Procedures

Why C-A-B?

AHA changed from A-B-C to C-A-B to reduce delay before starting chest compressions, the most critical action.

AED Use

Automated External Defibrillator analyses rhythm and delivers shock if needed. Apply pads to bare, dry chest. Do not rub pads together – gel must not be removed.

Advanced Airway

When advanced airway in place, compressions continuous at 100–120/min, one breath every 6 seconds (10 breaths/min).

Insertion Key Points

Clean meatus with betadine, lubricate catheter, insert until urine flows, advance 2.5–5 cm more, then inflate balloon with sterile water (not saline).

Securing the Catheter

Female: secure to inner thigh. Male: secure to lower abdomen or upper thigh. Avoid taping under thigh – can compress tubing and cause pressure injury.

Drainage Bag

Keep bag below bladder level to prevent backflow. Backflow causes CAUTI.

Measuring Length

Measure from nose to earlobe to xiphoid process (NEX). For post-pyloric, add 20–30 cm.

Confirming Placement

Gold standard: X-ray. Bedside: aspirate gastric contents and test pH (≤5.5). Air auscultation is unreliable.

During Insertion

If patient coughs, withdraw tube – may be in trachea. Ask to swallow or sip water to guide tube. Never force against resistance.

Humidification

Oxygen is dry and dehydrates mucous membranes. Humidify when flow ≥4 L/min or if patient uncomfortable. Adds water vapour, does not sterilize.

Safety

Oxygen is a drug; unnecessary use can cause toxicity. Never use petroleum jelly near oxygen – combustible.

Lumbar Puncture

Also called spinal tap. Accesses subarachnoid space to withdraw CSF or inject medication. Position: lateral recumbent or sitting with spine flexed. After: lie flat, increase fluids to prevent headache.

Bone Marrow Biopsy

True-Cut needle obtains core of tissue for histopathology. Used for solid organs like breast, liver, kidney, prostate.