INFANT FEEDING TUBE

PAEDIATRIC DEPARTMENT
Nepalese Army Institute of Health
Sciences
 INFANT FEEDING TUBE Ent
5 E t

Ed16 18 C
Eat
brown

PAEDIATRIC DEPARTMENT
Nepalese Army Institute of Health
Sciences
 DESCRIPTION
• Transparent odorless PVC made non calibrated
-

tube with coned distal end and 2 side openings.

• Fitted with female lure mount for easy connection

to feeding funnel or syringe.

• Disposable sterile ready to use

• Length 52 cm

• Sizes Fr 5,6,7,8,9,10,11,12 (total & gizel)

 DIAGNOSTIC USES
• Tracheoesophageal fistula
•
~ Choanal atresia
• Imperforate anus
•
- Meatal stenosis
– Infant (inability to insert size Fr 5)
– 4 years (inability to insert size Fr 8)
– 10 years (inability to insert size Fr 10)
•
- Gastric aspiration for AFB
•
- Catheterization for urine analysis
• Umbilical catheterization for ABG and blood
sampling
• Diagnosis of upper GI bleed
 THERAPEUTIC USES
• Feeding
-

– Orogastric:
• 1st measure the length of tube to be
inserted from angle of mouth to tragus to
epigastrium.
• Confirmation of position of tube can be
done by:
–Aspiration of gastric contents
–Auscultating gurgling sounds in
epigastrium on pushing air into tube.
– Nasogastric : done especially in infants.
 – Nasoduodenal/Jejunal Transpyloric feeding):
• Length approximately equal to distance from
tip of nose to knee confirmation by:
• yellow color aspirate
• pH >5
• Gastric Lavage
•
- Catheterization to relieve urinary retention
•
- Enema
• Drugs
• Constant aspiration (int. Obstruction)
• Gastric decompression
• Exchange transfusion
• suction
 RYLE’S TUBE

PAEDIATRIC DEPARTMENT
Nepalese Army Institute of Health
Sciences
 description
• Disposable, PVC made stomach tube with 4 side
openings.

• Provided with corrosion resistant steel balls at the

distal end which provides stiffness to the tube
and therefore easy to introduce.

• Length is 105 cm with markings at 50, 60, 70 cm

from tip for accurate placement.
• Sterile, ready to use.

• Size: Fr 8, 10, 12, 14, etc.

• X ray opaque line provided to determine

position of tube.
 USES
• Diagnostic:
– Tuberculosis (early morning gastric aspirate for
AFB)
– Detection of poison.
– GI bleeding.
• Therapeutic:
– Feeding
– Gastric lavage
– Drug administration
– Aspiration in intestinal obstruction
– Gastric compression during oxygen therapy
 Suction tube

Department Of Paediatrics
Nepalese Army Institute of Health
Sciences
• Atraumatic, soft and rounded open tip with
two lateral eyes.

• Its used for removal of secretions from

– Mouth
– Trachea
– Bronchial hub

• Length: 52 cm
 OXYGEN MASK

PAEDIATRIC DEPARTMENT
Nepalese Army Institute Of Health
Sciences
 DESCRIPTION

• Moulded face mask with adjustable elastic strap

and integrated nose clip for proper position of
mask on mouth and nasal area.

• Exhalation ports in the side and between mask

and face

• Provided with a long tube to ensure continuous

flow of oxygen
 USE
• Oxygen Therapy
• Nebulisation

Gas Flow Rate % of Oxygen

6 – 8 L/min 40 - 60
 PROPERTIES
• Mask should be transparent. If colored,
cyanosis, regurgitation and condensation
cannot be detected.

• Under mask volume (dead space) should be

low (100 – 200 ml). This will decrease the
chances of rebreathing of exhaled gases
 DISADVANTAGES
• If oxygen flow rate is less than 6 L/min, rebreathing of
exhaled CO2 can occur.

• Interference with feeding.

• Tightly fitted mask are poorly accepted by infants and

toddlers.

• Loosely fitted mask provides only 40% of oxygen.

• If mask in place, aspiration of vomitus can occur.

Twin bore nasal oxygen
set
(nasal cannula)

PAEDIATRIC DEPARTMENT
Nepalese Army Institute of Health
Sciences
• DESCRIPTION:
– Consists of two
short plastic prongs
arising from a
hollow face piece.

• TECHNIQUE OF USING:
– Prongs are inserted
into the anterior
nares and oxygen is
delivered into the
nasopharynx.
• INDICATION:
– hypoxemia

• USES:
– Simple low flow oxygen delivery for infants
and children.

Gas Flow Rate % of Oxygen

1 – 4 L/min 24 - 36
• ADVANTAGES:
– Leaves mouth free for nutritional and
communication purposes.
– CPAP

• DISADVANTAGES:
– Does not provide humidified oxygen.
– Prongs are difficult to maintain in position.
– Excessive oxygen flow leads to nasal irritation
and gastric distension.
– Nasal mucosa injury.
– Cannot be used in patients with
-• Nasal obstruction,
-
• DNS
-• Nasal polyp
• Hypertrophied turbinates and
-
• Choanal atresia.

– Neonates, who are purely nasal breathers, any

interference in oxygen flow will lead to
hypoxemia and hypercapnia.

***************************************
****************
 OXYGEN HOOD

DEPARTMENT OF PAEDIATRICS
Nepalese Army Institute Of Health
Sciences
Oxygen Tent
• It is a clear transparent shell that encompasses the
infant’s head.
• Stainless steel oxygen inlet nozzle.
• Port hole for easy access.
• Neck height adjustment facility
• With a gas flow rate of 10-12 L/min, it provides 80-
90% of oxygen.
• USES:
• Hypoxemia -
• Oxygen administration
>
-

• ADVANTAGES:
• Humidification decreases the size of oxygen
>
-
-
-

molecule, therefore, reaches alveoli easily.

• Humidification prevents drying of
secretions as dried secretions may block the
airway.
• Well tolerated by infants.
• Allows easy access to rest of the body.
• DISADVANTAGES:
• Prolonged exposure to humidified oxygen
increases the risk of Cutaneous fungal
infections.
• Low temperature within enclosure system
may result in cold stress injury.
• Inadequate oxygen flow rate, may result in
hypoxia or hypercapnia.
• Any opening in the enclosure may result in
decrease in the concentration of oxygen.

*************************************
***************
 Paediatric
self inflating bag with
face mask and oxygen
reservoir

Paediatric department
Nepalese Army Institute of Health
Sciences
• It is used to provide Positive Pressure
Ventilation.

• SIZES:
– Neonate : 250 ml
– Infant and children : 500 ml
– Children > 10 years : 700 ml

• PARTS:
– Paediatric face mask
• Cushioned and non - cushioned
– Non rebreathing patient valve:
• Present just proximal to patient outlet.
• During expiration, these valves close and
patients exhaled gases are vented to
atmosphere to prevent re breathing and
retention of CO2.
– Compressible self refilling ambubag:
• Bag recoil allows the self inflating bag to
refill independent of flow from a gas
source.

– Intake valve
– Nipple for oxygen tubing
– Oxygen reservoir (bag or corrugated pipe),
connected to the air inlet
• Percentage of Oxygen delivered:
• In absence of supplemental O2 : 21%
• In presence of supplemental O2 : 40%
• With Oxygen reservoir bag : 90%

• Indications:
• Neonatal resuscitation
–Apnea or gasping
–Heart rate <100/min
–Persistent cyanosis
• Infant and children:
–Respiratory failure or arrest
• Technique of use:
• Position of baby: slight extension of neck by
putting towel under shoulder.

• Doctor should stand at the head or side of

the baby.
• Hold the bag with right hand and mask with
left hand.
• Hold the mask firmly on face in CE method.
oSqueeze to see adequate chest rise.
oRhythm: squeeze – release-release
• Remarks:
• Whenever the child deteriotes, look for air
tight face mask seal
• Listen over tail of the bag for oxygen sound.
• See for the pressure.
• Contraindication:
• Suspected diaphragmatic hernia
• Meconium aspiration
• Complication:
• Injury
• Hypoxia

*************************************
 ENDOTRACHEAL
TUBE

PAEDIATRIC DEPARTMENT
Nepalese Army Institute Of Health Sciences
 Description
• Sterile, ready to use, disposable, translucent
PVC made with radio opaque marker and
adapter at the proximal end.
 INDICATIONS
• Upper respiratory tract obstruction
• Mechanical ventilation
• Loss of protective airway reflex (in coma,
paralysis of respiratory muscle etc)
• Need for high peak inspiratory pressure
• Administration of general anesthesia.
• Inadequate CNS control of ventilation
• Tracheal clearance in MAS
 Drugs that can be given endotracheally

• Epinephrine
• Naloxone
• Atropine (LANES)
• Lignocaine
• Surfactant
 SIZE OF ETT
• NEWBORN:
– Expected gestational age divided by 10.
ID (mm) WT (kg) GA (weeks)

2.5 <1 28

3 1-2 28 – 34

3.5 2-3 34 – 38

4 >3 >38

• INFANT: 4 mm
• TWO YEARS: 5 mm
• > 2 YEARS:
Age in years
------------------ + 4 =
ID
4

 length:
Weight in kg + 6
ID x 3
 Types of ett
• Uncuffed ( in children under 8 years as normal
anatomic narrowing at the level of cricoid
cartilage acts as functional cuff)

• Cuffed
 Intubation procedure
• Place the baby with neck slightly extended
position.
• Stand at head end of the baby
• Hold the laryngoscope in left hand with blade
pointed away.
• Introduce the laryngoscope blade in mouth
between baby tongue and palate.
• Advance the tip of blade just beyond the base
of tongue.
• Lift the blade in direction of handle of the
laryngoscope.
• You will see the glottic opening just below
epiglottis, mild pressure over trachea by little
finger lowers the trachea and glottis will be seen
clearly.
• Hold ETT in right hand and insert from the corner
of mouth until vocal cord guide is at the level of
vocal cord, tip should be 1.2 cm above carina.
• All these procedure should be completed in 20
seconds to avoid hypoxia.
• Hold the ETT with right hand and remove the
laryngoscope.
• See the signs of correct ETT placement:
– Bilateral equal breath sounds
– Chest movements
– No sound on epigastric area
– Radiology
– Improvement in heart rate and color

• Secure the ETT with tape.

 complications
• Hypoxia
• Bradycardia
• Apnea
• Pneumothorax
• Injury
• Infection
• Obstruction

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******
 LARYNGOSCOPE

PAEDIATRIC DEPARTMENT
Nepalese Army Institute of Health
Sciences
 description
• PARTS:
– Handle with battery
– Blade with light source
• Blades:
–Straight: used in children under 3 years
of age because it provides better
visualization of the relatively cephaled
and anterior glottis (Miller).
–Curved: used for older children because
its broader base and flange facilitates
displacements of tongue and improve
visualization of glottis (MacIntosh).
• SIZES:
– Zero: Preterm neonate
– One: Term neonate and infant
– Two: Children
– Three: Adolescent

• NAME:
– Miller: sizes available are 0, 1, 2, 3.
– MacIntosh: sizes available are 2, 3.
 USES
• Therapeutic:
– Endotracheal tube placement
– Suction catheter placement
– Magill forceps placement for foreign body
removal.

• Diagnostic:
– Foreign body inhalation
– Neoplasm, eg papilloma etc
– Congenital anomaly: eg: Laryngomalacia
– Cord palsy
• STERILIZATION:
– Autoclaving

• COMPLICATIONS:
– Injury
– Bradycardia
– Hypoxia
 VENOUS CANULA

PAEDIATRIC DEPARTMENT
Nepalese Army Institute of Health
Sciences
61
62
• Parts:
– Outer polyethylene sheath
– Inner metal stillete

• Indications:
– Fluid administration
– Medications
– Blood products
– Blood sampling
– Various diagnostic and therapeutic procedure:
• Pleural tapping
• IVU
– Iv access required for more than 24 hours

63
 8
SIZES
AGE GROUP SIZE COLOR

Pre Term 26G Purple T

Newborn 24G Yellow T

Child 22G Blue ↑

Adolescents 20G Pink &

adults 18G Green E

“ 16G Brown Ed

64
 SITES
• Upper extremity (use distal site first)
– Median antecubital vein at elbows
– Dorsum of hand

• Lower extremity
– Great saphenous vein at ankle
– Median marginal veins
– Veins of dorsal arch

• Scalp veins (rarely)

65
 PROCEDURE
• Locate and stretch the vein
• Apply tourniquet proximal to vein
• Maintain asepsis
• Puncture the skin slightly distal or lateral to the
side of venipuncture with a needle
• Insert the cannula with bevel up
• Slowly advance till blood flows back freely
• Remove the needle simultaneously while
advancing the catheter into the way

66
• Remove the torniquet
• Secure the cannula with tape

67
 COMPLICATION

• Thrombophlebitis
• Cellulitis
• Embolism

68
 MICRODRIP SET

DEPARTMENT OF PAEDIATRICS
NEPALESE ARMY INSTITUTE OF HEALTH SCIENCES

69
70
• Clear, soft, cylindrical and calibrated measured
volume chamber with bold graduation.

• Chamber injection port allows medication to be

injected into burette chamber for medication
mixture.

• Chamber vent allows air to enter chamber

through hydrophobic membrane to prevent
solution contamination.

• Burette sizes available: 110ml, 150ml

71
• 1 ml of it contains 60 drops.

• It contains Murphy chamber through which it is

possible to regulate the number of drops falling
per minute.

• A fluid level must be maintained in the Murphy’s

chamber. If the chamber gets full, it has to be
reset. 72
• If you want to give 40 ml/hour fluid through the
micro-drip set, adjust it to set at just 40
drops/min.

• USES
– Intravenous fluid administration
– Drug administration
– Parenteral nutrition

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*************
73
 TUBERCULIN SYRINGE

DEPARTMENT OF PAEDIATRICS
Nepalese Army Institute of Health
74
75
 Mantoux Test:
• 0.1 ml of tuberculin, which is a purified protein
derivative (PPD) is injected intradermal on the
volar aspect of forearm.

• A wheal of 5 mm should be raised.

76
 • Standard dose is 5TU (equivalent to 1TU PPD with
RT Tween 80)

• PPD is obtained by culturing M tuberculosis H37RA

strain with Tween 80 on a synthetic protein free
medium Quinosol.

– NOTE:
• Positive Tuberculin Test may be seen in infants
vaccinated with BCG.

• In older children, interpretation of tuberculin test is

not altered by BCG.
77
• Negative test does not rule out TB.
 Interpretation:
• induration is measured and read after 48 – 72
hours.
• A TST should be regarded as positive as follows:

– In high-risk children
» HIV-infected children
» Severely malnourished children >5 mm

– In all other children

» whether they have received a BCG
vaccination or not: >10 mm diameter

(Guidance for national tuberculosis programmes on the management of

78
tuberculosis in children, WHO)
• American Academy of Paediatrics
guidelines:

– Induration ≥ 5 mm

• Children in close contact with known or suspected

tuberculosis patient.

• Children suspected to have tuberculosis disease:

– CXR suggestive of TB
– Clinical evidence of TB
– Children receiving immunosuppressive therapy
– Children with immunosuppressive condition, eg 79

HIV infection.
– Induration ≥ 10 mm

• Children < 4 years of age

• Children with other medical condition like Hodgkin
disease, lymphomas, DM, chronic renal failure etc.
• Children born in high prevalence regions.
• Children exposed to high risk people like HIV
infected, drug users, migrant farm workers etc

– Induration ≥ 15 mm

• Children ≥ 4 years of age without any risk factors.

80
 BUTTERFLY NEEDLE
(SCALP VEIN SET)

DEPARTMENT OF PAEDIATRICS
Nepalese Army Institute of Health
Sciences
 Rotahaler
(dry powder inhaler)

PAEDIATRIC DEPARTMENT
Nepalese Army Institute of Health
Sciences
• PARTS:
– Mouth piece
– Reservoir

• ROTACAPS:
– Gelatin capsule containing the drug in powder
form. Rotacaps available are:
–Salbutamol
–Beclomethasone
–Budesonide
–Fluticasone
–Salmetrol
–Sodium cromoglycate
• USES:
– Used in treatment and prevention of asthmatic
attack in school age children.

• ADVANTAGES OVER METERED DOSE INHALER:

– Cost is less
– Easy to use
– Easy to teach
– Easy to carry
– Being breath activated device, it eliminates the
need for coordination of inspiration with drug
delivery.
– Propellant free so environment friendly.
• TECHNIQUE OF USE:
– Hold the rotahaler vertically so that mouth piece
faces up.

– Insert the rotacap, transparent end into the

raised square hole

– Press the rotacap firmly such that the top end of

the rotacap is at level with the top of the hole.
– Hold the mouth piece firmly with one hand,
rotate the base, fin separates the 2 halves of
the rotacap.

– Breathe out completely

– Grip the mouth piece between your teeth and

close your lips around it, tilt your head slightly
backward , breathe in deeply.

– Remove the rotahaler from the mouth and

hold the breath till you can.
****************************************
*************
 Metered dose inhaler
(MDI)

PAEDIATRIC DEPARTMENT
Nepalese Army Institute of Health
 SPACER DEVICE

PAEDIATRIC DEPARTMENT
Nepalese Army Institute of Health
Spacer device with mask
 Peak flow meter

PAEDIATRIC DEPARTMENT
Nepalese Army Institute of Health
Sciences
• USES:
– To diagnose Asthma
–(> 15% increase in peak flow when
measured after administrating a
bronchodilator) OR (>15% decrease in
peak flow after exercise)

– To detect impending attacks of asthma

–(Peak flow monitoring should be done
twice daily. Once in morning (8am) and
other prior to sleep at night (8pm). Drop
in peak flow is a warning sign of
impending attack.
• Monitoring effectiveness of drug:
– Done by measuring peak flow before and
after drug use.

• Informs regarding severity of attack:

– Normal value: 300 – 600 L/min
– Mild attack: > 80%
– Moderate attack: 60 – 80%
– Severe attack: < 60% of patients
normal peak value.
• TECHNIQUE:
– Move the indicator to the bottom of
numbered scale.
– Breathe in deeply.
– Keep the mouth piece in mouth and close your
lips around it.
– Blow out maximally in a single blow.
– Note the reading.

**************************
Bone marrow aspiration
needle

PAEDIATRIC DEPARTMENT
Nepalese Army Institute of Health
Sciences
Vim Silverman
needle

Jamshidi
Needles
 Bone Marrow Aspiration and Biopsy

• Done when there is presence of

– Pancytopenia,
– Bicytopenia,
– Unexplained thrombocytopenia
– Leucocytosis in order to rule out significant
pathology
– Unexplained fever
• DESCRIPTION:
– Thick body with needle proper.
– Guard (2 cm from tip) to prevent through and through
penetration of bone.
– Stillete.

• SITE:
– Age < 2 years:
• Tibial tuberosity
– (1 cm madial and 1 cm
distal to tibial tubercle).
– Age >2 years:
• Posterior superior iliac crest
• INDICATION OF BMA:
– Diagnostic:
– Hypoplastic, Megaloblastic anemia
– Infections: Malaria, Kala-azar, Typhoid
– Malignancy: Leukemia, Lymphoma,
Histiocytosis
– ITP
– Storage disorder:
» Gaucher’s disease
» Myelofibrosis

– Therapeutic:
– Intra-osseous fluid therapy
– Bone marrow transplantation.
 – Prognostic:
• Hypo-plastic anemia
• Malignancy: Leukemia, Lymphoma

• Procedure:
– Child should be fasting 3–4 hours before procedure
– Sedation can be done with Midazolam and Ketamine
– Atropine can be used to counteract excessive secretions.
– Child is positioned prone with face turned to a side.
– The site is cleaned with chlorhexidine and betadine.
– Posterior superior iliac spine is located by tracing the iliac
crest backwards to its most prominent and elevated
point.
– 2 ml of 1% Lidocaine is injected S/C into the periosteum.
– The BM needle is holded with the dominant hand firmly
with the index finger placed over the needle to act as a
guard.
– Needle is advanced perpendicularly into the identified
area.
– Advancement is done in twisting motion till bone is felt.
– On advancing further, a “give way” is felt that indicates
that the needle is in the marrow.
– Remove the stylet and attach a 20 ml syringe.
– Aspirate 0.5 to 1 ml of marrow
– Make slides of the marrow.
• COMPLICATIONS:
– Bleeding and pain at the aspiration site
– Fracture of iliac bone
– Subcutaneous infection
– Osteomyelitis (rare)

• CONTRAINDICATIONS:
– Local infections
– Osteomyelitis
– Hemorrhagic diasthesis
– Hemophilias
 CORD CLAMP

DEPARTMENT OF PAEDIATRICS
Nepalese Army Institute Of Health
Sciences
• Used for clamping the umbilical cord of newborn
baby immediately after birth.
• Provided with finger grip for safe and convenient
handling.
• Security lock to prevent accidental opening after
clamping.
• Grooved clamping area to prevent slipping of
umbilical cord.
 GUEDEL AIRWAY

DEPARTMENT OF PAEDIATRICS
Nepalese Army Institute Of Health
Sciences
• Suitable for maintaining an unobstructed
oropharangeal airway during general
anesthesia and in unconscious patients.
• It has rounded atraumatic edges with
smooth airway path for easy cleaning.
• Length of Guedel airway used is 2/3rd of
distance between angle of mouth and
temporo-mandibular joint.
 uses
• Macroglossia • Seizuring child
• Retrognathia • Unconsious
• Choanal atresia child
• Neonatal resuscitation • Pierre Robin
syndrome
 infantometer

PAEDIATRIC DEPARTMENT
Nepalese Army Institute of Health
Sciences
• Acrylic infantometer for recording length/height
of baby.

• Sleek broad acrylic base with one sliding side as

per length of baby.

• Dual scale for direct reading in cm from 0 to 45

and 45 to 90 cm.

• Folding sides for easy storage.

• Vertical model allows height measurement up to

4 feet.
• AVERAGE NORMAL HEIGHT:
AGE LENGTH/HEIGHT
(CM)

At Birth 50

At 1 year 75

2 to 12 years (Age in years X 6) + 77

************************************
*********************
RESPIRATORY EXERCISER

DEPARTMENT OF PAEDIATRICS
Nepalese Army Institute Of Health
Sciences
• Consists of three balls.
• It helps the patient to recover normal
respiration after a chest or abdominal
surgery.
 Three way stopcock

PAEDIATRIC DEPARTMENT
Nepalese Army Institute of Health
Sciences
• PARTS:
– One protective cap
– Two screw cap (white)
– Luer lock (transparent)
• Flow indication on tap (white color)
indicate direction of flow.
• Transparent base and legs facilitate
observation of flow.
• INDICATIONS:
– To incorporate between infusion line and
inserted catheter in patients vein in order to
give medicine or other fluid.
– Exchange transfusion
– Pleural or peritoneal tapping to prevent air
entry
– CVP monitoring
– Spinal manometry
– Dialysis

***************************************
**************
LUMBER PUNCTURE NEEDLE
AND
PROCEDURE

Department of Paediatrics
• Lumber puncture is a procedure to tap CSF from
vertebral canal for diagnosis and therapeutic purposes.

• Prerequisites for lumber puncture:

– Fundus examination should be done to R/O raised ICP.
Sudden release of CSF can lead to medullary coning
and cardiac arrest.
– Spinal column should be normal.
– Puncture site should not be infected.

• Contraindications:
– Bleeding and clotting disorders
– Hypertension.
• Procedure:

– Place the patient on one side of hard table.

– Child back is flexed by an assistant and neck is flexed to
chest and knee drawn forwards to abdomen.
– Inter vertebral space between L4 and L5 (in line with
posterior superior iliac spine) is palpated.
– Skin over the same area is prepared and draped.
– The skin over L4 and L5 is infiltrated with local
anaesthetic.
– Thumb of left hand is placed over l4 and
intervertebral space just below it is approached by
lumber puncture needle.
– By giving gentle pressure, the needle is introduced
through;
• Skin
• Ligamentum flavum
• dura
– The stylet of lumber puncture needle is removed and
CSF collected in sterile bottles.
– The needle is withdrawn and tincture
benzoin/micropore plaster seal applied to prevent
oozing.
• Collected CSF is sent for the following examinations:

– Color
– Cell count
– Protein, sugar, lactic acid levels
– Gram staining
– CRP Levels
– Culture of CSF
• LP is useful in diagnosing following conditions:

• Meningoencephalitis
• Neonatal Sepsis
• Meningitis
• Neurological malignancies
• Autoimmune disease
• Demyelinating illness
• Subacute sclerosis pan encephalitis (SSPE)
• Neuro-metabolic disorders.
UMBILICAL CATHETER

DEPARTMENT OF PAEDIATRICS
NEPALESE ARMY INSTITUTE OF HEALTH SCIENCES
• Designed for intermittent or continual access to
the umbilical artery or umbilical vein of the newly
born or premature baby.

• Tube with radiopaque line, marked at every cm

from 5 to 25 cm from the open distal tip for
accurate placement.
– 1ST marking: Under surface of liver
– 2nd marking: Hepatic vein
– 3rd marking: Inferior Vena Cava
• Open distal end without lateral eyes eliminate the
chance of clot formation in the blind spaces.
• Has female flexible mount and luer lock.
• Color coded funnel end connector for easy
identification of size.
• Length: 40 cm
• Sizes: FG 4, 5, 6, 8
• Optimal length for umbilical vein catheterization:
– 20% of crown heel length or
– 50% of shoulder umbilicus length.
• USES:
– Infusions, Transfusions
– Administration of medications
– Blood sampling
– CVP monitoring

• COMPLICATIONS:
– Immediate:
–Bleeding
–Thromboembolism
–Infections
– Late:
–Portal hypertension
URINE COLLECTION BAG

DEPARTMENT OF PAEDIATRICS
Nepalese Army Institute Of Health
Sciences
• Bag graduated in ml to measure urine
output
• Contains non return valve
• Conical inlet connector with cap