and send to central sterilisation
dept.
• 2.

17. • Identify the procedure going on.
• Name 2 cardiac and 2 resoiratory indications, 2 contraindications
• Name 4 complications

18. • ECMO support
• 2. indications
• cardiac: refractory arythmias in cardiogenic shock
• myocarditis
• inability to come off cardio pulm bypass postoperatively
• respiratory: MAS, PPHN,CDH
• Contraindications: <32 wks, major IC bleed, lethal malformations not
compatible with life
• 3. complications: bleed, decanulation

19. 1. Whats the devise called?
2. Whats its use?
3. What does the number indicate?

20. • 1. orchidometer
• 2. for measuring testicular volume
• 3. number indicates volume in mm

22. 1. Identify the instrument.
2. Which illness is it used in ?
3. What are the three
settings ?

23. 1.Peak Flow Meter 1
2.Bronchial Asthma 0.5
3.(a)Green zone >80% PEF 0.5X3 1.5
(b)Yellow Zone 50-80 % PEF
(c) Red zone < 50% PEF
(Total marks 3)

24. Demonstrate the use of
this instrument on this 7
year old child Explain the
mother about its use
Explain about prevention
of asthma triggers

25. • Avoid the maneuver in patients with severe airway obstruction, as it
may worsen bronchospasm acutely.
• • Do not attempt in a child less than 5 to 7 years of age unless the
child has previous experience before the present ED visit.
• • Review the procedure before the patient performs it.
• • Be sure the patient has a tight seal on the mouthpiece, the
exhalation hole on the meter is not blocked, and the meter measuring
gauge is unimpeded by the patient.
• • Coach the patient with encouraging words during the maneuve

26. • Take the best of three measures for the current peak flow. •
• If done after use of a bronchodilator, wait 10 to 15 minutes to obtain
an adequate response. A clinically relevant bronchodilator response is
an improvement in PEFR of greater than 15%.
• • Check the result against the standard for this child or against the
standard nomograms for the patient's size.
• • Observe the technique for: – Poor maximal inspiration – Less than
maximal effort – Occlusion of the exhalation hole or gauge –
Premature cessation of the exhalation

27. 1) Identify the instruments?
2) Administer MDI inhalations to a 1 year
old child?
3) Advice about cleaning of these
instruments

30. rotahaler

31. • 1.What is this device?
2. Two Indications?
3. Contraindication?
4. Two Limitations?
5. Complication?

32. • 1.
Laryngeal Mask Airway
2. Indications?
a. Routine airway in operating room,
b. In cases with difficult bag mask ventilation
3. Contraindication?
Severe airway obstruction
4. Two Limitations?
a.Dislodgement during transport,
b. minimizes but cannot prevent aspiration
5. Complication?
Regurgitation and aspiration

33. 1. Identify the instrument
2, write two advantages over the conventional
mode
3. two contraindiactions

34. • Video laryngoscope
• VLs improved glottis visualization in pediatric patients,
• this was at the expense of prolonged TTI (total time of intubation) and
increased failures.

36. 1. PICC 1
2. Preserves veins, 0.5X2 1
allows concentrated infusates,
permits long term IV alimentation
3. Complications- 0.5X4 2
a. Catheter fracture and embolisation,
b. Leakage
c. Thrombosis of catheter
d. Accidental displacement / Tip Migration
e. Deep Venous Thrombosis
f. Infection
(Total marks-4)

37. 1. Name the catheter
2.How is it different from
regular catheter?
3.Disadvantage ?
4.Precaution for continuous
drainage ?

38. • 1.intercostal / chest drainage with trocar
• 2.with trocar for easy closed method introduction
• 3.sharp tip will injure the mediastinum when overshooted
• 4. always in underwater seal drainage

39. 1.Identify the instrument.
2. What are the indications for its
use?
3. What is the mechanism of its
action?.

40. 1. Sengstaken blakemore tube
2 For controlling variceal bleed which
is refractory to both pharmacological
and endoscopic interventions
3. Has two inflatable balloons, which
can mechanically compress both the
gastric and esophageal varices.

41. 1. Identify
2. 2 indications
3. complications

42. • G tube
• Cp, cleft palate
• Infection, irritation of surrounding skin

43. .Name the device
2.Indication for usage ?
3.Advantage ?
4.Life span of catheter ?

44. • G button / gastrostomy button / mickey tube
• 2.children with feeding difficulties ( feeding gastrostomy )
• 3.silastic / easy to handle the child & to feed
• 4.Life span of catheter ? – 6 months