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The instructions will include a toll-free phone number that you can use to contact the manufacturer if you have questions about how to use the meter.

Always follow the instructions that came with your INR test meter and lancet. To get a successful blood sample:. Be sure to talk with your health care provider before making changes to any of your medications, which could affect your warfarin dose or monitoring schedule.

Monitoring warfarin at home with an INR test meter is convenient. However, there are risks associated with using INR test meters at home.

If you experience any of the following situations while on warfarin, seek medical attention immediately:. If you obtain an INR result outside your identified target INR range, you should immediately contact your health care provider.

INR results above 4. If you obtain an INR result above 4. Healthcare , Medical Science. Prostate milking, which is the stimulation of the prostate gland in males and also known as prostate massage, is performed either for medical or sexual purposes.

Many men do not know, but milking prostate has many important benefits for men of all ages. Here are two main benefits existing.

The first benefit is to improve prostate health and to reduce its problems and pain in an all natural alternative to taking pills, vitamins or supplements.

This is important to remember because there is generally no harmful side effects to prostate milking, if you know the correct ways and techniques prior to starting.

The second main benefit is for pleasure. Many men enjoy the sensations and the ability to achieve an orgasmic state of pleasure and what is more commonly known as a prostate orgasm.

If you take a look at the picture below, you will see how close the prostate really is to the wall of the rectum. It is this proximity between these two objects that can allow us to massage the prostate to potentially allow for meaningful and natural benefits.

Air Leak bubbling An air leak will be characterised by intermittent bubbling in the water seal chamber when the patient with a pneumothorax exhales or coughs The severity of the leak will be indicated by numerical grading on the UWSD 1-small leak 5-large leak Continuous bubbling of this chamber indicates large air leak between the drain and the patient.

Check drain for disconnection, dislodgement and loose connection, and assess patient condition. Notify medical staff immediately if problem cannot be remedied.

This will diminish as the pneumothorax resolves. Watch for unexpected cessation of swing as this may indicate the tube is blocked or kinked Cardiac surgical patients may have some of their drains in the mediastinum in which case there will be no swing in the water seal chamber.

Consider converting to a portable flutter valve system such as the pneumostat to facilitate this. If chest drain will be required for prolonged period If a patient is on strict bed rest or is an infant, regular changes in position should be encouraged to promote drainage, unless clinical condition prevents doing so Patient Transport If the patient needs to be transferred to another department or is ambulant, the suction should be disconnected and left open to air.

If using the patient tube clamp the tubing then use a 20 gauge needle with syringe to aspirate specimen. Accidental disconnection. Insert the tubing into the new chamber until you hear it click.

Once the required drains are removed, unclamp remaining drains Remove disposable gloves, perform hand hygiene and don sterile gloves Place sterile towel under tubes Clean around catheter insertion site and cm of the tubing with age appropriate skin cleaning solution If purse string present cardiac patients unwind in preparation for assistant to tie Remove suture securing drain ensuring purse string suture not cut Instruct patient exhale and hold if they are old enough to cooperate; if not, time removal with exhalation as best as possible.

Pinching the edges of the skin together, remove the drain using smooth, but fast, continuous traction. The assistant pulls purse string suture closed as soon as the drain is removed, tying 2 knots and ensuring the suture is not pulled too tight.

Cut tails of suture about 2cm from knot If there is no purse string present remove drain and quickly seal hole with occlusive dressing Instruct patient to breathe normally again Apply occlusive dressing bandaid for cardiac children over site Remove and discard equipment into a yellow infectious waste bag and tie Perform hand hygiene Post Procedure Care Attend to patients comfort and sedation score as per procedural sedation guideline CXR should be performed post drain removal Patients in PICU may wait until routine daily CXR if clinically well Clinical status is the best indicator of reaccumulation of air or fluid.

Clean ends of drain and reconnect. Ensure all connections are cable tied. If a new drainage system is needed cover the exposed patient end of the drain with sterile dressing while new drain is setup.

Ensure clamp removed when problem resolved Check vital signs Alert medical staff Accidental drain removal Apply pressure to the exit site and seal with steri-strips.

Place an occlusive dressing over the top Check vital signs Alert medical staff. Purse string cut or not present Small bore drains such as pigtails do not require purse strings.

Simply apply an occlusive dressing.

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