Wash the burned area twice daily, once in the morning and once in the evening. After washing, apply a clean dressing as described below.
Wash your hands and work space with soap and water.
Assemble all supplies and place them within reach on your work space.
Carefully remove the old dressing allowing any loose skin and drainage to pull away from the burn, it may be loosened with warm water. Quickly take off the old dressing.
Wash your hands with soap and water.
Spread antibiotic ointment on Adaptic gauze over the burn site as shown by the nurses and doctors before leaving the hospital.
Clean the burn area with soap using circular motions starting from the centre and moving outward. Remove all loose skin and ointment. Rinse completely.
Apply prepared dressing to the burn area and wrap it securely with a gauze wrap. Apply tape.
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The first beingintradermal injections, this technique involves the injection of the fluid into the top layer of the skin which is soft. This technique is mostly used for treating certain health problems mainly many allergies.
The liquid drug is inserted with an intradermal injection, which will lie just beneath the skin surface in between the layers of the skin. The needle is extremely tiny and inserts the fluid under the skin.
Another type of injection is the intramuscular injections. This is the most common way of injecting medication directly into a patient. The medicine from the injection is absorbed directly into the muscle. It allows the medicine to gain easy access to the blood stream. This type of injection is the best and safest way of injecting medication into a patient.
The third type of injection is subcutaneous injections. Such types of injections are administered when the medicine needs to be absorbed slowly. In this case the needle must go through the first two layers of skin that is the epidermis and dermis. The needle should then reach the subcutaneous tissue which is the fatty layer of the skin. Medicines administered through subcutaneous injections have the least chance oh having an adverse reaction. The most common medicine given in this kind of way is insulin.
In all these injections, the size of the needle varies, the deeper the injection the longer the needle should be.
For an intradermal injection the needle should be the shortest available because it is inserted just under the first layer of the skin. for the intramuscular injection the needle should be at least a few inches long and for the subcutaneous injection are roughly a few inches long.
By inserting a nasogastric tube down the throat, you are gaining access to the stomach and its contents. The tube first passes through the nose, goes past the throat and straight down to the stomach. NG tubes can be used for enternal feeding and administering drugs. Here is a step by step guide to performing the procedure:
Gather equipment
Wear non-sterile gloves
Explain the procedure to the patient and show equipment
If possible, sit patient upright for optimal neck/stomach alignment
Examine nostrils for deformity/obstructions to determine best side for insertion
Measure tubing from bridge of nose to earlobe, then to the point halfway between the end of the sternum and the navel
Mark measured length with a marker or note the distance
Lubricate 2-4 inches of tube with lubricant (preferably 2% Xylocaine). This procedure is very uncomfortable for many patients, so a squirt of Xylocaine jelly in the nostril, and a spray of Xylocaine to the back of the throat will help alleviate the discomfort.
Pass tube via either nare posteriorly, past the pharynx into the esophagus and then the stomach.
Instruct the patient to swallow (you may offer ice chips/water) and advance the tube as the patient swallows. Swallowing of small sips of water may enhance passage of tube into esophagus.
If resistance is met, rotate tube slowly with downward advancement toward closes ear. Do not force.
Withdraw tube immediately if changes occur in patient's respiratory status, if tube coils in mouth,or if the patient begins to cough.
Advance tube until mark is reached
Check for placement by attaching syringe to free end of the tube, aspirate sample of gastric contents. Do not inject an air bolus, as the best practice is to test the pH of the aspirated contents to ensure that the contents are acidic. The pH should be below 6. Obtain an x-ray to verify placement before instilling any feedings/medications or if you have concerns about the placement of the tube.
Secure tube with tape or commercially prepared tube holder
If for suction, remove syringe from free end of tube; connect to suction; set machine on type of suction and pressure as prescribed.
Document the reason for the tube insertion, type & size of tube, the nature and amount of aspirate, the type of suction and pressure setting if for suction, the nature and amount of drainage, and the effectiveness of the intervention.
