Dilated Veins on the chest walls

SVC obstructions, Mediastinal syndromes, Respiratory failure , Pulse oximetry ,
Chest Xrays

1. Dilated veins on chest wall

2. Svc Obstruction

3. Intro
The great venous trunks that return
deoxygenated blood from the
systemic circulation to the right
atrium of the heart.
This is also the second largest vein
in the human body.

4. et dolore magna aliqua

13. Mediastinal syndromes
Mediastinal syndromes are a group of disorders characterized by
infiltration, entrapment or compression of mediastinal structures.
Symptoms of the syndromes are associated with the anatomic structures
involved;
❖the compression of the trachea results in dyspnea and respiratory
insufficiency.
❖compression of the esophagus results in dysphagia.
❖The superior vena cava (SVC) and nerves can become trapped, resulting
in vein distention, edema of the face or upper extremities, and nervous
system symptoms.

14. Respiratory faliure

15. Respiratory failure is a syndrome in which the respiratorysystem fails in one
or both of its gas exchange functions: oxygenation and carbon dioxide
elimination.
The two types of acute and chronic respiratory failure :-
❖Hypoxemic respiratory failure means that you don’t have enough oxygen
in your blood, but your levels of carbon dioxide are close to normal.
❖Hypercapnic respiratory failure means that there’s too much carbon
dioxide in your blood, and near normal or not enough oxygen in your blood.

16. Bed side detection of hypoxia
➔Restlessness or anxiety
➔Tachypnea -Increased respiration rate
➔Dyspnea- Shortness of breath (SOB)
➔Use of accessory muscles
➔Decreased oxygen saturation levels.
➔Flaring of nostrils or pursed lips
➔Skin colour of patient
➔Position of patient.
➔Ability of patient to speak in full sentences
➔Change in mental status or loss of consciousness

17. Bed side detection of hypocarpnia
●flushed skin
●drowsiness and dizziness
●mild headaches and exausted
●Dyspnea
If the case is severe as in case of COPD related Hypocarpnia ,then
●irregular heartbeat
●Hyperventilation
● seizures ,panic attack ,depression
●passing out

18. BED side detection of Flapping tremors

19. Classical cxr of pneumonia

20. Classical cxr of pleural effusion

21. Classical cxr of Tuberculosis

22. Classical cxr of mediastinal syndrome

24. pulse oximeter
A pulse oximeter is a medical device that indirectly
monitors the oxygen saturation of a patient's blood and
changes in blood volume in the skin, producing a
photoplethysmogram.

This works by comparing how much red light and infra red
light is absorbed by the blood. Depending on the amounts
of oxy Hb and deoxy Hb present, the ratio of the amount
of red light absorbed compared to the amount of infrared
light absorbed changes

25. Demonstrating injections
Intramuscular injections are
absorbed faster than
subcutaneous injections. This is
because muscle tissue has a
greater blood supply than the
tissue just under the skin.
Muscle tissue can also hold a
larger volume of medication than
subcutaneous tissue

26. Subcutaneous injection can be used to give
many types of medications for various
medical conditions. There are fewer blood
vessels in the fatty layer of connective
tissue just beneath the skin than the
muscle tissue. Having fewer blood vessels
means that medication injected
subcutaneously is absorbed more slowly.

27. Intravenous therapy (IV) is a
therapy that delivers liquid
substances directly into a vein.
The intravenous route of
administration can be used for
injections or infusions. Intravenous
infusions are commonly referred
to as drips.

28. Procedure for iv cannulation
1.Don your gloves and apron
2.Clean the puncture site with the chloraprep wipe (in a cross-hatch formation) and allow to
air dry
3.Apply the tourniquet and do not repalpate the cleaned skin
4.Placing traction on the skin below the intended puncture site, insert the cannula with the
bevel up at an angle of 30o into the puncture site
5.Advance the cannula and observe flashback
6.Hold the needle introducer still whilst advancing the cannula forward, over the needle and
fully into the vein
7.Release the tourniquet and dispose the needle into the sharps bin
8.Connect your bionector to the cannula
9.Secure the cannula in place with the sterile dressing

29. 10.Ensure not to cover the puncture site with the tape when securing down, as this can cover up
any possible phlebitis developing
11.Flush the bionector and cannula with 5ml of saline
12.No resistance should be felt
13.Check for any signs of extravasation / tissuing around the cannula site. Remove cannula if
suspected
14.Discard all waste into the correct disposal bins and ensure the patient is comfortable
15.Remove your gloves and decontaminate your hands

30. Thanks!
REFERENCE :

Medlineplus.gov
Opentextbc.ca
http://teachmesurgery.com
https://en.wikipedia.org/wiki/Mediastinum
https://www.howequipmentworks.com/pulse_oximeter/