A A AText only | Accessibility | Privacy and cookies

Browse site A to Z

Search results

Go To Advanced Search

Magnetic resonance imaging (MRI) cardiac stress scan (adenosine) - patient information

Description
This factsheet explains what a magnetic resonance imaging (MRI) cardiac stress scan with adenosine is and what to expect at your
Url
/Media/UHS-website-2019/Patientinformation/Scansandx-rays/Magnetic-resonance-imaging-MRI-cardiac-stress-scan-adenosine-3148-PIL.pdf

Your non-invasive ventilation (NIV) device: Trilogy Evo - patient information

Description
This factsheet explains how to use and care for your Trilogy Evo non-invasive ventilation (NIV) device safely at home.
Url
/Media/UHS-website-2019/Patientinformation/Respiratory/Your-non-invasive-ventilation-NIV-device-Trilogy-Evo-3629-PIL.pdf

Your non-invasive ventilation (NIV) device: VIVO 55 - patient information

Description
This factsheet explains how to use and care for your VIVO 55 non-invasive ventilation (NIV) device safely at home.
Url
/Media/UHS-website-2019/Patientinformation/Respiratory/Your-non-invasive-ventilation-NIV-device-VIVO-55-3628-PIL.pdf

Angiogram and angioplasty - patient information

Description
Information about angiogram to assess the blood flow into your leg and angioplasty to improve the blood flow.
Url
/Media/UHS-website-2019/Patientinformation/Cardiovascular-and-thoracic/Angiogram-and-angioplasty-1655-PIL.pdf

Magnetic resonance imaging (MRI) cardiac stress scan (adenosine or dobutamine) - patient information

Description
This factsheet contains information about a having a cardiac MRI stress scan with adenosine or dobutamine.
Url
/Media/UHS-website-2019/Patientinformation/Scansandx-rays/Magnetic-resonance-imaging-MRI-cardiac-stress-scan-adenosine-or-dobutamine-3147-PIL.pdf

Chest drain insertion - patient information

Description
Patient information factsheet Chest drain insertion This factsheet explains about having a chest drain. If you have any questions please ask a member of your healthcare team. What is a chest drain? A chest drain is a narrow plastic tube that is inserted into the chest to drain fluid or air that may be collecting there. The lungs and inside of the chest cavity have a smooth covering called the pleura which lets the lungs expand without rubbing on the inside of the chest. The two layers of pleura are usually in close contact with only a small space in between (pleural space). Lung Pleural space Chest drain After an operation or accident or as a result of illness, the pleural space can fill up with air or fluid. This stops the lungs inflating completely when breathing in, causing breathing difficulties. Why do I need a chest drain? Air or fluid has collected in the pleural space, which may stop your lung from working normally. The chest drain will allow this air or fluid to leave the body so that the lung can reinflate to its normal shape, helping you breathe more easily. If required, the fluid can be sent away for tests to find out why it is building up. Your doctor will give you more details about why a chest drain is required in your particular case. www.uhs.nhs.uk Patient information factsheet How does a chest drain work? Once the chest drain is inserted, it is connected to a bottle containing sterile water. The air or fluid from your chest then drains down the tube and into the bottle. The water acts as a seal, preventing air or fluid from coming back up the tube and into your chest. It may take several days for the fluid or air to drain completely. If you have a drain because of an air collection in your pleural space, you will see bubbles in the bottle, this is just the air escaping and it’s normal. How will the chest drain be put in? Chest drains are usually inserted by a doctor in a dedicated room, or sometimes on the ward. We will ask you to sit or lie in a comfortable position. The chest drain will be inserted into the side of your chest below the armpit, or sometimes in the front of your chest or on your back. Before inserting the drain we will usually do an ultrasound scan of the chest. Your skin will be cleaned with antiseptic to reduce the risk of infection. Local anaesthetic will then be injected to numb the area. This can sting a little but doesn’t last long. The doctor will use a needle to locate the fluid or air, which ensures the drain is inserted in the correct place. A small cut will be made in your skin and the drain will then be gently guided into the chest. This should not be painful but you may feel some pressure or pushing. If at any time during the procedure you do feel pain, please tell us. The drain will be held in place with stitches and covered by a dressing. The whole procedure usually takes around 45 minutes to an hour. Your chest drain will be monitored regularly by your healthcare team to ensure it is working correctly. After it is inserted, the fluid or air around the lung will start draining and you should be able to breathe more easily, although it may take a bit of time for the lung to reinflate. It is normal to feel some pain after the local anaesthetic wears off. To help with this, you will be offered regular painkillers and you should ask for more if necessary. It is important that you take enough painkillers to allow you to take deep breaths and cough comfortably. Are there any risks? In most cases, the insertion and use of a chest drain is a safe, routine procedure. However, as with all medical procedures, there can be some risks. Common risks Pain Bleeding Infection Damage to underlying organs How we minimise these risks Using local anaesthetic and painkillers Blood tests, checking you are not on blood thinning medications Performing procedure in a sterile manner Using the ultrasound scanner www.uhs.nhs.uk Patient information factsheet Can the chest drain fall out? Occasionally the chest drain falls out after insertion and needs to be replaced. Your doctor will use several dressings and a stitch to try to stop this from happening. You can help reduce the likelihood of this problem by: • handling your chest drain carefully • trying not to pull on it • not allowing it to get tangled around your bed. Looking after your chest drain There are a few other simple things you can do to look after your chest drain. When you are moving around: • Keep the drain below the point where it comes out of your chest. If you lift the bottle above where the drain is inserted, fluid from the bottle can flow back into your chest. • Move and walk around as much as you can, but remember to carry the bottle with you, holding it by its handle. • Think about your drain when you stand up, walk around or turn in bed so it doesn’t pull or disconnect. • Be careful not to kink the tubing by sitting or stepping on it and don’t let it get tangled up. • Avoid knocking the bottle over, ensure it is upright and the tube tip is under water. Correct Bottle upright, tube tip under the water Incorrect Bottle is tipped, tube tip is not under water • You must not leave the ward without telling your nurse or the nurse in charge. Asking for help • Please ask for help immediately if the chest drain disconnects or the bottle falls over. • Ask for pain relief as and when you need it. • Look out for any leaks of air or fluid. Tell your nurse if you: - think your drain may have moved - feel more short of breath - notice an increased amount of bubbles in your bottle - or if the dressing is wet or coming off Suction • Sometimes suction is used to help reinflate the lung. • If the suction is delivered with a portable unit, you may walk freely around the ward. However, if the suction is connected to the wall you should not disconnect it to move about, unless your doctor is happy for you to do so. If you are finding the suction painful, please let the nurses know. If you would like to leave the ward while you are connected to portable suction, you will need to be accompanied by a member of the nursing team. www.uhs.nhs.uk Patient information factsheet How long will the chest drain stay in for? Your doctors will explain to you how long the drain needs to stay in. The time will vary depending on your progress. It may be just a few days or a bit longer. Once your drain can come out your doctor will let you know. You may need to have several chest x-rays during this time to check progress. How will it be removed? The removal of the chest drain is straightforward and is done by a doctor or senior nurse. Once all the dressings are removed, the skin is cleaned, the suture is cut and then the drain is pulled out gently. You may be asked to hold your breath briefly when this is done. It can be uncomfortable but only lasts a few seconds. The wound will be dressed with gauze and a dressing. These do not need changing for two days, so you should be careful not to get them wet. Symptoms to look out for It is normal to still feel some discomfort in your chest after the drain has been taken out, which can be eased by taking painkillers. However, if you develop any other worsening symptoms (severe amount of pain, breathlessness and/ or fever) you should tell your healthcare team. If you have left hospital, please contact your GP. Further information If you would like further information please ask a member of your healthcare team. If you need a translation of this document, an interpreter or a version in large print, Braille or on audiotape, please telephone 023 8120 4688 for help. © 2019 University Hospital Southampton NHS Foundation Trust. All rights reserved. Not to be reproduced in whole or in part without the permission of the copyright holder. Version 1. Published May 2019. Due for review May 2022. www.uhs.nhs.uk
Url
/Media/UHS-website-2019/Patientinformation/Respiratory/Chest-drain-insertion.pdf

Procedure for measuring gripstrength using the JAMAR dynamometer

Description
NIHR Southampton Biomedical Research Centre The NIHR Southampton Biomedical Research Centre (BRC) has a tight quality assurance system for the writing, reviewing and updating of Standard Operating Procedures. As such, version-controlled and QA authorised Standard Operating Procedures are internal to the BRC. The Standard Operating Procedure from which information in this document has been extracted, is a version controlled document, managed within a Quality Management System. However, extracts that document the technical aspects can be made more widely available. Standard Operating Procedures are more than a set of detailed instructions; they also provide a necessary record of their origination, amendment and usage within the setting in which they are used. They are an important component of any Quality Assurance Framework, but in themselves are insufficient and need to be used and interpreted with care. Alongside the extracts from our Standard Operating Procedures, we have also made available here an example Standard Operating Procedure and a word version of a Standard Operating Procedure template. Using the example and the Standard Operating Procedure template, institutions can generate their own Standard Operating Procedures and customise them, in line with their own institutions. Simply offering a list of instructions to follow does not assure that the user is able to generate a value that is either accurate or precise so here in the BRC we require that Standard Operating Procedures are accompanied by face-to-face training. This is provided by someone with a qualification in the area or by someone with extensive experience in making the measurements. Training is followed by a short competency assessment and performance is monitored and maintained using annual refresher sessions. If you require any extra information, clarification or are interested in attending a training session, please contact Dr Kesta Durkin (k.l.durkin@soton.ac.uk). This document has been prepared from Version 2 of the BRC Standard Operating Procedure for using the JAMAR hydraulic hand dynamometer to measure grip strength. It was last reviewed in May 2014 and the next review date is set for May 2016. The version number only changes if any amendments are made when the document is reviewed. Page 1 of 6 NIHR Southampton Biomedical Research Centre NIHR Southampton Biomedical Research Centre Procedure for Measuring HAND GRIP STRENGTH USING THE JAMAR DYNAMOMETER BACKGROUND This procedure is to be used for measuring handgrip strength. Grip strength has been shown in previous studies to be a predictor of current and future health. PURPOSE To ensure correct and uniform measurement of handgrip strength. SCOPE This procedure applies to any study requiring measurements of handgrip strength, within the BRC RESPONSIBILITIES It is the responsibility of the measurer to use this procedure when measuring handgrip strength. It is the responsibility of the principal investigator to ensure that staff members who are working on specific studies have adequate experience to do so. PROCEDURE Measurements are made using the Jamar Hand Dynamometer (figure 1). Page 2 of 6 NIHR Southampton Biomedical Research Centre Figure 1. Jamar Hand Dynamometer The dynamometer has a dual scale readout which displays isometric grip force from 0-90 kg (0-200 lb). The outer dial registers the result in kg and the inner dial registers the result in lb. It has a peak hold needle which automatically retains the highest reading until the device is reset. The handle easily adjusts to five grip positions from 35-87 mm (1? - 3?") in 13 mm (?") increments. Always use the wrist strap to prevent the dynamometer from falling on the floor if accidentally dropped. The checks below are carried out on SCBR dynamometers quarterly, to ensure that the instruments are measuring accurately. These suggestions for the Jamar dynamometer are made by the manufacturer in the owner's manual (https://www.homecraft-7rolyan.com/catalog/pdf/3_User%20Instruction.pdf): To check the posts: Remove the adjustable handle. Check that each post moves freely in its guide (the plastic section where the posts attach to the main unit). There should be a little bit of movement and the posts should wiggle slightly; they should be loose in their guides, even when you put pressure on the sides of the post. To check the hydraulics: Remove the adjustable handle. Whilst watching the top post, push the bottom post inwards. When you do this, the top post will move in the opposite direction. Then repeat on the other side, i.e., whilst watching the bottom post, push the top post inwards and the bottom post will move in the opposite direction. Normally both posts should travel approximately 1/8 inch (3mm), with top and bottom posts travelling in opposite directions. Travel less than 1/16 inch (1.5mm) means that the device requires servicing as it indicates a leak in the hydraulics system. You can measure this by holding a ruler by the guide whilst pushing on the opposite post and/or by enlisting the help of another researcher. To check the handle: Grasp the instrument normally and carefully look at the way the forks of the adjustable handle are supported on the posts. Each fork should touch the post approximately at its mid-point. If not, the instrument should be returned for adjustment. To check the peak-hold (red) needle: Turn the peak hold knob (figure 2) counter-clockwise and check the peak-hold and gauge needle move without Page 3 of 6 NIHR Southampton Biomedical Research Centre any excessive friction. If the peak-hold needle is not in-line with the gauge needle when it is set back to zero and/or if there feels to be excessive friction when doing so, then you should return the instrument for servicing. Annual Greasing. About once a year, place a small amount of grease on the two guides. If excessive friction exists between the post and guide, return the dynamometer for servicing. Figure 2. The dynamometer dial. If the peak-hold needle is knocked off its support pin it can readily be repositioned. Unscrew the see-through crystal cover (figure 2) and turn it upside down. Locate the brass pin in the centre of the crystal (part of the chrome knob on the outside of the crystal). Locate the slot on the brass pin and place the peak-hold needle into this slot. Calibration The Jamar Hand Dynamometer calibration procedure is carried out off-site. The frequency of external calibrations will be specific to each study so make sure you are aware of when the external calibrations are due and ensure that, if required, there is another device available for use during the period of time when yours is off-site. If well cared for, the device should only need to be calibrated annually. A six monthly calibration is recommended by the manufacturers if the device is subjected to vibrations on a frequent basis, e.g. carried around in a car. If the instrument has been dropped or there is any reason to suspect that the calibration is erroneous, the instrument should be sent for servicing. Page 4 of 6 NIHR Southampton Biomedical Research Centre To arrange for the device to be calibrated contact: Certain Indexes Limited 4 Park Road, Sileby, Loughborough, Leics. LE12 7TJ, UK Tel. (44) 01509 814790 Fax. (44) 01509 817701 Document the serial number of the dynamometer you are using. 1. Wash your hands and explain the procedure to the participant. 2. Ensure that the dynamometer is cleaned before use. 3. Ask the participant to remove their shoes and also any watches and/or bracelets. 4. Record the participant's hand dominance. 5. Demonstrate how to hold the dynamometer to the participant by testing it on yourself and explain how the dial registers the best result by squeezing as tightly as possible. 6. Sit them comfortably in a chair with a back support and fixed arm rests. 7. Use the same style of chair (low backed, with fixed arm rests) for every measurement. 8. Ask the participant to rest their forearms on the arms of the chair and keep their feet flat on the floor. You should ask the participant to roll their trousers/jeans up in order to ensure their feet are flat on the floor and do not rise from the floor when squeezing the dynamometer. 9. Their wrists should be just over the end of the chair's arm, thumb facing upwards. 10. Ask them to position their thumb round one side and their fingers around the other side of the handle. When they are holding the dynamometer in the correct position their fingers and thumb should be visible on the same side of the apparatus (figure 1). 11. Check with them that the instrument feels comfortable in their hand. The position of the handle can be adjusted if necessary for different sized hands. You will notice whether the handle needs altering based on the distance of the four fingers from the palm of the hand. If the finger nails are digging in to the palm, it will be uncomfortable for the participant and means that the handle needs moving further away from the mechanism. If it looks as though the fingers are not close enough to the palm and it feels to the participant as though their hand may slip off the handle when squeezing, it suggests that the handle needs to be adjusted to bring it closer to the mechanism. 12. Inform them that it will feel as if there was no resistance. 13. Ensure the red needle is in the "0" position by turning the dial. Page 5 of 6 NIHR Southampton Biomedical Research Centre 14. Start with the right hand and then repeat the measurement with the left hand. 15. The measurer should support the weight of the dynamometer by resting it on their palm while the subject holds the dynamometer but they should not be restricting the movement of the device. 16. Encourage squeezing as long and as tightly as possible for the best result until the needle stops rising. Use a standard squeezing phrase "Squeeze......harder, harder...and stop squeezing" 17. When the needle stops rising read the measurement (in kg) from the dial and record the result to the nearest 1kg. The outside dial registers the result in kg and the inner dial in lb. 18. Disregard and repeat the test if the participant's arm rises above the arm of the chair, or if their feet lift off the floor during the measurement. 19. Record three measurements for each hand, alternating sides. 20. Thank the participant. Page 6 of 6
Url
/Media/Southampton-Clinical-Research/Procedures/BRCProcedures/Procedure-for-measuring-gripstrength-using-the-JAMAR-dynamometer.pdf

Leg artery bypass (fem-pop bypass) - patient information

Description
Information about an arterial bypass (also known as a fem-pop bypass) - an operation to create a new route for blood to getinto the leg.
Url
/Media/UHS-website-2019/Patientinformation/Cardiovascular-and-thoracic/Leg-artery-bypass-fem-pop-bypass-1659-PIL.pdf

Femoral endarterectomy - patient information

Description
information about having a femoral endarterectomy to improve the circulation to the legs
Url
/Media/UHS-website-2019/Patientinformation/Cardiovascular-and-thoracic/Femoral-endarterectomy-1658-PIL.pdf

Tracheostomy - patient information

Description
A tracheostomy is an opening created at the front of the neck allowing a tube to be inserted into the windpipe
Url
/Media/UHS-website-2019/Patientinformation/Childhealth/Tracheostomy-1139-patientinformation.pdf
1 to 10 of 14
Previous 1 2 Next