ARTICLES / INSTRUMENTS.

• Fetoscope

*Introduction-

°Fetoscscpe is also called pinard horn or pinard fetoscope.

° Fetoscope is used by healthcare professionals to listen fetal heart sound of fetus during pregnancy.

*Parts –

(1) Aural end
(2) Abdominal end

*Shape – Cone shape or Funnel shape

*Principle —

Conduction to Conversion

• The principle of fetoscope includes the transmission and amplification of sound waves from fetal heart sound to listener’s ear, which helps us to listen fetal heart sound easily.

*Purpose:

During pregnancy, the fetal heart sound of the fetus is auscultated and monitored through fetoscope.

• Fetoscope helps in assessing well being of fetus, detecting abnormality of fetal heart rate and monitoring fetal distress during labor.

*Use:

It is used to auscultate the fetal heart sound of the fetus during pregnancy.

*Place:

During pregnancy, the anterior shoulder of the fetus is detected by detecting the lie and position of the fetus.
Then the fetal heart sound is listened by placing the abdomen end of the fetoscope on the abdomen of the mother where the anterior shoulder of the fetus is.

• If there is a vertex presentation of the fetus, the fetoscope is placed in the lower part of the umbilical cord and the fetal heart sound is heard.
• When there is a breech presentation, the abdominal end of the fetoscope is placed around the umbilical cord and the health care professional listens through the aural end of the fetoscope.

•Sterilization: Autoclave

Thermometer:

Thermometer is used to measure body temperature during physical examination.
There are 2 types of temperature.

Surface temperature

Core body temperature 1.Surface temperature:
In this temperature can be taken in skin, subcutaneous tissue and fat.
Eg. Axillary temperature 2.Core body temperature:
In this temperature is taken from deep tissue like abdominal cavity, pelvic cavity.
Eg. Temporal
Tympanic
Oral
Oedophagal
Urinary bladder
Rectal
pulmonary

Normal value of temperature (normal body temperature):-
Oral temperature: 37°C / 98.6°F

Rectal temperature:
37.5°C/ 99.5°F (oral temperature greater than 0.5°C)

Axillary temperature:
36.5°C/ 97.7°F (less than oral temperature)

Conversion Formula for temperature:-
°F=(°C× 9/5) + 32
°C=(°F- 32) ×5/9

♦There are many types of thermometer which are as follows.

Clinical thermometer or glass thermometer or mercury thermometer

electronic thermometer

digital thermometer

tympanic thermometer

Non contact digital infrared thermometer or forehead thermometer

Disposable thermometer strip 1.Clinical thermometer:
Clinical thermometer is used to take body temperature. Clinical thermometer is made of a glass tube shape which is filled with mercury through which body temperature can be measured.
Oral, axillary etc. temperature can be taken from this thermometer.

Electronic thermometer:
This thermometer is used to take oral and rectal temperature.
which for blue tipp Oral temperature and
Red tip is used for rectal temperature.

Digital thermometer:
Digital thermometer is used to take body temperature during physical examination.
Digital thermometer can take oral, axillary, rectal, etc. body temperature.

Tympanic thermometer:
This thermometer is used to take temperature from the ear during physical examination.

If there is ceruman (ear wax) in the ear, there may be a change in temperature

This thermometer is kept in the ear up to the tympanic membrane and the temperature is measured.
The temperature is measured by infrared rays in this thermometer.

Non-contact digital infrared thermometer:
This thermometer is measured on the upper part of the person’s head and the body temperature without touching the head.
Body temperature is taken by this thermometer without touching the person’s body.
This thermometer was used excessively during the corona period.

Disposable thermometer strips:
In this, this strip is placed in the person’s mouth under the tongue and after 60 seconds, it is removed from the mouth and the temperature is observed.

How to clean the thermometer..?

The thermometer is cleaned with cotton swab through normal saline or spirit.

In it digital and clinical thermometer…
Bulb to stem is cleaned before using the thermometer.
And after use, stem to bulb is cleaned.

NOTE:
During the procedure, the thermometer is kept with savlon solution and cotton swab.
The main goal of keeping a cotton swab in it is that if there is a cotton swab, when the thermometer is kept in a bowl with savlon during the procedure, the tip (bulb) of the thermometer does not break and the mercury does not fall.

(More usage explained in PROCEDURE)

♥ 2. BP INTRUMENTS (MERCURY SPHEGMOMENOMETRE).

Introduction

Another name of BP mercury instrument is sphagmomanometer.
It is called the gold standard.

Where sphingomanometer is the Greek word ‘sphagmus’ meaning heartbeat, and ‘manometer’ means an instrument for measuring pressure using dimensional analysis.

It was invented in 1881 by Samuel Seyfried curl fighter von Besch.

A sphygmomanometer is a type of instrument that can be used to measure blood pressure.

Mercury sphagmomanometer is the most commonly used sphagmomanometer.

It consists of a graduated tube containing mercury which measures the pressure applied by an inflatable rubber on the upper arm.

For proper measurement the instrument is placed on a flat surface.

They measure BP directly by observing the height of the column of mercury so there can be no measurement errors.

There are three types of sphygmomanometers

1.Mercury Sphagmomanometer

2. Aneroids sphagmomanometer
3. Digital sphygmomanometer

Use

1. To measure people’s blood pressure
2. To detect any abnormality in blood pressure which may indicate any disease.
3. To monitor the effectiveness of drugs that alter blood pressure in people.

4.Various techniques can be used to help the suffering patient depending on the blood pressure as first aid in the ambulance.

The steps for measuring blood pressure by sphygmomanometer are as follows

1. When the upper arm is tied with an inflatable cuff, keep in mind that at least 80% of the upper arm area is covered and the bottom of the cuff should be two centimeters above the antecubital fossa or elbow.
2. If the valve of the BP instrument bulb is loose, tighten it medium tight, do not over tighten.
3. Air is pumped into the phlegm bladder to a pressure greater than the systolic and diastolic pressures.
4. The stethoscope is then placed over the brachial artery of the arm.
5. Then the air is slowly released by loosening the bulb valve little by little and due to this the pressure through the cuff also decreases until the pressure drops to 180 mmHg.

6.A stethoscope is used to listen for the sound when the cuff deflates the pressure is also monitored in the manometer and this sound is the systolic pressure.

Normal systolic pressure is 120 mmHg.

7. The pressor inside the cuff is further reduced by releasing the air until no sound is heard through the stethoscope.

The pressure at which the sound of flow in the blood is not heard is the diastolic pressure, it is also seen in the manometer when the sound stops.

Normal diastolic pressure is 90 mmHg.

Principles of Sphagmomanometer

Its main principle is that the pressure in the cuff bladder should be equal to the arterial pressure.

Blood pressure is usually measured from the brachial artery as it is the main blood vessel of the upper arm.

The brachial artery is inflated until it is compressed (narrowed) and blood flow is stopped.

Points to consider for accurate BP measurement

Remove tight clothing.

Do not eat or drink anything and do not exercise for 30 minutes before BP measurement otherwise the BP will be high (increased).

Remove excess air from the cuff before measuring BP otherwise the BP will be inaccurate.

Keeping both feet flat on the ground and not crossing the legs.

Do not talk to the patient while measuring the patient’s BP.

Place the patient in a chair and sit straight back.

Place the patient’s hand on the table at the level of the patient’s heart.

Ask the patient to rest for 5 minutes before measuring BP.

Tie the cuff on the upper arm two centimeters from the elbow.

The cuff should not be too tight on the upper arm, it should easily fit two fingers.

Determining the appropriate cuff age wise for measuring BP.

After care

Use a soft dry cloth or a soft cloth moistened with a mild detergent to clean the cuff of the manometer and wipe with a dry cloth.

Do not wash the cuff and other parts of the BP instrument in water and also do not use gasoline or other components.

♥ STETHOSCOPE:

Usage:

A stethoscope is used to measure blood pressure.
Heart, lung, intestinal track (intestinal movement called peristalsis movement) is done to hear the sound.

After care
Keep away from excessive heat and oil.
Clean with 70% isopropyl alcohol. To remove organic material while cleaning

A stethoscope is a medical instrument used to listen to the sounds inside the human body.
Mainly lung, heart, intestine sound is heard through stethoscope.
Apart from this, it is also used to listen to the fetal na heart sound.
Stethoscope is also used to manually check blood pressure.

Uterine sound

introduction:-

➡️ Uterine sound is a medical instrument.
➡️ It is used by gynecologists to measure the depth and direction of uterite cavity.

Characteristics:-

➡️ It is 12 inches long.

➡️ Its distal end is curved.
➡️ Its tip is blunt.

Design and Functionality:-

Shape:-
➡️ It is of long, slender & curved shape.

Size:-
➡️ The size of uterine sound is different.
Its size is 6 to 10 cm.

Uses:-
➡️ The depth & direction of the uterine cavity has to be measured.
➡️ To insert intra uterine device.
➡️ To detect the abnormal position of the uterine cavity.
Example:- Tumor, polyp, product of conception & IUCD
➡️ Works as initial dilator before operation of Uterus & cervix.

Indication :-

1 The death and direction of uterine KV is to be measured.

2 is done for cervical dilation.

3 To insert the intrauterine device.

4 for Diagnostic Assessment

Assist in 5 surgical procedures.

Contraindications :-

1 pregnancy

2 pelvic infection

3 cervical cancer

4 Uterine cancer

5 severe cervical stenosis

6 vaginal bleeding

7 Recent Uterine surgery

sterilization:-

1 Cleaning :-

➡️ First clean and remove visible debris and blood in uterine sound.

2 Disinfection:-

➡️ After cleaning, the uterine sound is immersed in Gluteraldehyde solution and then disinfected.

3 Autoclave :-

➡ With the help of autoclave, bacteria, virus, and spores are eliminated in microorganisms.

➡️ Its Temperature:- 121’C
Pressure:- 15 lbs
Time :- 30 minutes

SIMS UTERINE CURETTE

INTRODUCTION:

Curettes are gynecological and obstetrical instruments.
It is made of stainless steel.
Its length is 25 cm.

Types:

1) Blunt
2) Sharp

Broader than blunt loop and sharp loop.
A transverse ridge is present on the shaft.
Sharp loop is used in gynec curettage.
Blunt loop is used in obstetric curettage.
End of curette blunt & sharp
OR
Both ends sharp
OR
Both ends can be blunt.
It has different sizes.
Blunt curettes are used in dilatation, evacuation, suction evacuation operation.
Sharp curette is commonly used in gynecology for curetting of endometrial cavity.

USES:

Curettes are used for diagnostic and therapeutic purposes in gynecological conditions.
To take an endometrial sample
To remove the decidua
To remove increased product of conception in case of PPH

COMPLICATION:

Removal of basal layer of endometrium can lead to permanent amenorrhea & infertility.
Endomeriosis can occur due to implantation of endometrial tissue in the vagina or perineal scar.
complication of dilatation (cervical trauma)

STERILIZATION:

1) Boiling : Boil for 15 to 20 minutes followed by autoclaving.

2) Autoclave : 121°C temperature
Using 15 lbs pressure
Autoclave for 30 minutes.

Vulcellum forceps

➡️Introduction of vulsellum forceps

Vulsellum forceps are used to grip the cervical lips for visualization of the cervix.

It is also used in vaginal hysterectomy.

It is a long scissors type forceps which is thin and long in appearance.

It has two types of forceps, straight and curved.

➡️Size of vulsellum forceps
It is available in 8 to 10 inches.

It is an s shaped forceps and features 5 to 6 teeth which are used to grip the membrane.

➡️Type of vulsellum forceps

(1) Multiple teeth vulsellum
1.1 straight
1.2 curved

(2) Single teeth vulsellum

➡️Use of multiple teeth vulsellum

(1) For intra uterine control device insertion.
(2) For endometrial biopsy.
(3) For cervical biopsy.
(4) For dilatation and evacuation.
(5) For suction evacuation.

➡️Use of single tooth vulsellum

(1) It is primarily used for gynecological purposes, such as for holding nalliparous cervix and amputated cervical stamp.

➡️Indication of vulsellum forceps

(1) It is used to hold the anterior lips of the cervix in dilatation and evacuation & suction evacuation.

(2) In Manchester repair.

(3) In colpotomy.

(4) In culdocentesis.

➡️Contraindication of vulsellum forceps

(1) Pregnancy and immediately after delivery because the cervix is ​​soft, then the cervix ruptures.

➡️Sterilization of vulsellum forceps

(1) Firstly after using vulsellum forceps if there is any debris, remove it and then clean it with detergent and enzymatic cleaner and runny water.

(2) We vulsellum forceps are sterilized by autoclave method of sterilization.

Sim’s vaginal speculum

Introduction

• Sim’s vaginal speculum is called duck bill speculum.
  -Sim’s vaginal speculum cannot be self-retaining, so an assistant is needed to hold karva in its position.
• Made of stainless steel.
• Available in many sizes.

➡️Types of sim’s vaginal speculum

1) single blades sim’s vaginal speculum.

-In which singal blades are located.

Examination of cervix can be done through these single blades.

2) Double Blades sim’s vaginal speculum

• Which has double blades.

-Examination can be done using both these blades.

➡️size of sim’s vaginal speculum

1) Small sim’s vaginal speculum (25mm to 30mm)

2) Medium sim’s vaginal speculum (30mm to 35mm)

3) large sim’s vaginal
speculum (35 mm to 40 mm)

➡️ Insertion of sim’s vaginal speculum (how to insert)

-Keep the patient in the lithotomy position and his buttocks along the edge of the table.

• Clean and lubricate the speculum.

-Gently enter the speculum in the vaginal opening and slightly 90 degree downwards, then gradually rotate it to a horizontal position.

• Then spread the leads generally so that we can visualize the cervix.

This process should be done slowly and carefully so that discomfort and injury to the patient can be avoided.

➡️uses of sim’s vaginal speculum

-Taking pap smear.

Insert -Copper -T and
to remove.

-Colonoscopy

-Dilatation & curettage procedure

-Vaginal hysterectomy

-Os tightening

• For inspection of ruptured members

Par vaginal examination

➡️Sterilization

Sterilization is done by autoclave method.

-121 degrees temperature 15 pound/square pressure and sterilization is done for 30 minutes.

Tongue depressor:

It is made of wooden and stainless steel.

Usage:
Tongue depressor is useful to depress the tongue so that mouth and throat can be properly visualized.
Nowadays disposable tongue depressor is used more than stainless steel tongue depressor.

Principle:
It depresses the tongue so that proper examination can be done.

🙂 Glucometer:

Glucometer is used to check the level of sugar in the blood.
Glucometer measures blood sugar level in 3 ways.

invasive method

Non-invasive method (manually)

CGM (continuous glucose monitoring)

Mainly at present invasive method is used to check blood sugar level.
Blood sample is taken from the finger tip by lancet and then blood sugar level is checked by lancing device and test strips.
regular blood sugar level check karta People use pen-like glucometers which are painless and can be done by oneself.

Normal blood sugar level: 70-130 mg/DL

HYPERGLYSEMIA if blood sugar level is more than 130 mg/DL
is called

Blood sugar level less than 70 mg/dl is called HYPOGLYCEMIA.

Test tube

Test tubes are made of glass or hard plastic. They are also called “culture tubes” and “sample tubes”. They are long, cylindrical in shape, and open at one end and closed at one end. They are used in medical settings and laboratories. These are used for different purposes like specimen collection, storage and analysis.

Glass test tubes are reusable and can withstand high temperatures, so they can also be heated or autoclaved.

Size and shape
Test tubes come in different sizes and capacities, from small tubes with a capacity of a few milliliters, ie 5 milliliters, to large test tubes that can hold 12 milliliters or more. A test tube is usually cylindrical in shape with a flat or rounded bottom.

Uses
Test tubes are used for a wide range of purposes in laboratory and medical settings, including:-

Specimen collection
Test tubes are used to collect blood, urine, saliva, sputum and other body fluids for various diagnostic tests.

storage
Test tubes are used to store samples for long-term storage prior to analysis.

Analysis
Test tube samples are used for chemical, biochemical, haematological, microbiological and immunological analyses.

Centrifugation
A test tube is used in a centrifuge to separate components of a specimen based on their density. The specimen is placed in a test tube and rotated at high speed to separate solids and liquids.

Culture:
A test tube is intended for the growth of bacteria, fungi, viruses or other microorganisms for microbiological culture, diagnostic or research purposes.

🙂 Type
There are several types of test tubes designed for specific applications, including:-

Vacuum Tubes:
Used for blood collection and comes in different colors, with specific additives for different types of tests.

Culture Tubes: Used for microbiological culture and often have screw caps or plugs to prevent contamination.

Centrifuge Tubes: Designed to separate components in high speed centrifugation processes and may facilitate separation of components.

Urine collection tube:
Urine collection tubes are for collecting urine specimens and may have special features, such as leak-proof caps or integrated funnels.

Disinfect the test-tube

Cleansing
Wash the test tube properly with water to remove any visible debris and residue. Then, wash the tube thoroughly with warm, soapy water to clean the inside and outside surfaces. Use a brush or sponge to scrub the inside of the tube if necessary.

Rinsing
After cleansing, wash the test tube with a clean cotton swab to remove any soap residue.

Disinfection solution
Prepare disinfectant solution by diluting suitable disinfectant solution. Common disinfectants used in the laboratory setting involve bleach (sodium hypochlorite solution), alcohol (ethanol or isopropyl alcohol), or commercial disinfectant solutions.

Immersion
Immerse the cleaned test tube in the disinfecting solution, ensuring that all surfaces are completely soaked.

drying
Allow the test tube to dry completely before using it for specimen collection, or analysis. Ensure that test tubes are stored in a clean, dry environment to prevent contamination.

storage
Store the cleaned test tube in a proper surface so that the test tube is not contaminated until it is required for further use.

Test tube holder

A test tube holder is a piece of laboratory equipment used to hold and manipulate test tubes in various procedures.

A test tube holder usually consists of a pair of spring-loaded clamps or jaws that can be opened and closed to hold the test tube firmly. The bars can be lined with rubber or other non-slip materials for a secure grip and to prevent damage to the test tube.

Test tube holders are usually made of metal, such as stainless steel or aluminum, which provides durability and is resistant to corrosion. The handle of the test tube holder is covered with plastic or rubber to improve grip comfort.

Type

1) Single test tube holder
A single test tube holder can hold only one test tube at a time.

2)Multitest tube holder
Multiple test tubes can be held simultaneously in a multi test tube holder.

3) Adjustable test tube holder
The adjustable test tube holder can be adjusted in diameter to accommodate test tubes of different diameters.

🙂 Uses

Test tube holder is used in different types of medical procedures.

Mixing and agitation
A test tube holder is used to hold the test tube for users to mix the contents well.

Heating
Test Tube Holder No Use A test tube can be heated on a flame or heating element for sterilization purposes.

Centrifugation
Test Tube Holder No Use During Centrifugation Procedure Test tubes in centrifuge rotors are used to separate the components of the specimen during the centrifugation procedure.

The test tube holder is designed to provide a secure grip to the test tube, reducing the risk of accidents and spills during laboratory procedures. However, it is important to handle test tubes and test tube holders with care to prevent breakage or injury.

Cleaning and maintenance
Test tube holders should be regularly cleaned and inspected to ensure they remain free of debris or damage. They are cleaned with soap and water or a mild disinfectant solution and the test tube holder should be thoroughly air dried before storage.