SKIL402
Practical Log Book / 2014 -2015
Semester 1 (141)

Student Name

Student ID

  • This Log Book specifies practical laboratory sessions which shall be covered during (SKIL402) course.
  • Students should attend all labs & complete this log book and submit it to the course organizer before the End Block Exam.
  • Every student should complete each page according to the ILO's of each specific lab session.
  • Every page should be signed by the lab instructor at the end of each lab session.
  • At the end of the Course, the submitted Log books will be corrected and marked out of 10 marks according to the attended lab sessions and the completion of the log book.

Summary of Lab Sessions

Subject

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Lab Title

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Instructor

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Date

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Mark

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10
Subject / Instructor / Date
Introduction

COURSE coordinators

Dr.Haneen Mahmoud

Dr. Amaal Rayan

Dr. Abdulaziz S. Albatati

Assessment Guidelines

Continuous Assessment
S.No. / Assessment Method / Marks / Total Marks
1 / Exam – 1 (OSCE) / 30 / 30
End of Block Assessment
2 / End Block Exam / 60(20mcqs+40clinical) / 60
3 / Log Book / 10 / 10
Total Number of Marks / 100

1

SKIL402 / Practical Log Book / 2014 -2015 / Semester 1 (141)
Subject / Instructor / Date
Course Time table
Week/Day / Time / Date / Topics / Facilitator
Week-2 / Monday / 08/09/2014 / Hand washing + Temperature + Pulse+ BMI + Blood pressure / Dr. Albatati
Tuesday / 09/09/2014 / Dr. Amaal
Thursday / 11/09/2014 / Dr. Haneen
Week-3 / Monday / 15/09/2014 / IV cannulation + IM + ID + SC / Dr. Albatati
Tuesday / 16/09/2014 / Dr. Amaal
Thursday / 18/09/2014 / Dr. Haneen
Week-4 / Monday / 22/09/2014 / LP + ETI / Dr. Albatati
Thursday / 25/09/2014 / Dr. Albatati
Thursday / 25/09/2014 / Dr. Haneen
Week-5 / Monday / 13/10/2014 / NGT / Dr. Albatati
Tuesday / 14/09/2014 / Dr. Amaal
Thursday / 16/10/2014 / Dr. Amaal
Week-6 / Monday / 20/10/2014 / PV & Speculum + PR / Dr. Albatati
Tuesday / 21/10/2014 / Dr. Amaal
Thursday / 23/10/2014 / Dr. Amaal
Week-7 / Monday / 27/10/2014 / Male & Female Catheterization / Dr. Albatati
Tuesday / 28/10/2014 / Dr. Amaal
Thursday / 30/10/2014 / Dr. Amaal
Week-8 / Monday / 03/11/2014 / Suturing / Dr. Albatati
Tuesday / 04/11/2014 / Dr. Amaal
Thursday / 06/11/2014 / Dr. Amaal
Week-9 / Monday / 10/11/2014 / ABG / Dr. Albatati
Tuesday / 11/11/2014 / Dr. Amaal
Thursday / 13/11/2014 / Dr. Amaal
Week-10
Week-11
Week-12
Week-13
Week-14
Week-15
Subject / Instructor / Date
Topics for the First exam
Week / Topics
Week-2 / Hand washing + Temperature + Pulse+ BMI + Blood pressure
Week-3 / IV cannulation + IM + ID + SC
Week-4 / LP + ETI

General Principles

Score System

Mark / Symbol
95-100 / A+
90-94 / A
85-89 / B+
80-84 / B
75-79 / C+
70-74 / C
65-69 / D+
60-64 / D
Below 60 / F
Subject / Lab Title / Instructor / Date
Hand Hygiene / Hand Hygiene

Instructions: You are about to examine a patient. Wash your hands.

Time allowed: 6 minutes.

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.

Examiner’s global score

0 1 2 3 4

Hand Hygiene Definition:
When to Wash:
Subject / Lab Title / Instructor / Date
Hand Hygiene / Hand Hygiene

Instructions: You are about to examine a patient. Wash your hands.

Time allowed: 6 minutes.

  1. Wet your hands with water and apply soap to cover all hand surface

  1. Rub hands palm to palm

  1. Right palm over the left dorsum with interlaced fingers and vice versa

  1. Palm to palm with fingers interlaced

  1. Back of fingers to opposing palms with finger interlocked

  1. Rotational rubbing of left thumb clasped in the right palm and vice versa

  1. Rotational rubbing, backwards and forwards with clasped fingers of right hand in left palm and vice versa

  1. Rinse hands with water

  1. Dry thoroughly with single use towel

  1. Use towel to turn off faucet

  1. Done the procedure in 30 seconds

Examiner’s global score

0 1 2 3 4

Types of Hand washing:
Subject / Lab Title / Instructor / Date
Venipuncture / Venipuncture

Instructions: Assume that the anatomical arm is a patient and take blood from it for a full blood

Count (FBC). Talk through the various steps involved.

Time allowed: 6 minutes.

Examiner’s global score

0 1 2 3 4

What is Venipuncture?
Subject / Lab Title / Instructor / Date
Venipuncture / Venipuncture

Instructions: Assume that the anatomical arm is a patient and take blood from it for a full blood

Count (FBC). Talk through the various steps involved.

Time allowed: 6 minutes.

  1. Wash hands

  1. Introduce your self, Identify your patient, Explain the procedure, take permission

  1. Check equipment

  1. Place tourniquet and select the appropriate vein

  1. Clean with antiseptic and allow to dry (don’t repalpate the area)

  1. Select the appropriate cannula size

  1. Stretch the skin distally and tell the patient to expect a sharp scratch

  1. Insert the needle at 30 degrees

  1. Advance the needle until flashback of blood is seen in the back of the cannula, Progress for 2 mm

  1. Withdraw the needle while advancing the rest of cannula

  1. Release the tourniquet and apply pressure to the vein at the tip of cannula

  1. Remove the needle and into the sharp container

  1. Close the cannula

  1. Check function by flushing with saline

  1. Apply plaster to fix the cannula

  1. Ask the patient if he feels pain at the site of injection

  1. Document the procedure

  1. Communicate well with patient and address his concerns

Examiner’s global score

0 1 2 3 4

What are the Indications of Venepuncture?
What are the Contraindications of Venepuncture?
Subject / Lab Title / Instructor / Date
Lumbar Puncture / Lumbar Puncture

Station: Lumbar Puncture checklist

Examiner’s global score

0 1 2 3 4

What are the Indications ofLumbar Puncture?
What are the Contraindications ofLumbar Puncture?
Subject / Lab Title / Instructor / Date
Lumbar Puncture / Lumbar Puncture

Station: Lumbar Puncture checklist

  1. Check your patient name, Identify yourself to the patient Explain the procedure and position

  1. Check equipment

  1. Patient in setting position or left lateral position with his back flexed

  1. Localize posterior superior ilaic spine and the level of L3

  1. Wash your hands and wear sterile gloves

  1. With the help of sterile nurse ask her to open the kit and handle the Iodine for sterilize the area.

  1. Start cleaning /sterilizing the area in and out at least two times. Third time is to wipe excess iodine

  1. With a 5cc needle inject 1% lidocine locally and deep with aspiring to avoid injecting a vessel.

  1. Use 18 or 20 guag needle insert it toward umbilicus.

  1. Observe for the feeling that you're in the right space.

  1. Pull the needle and leave the other part of the needle inside.

  1. Fill the required tubes.

  1. Reinsert the needle and pull both out in the same direction of insertion

  1. Dispose the needle in the sharp container.

  1. Hold with clean gauze the puncture site then cover it.

  1. Advise the patient to stay on bed laying on back at least 5 hours to avoid headache.

  1. Thank the patient

Examiner’s global score

0 1 2 3 4

What isLumbar Puncture?
Subject / Lab Title / Instructor / Date
Suturing / Suturing

Station: Suturing checklist

Examiner’s global score

0 1 2 3 4

Types of Suturing:
Subject / Lab Title / Instructor / Date
Suturing / Suturing

Station: Suturing checklist

  1. Check your patient name, Identify yourself to the patient

  1. Explain the procedure

  1. Check the presence of sterile equipment

  1. Wash your hands and wear sterile gloves

  1. Opens the equipment or asks assistant to open it

  1. Cleans the wound with an aseptic technique

  1. Numbs the wound( local anesthesia)

  1. Requests suitable suture

  1. Grasps needle correctly after giving time to work anesthetic

  1. Picks up skin edge and passes the needle through the skin

  1. Passes through opposite side and opposes the skin edges

  1. Knots as follows:

  1. Coils the suture around needle holder , that is along the length of the wound

  1. Lays knot flat to one side of the wound edge

  1. Makes a single loop in the opposite direction and ties the second throw

  1. Leaves the end of the suture material in suitable length and cuts

  1. Repeats the mentioned procedure,

  1. Applies dressing

  1. Explains warning signs

  1. Explains time of bathing and suture removing if needed

  1. Sends the patient to receive a tetanus immunization if needed.

  1. Removes gloves.

  1. Thank the patient.

Examiner’s global score

0 1 2 3 4

What are absolute contraindications of Suturing?
Subject / Lab Title / Instructor / Date
IM, ID, & SC / IM, ID, & SC

Station: intramuscular/intradermal/subcutaneous injection checklist

Examiner’s global score

0 1 2 3 4

What are absolute contraindications of IM ?
Subject / Lab Title / Instructor / Date
IM, ID, & SC / IM, ID, & SC

Station: intramuscular/intradermal/subcutaneous injection checklist

  1. Wash hands

  1. Identify your patient , Introduce yourself, Explain the procedure, take permission

  1. Check equipment and drug

  1. Prepare the correct dose from the ampule selecting the appropriate syringe and needle

  1. Empty air bubbles

  1. Select the appropriate injection site

  1. Put non-sterile gloves

  1. Cleanse with antiseptic wash and left to dry

  1. Remove the needle cap, Insert needle at 90/45/15 degrees

  1. Pull back the pluger to check for blood

  1. Inject the drug slowly and steady

  1. Withdraw the needle and apply antiseptic swap at injection site

  1. Massage slightly if IM

  1. Dispose the needle in the sharp container

  1. Don’t recap

  1. Place Band-Aid , Remove the gloves

  1. Document medications administration

  1. Communicate well with the patient Evaluate the patient for response

Examiner’s global score

0 1 2 3 4

What are absolute contraindications of IV?
Subject / Lab Title / Instructor / Date
Blood Pressure / Blood Pressure

Station: Blood Pressure Measurement checklist

Examiner’s global score

0 1 2 3 4

Write the Blood pressure Scale:
Subject / Lab Title / Instructor / Date
Blood Pressure / Blood Pressure

Station: Blood Pressure Measurement checklist

  1. Wash hands

  1. Introduce yourself , Identify your patient , Explain the procedure, take permission

  1. Check equipment

  1. Position the patient: sitting, his arm and back are supported, Feet should be resting firmly on the floor, arm at the level of the heart

  1. Choose the appropriate size of the cuff and place it around the patient’s arm

  1. Palpate the brachial artery

  1. Place the stethoscope over it

  1. Inflate the cuff 20-30mmhg above the suspected BP

  1. Deflate slowly and listen for Korsakoff’s sound

  1. Record the systolic BP

  1. Record the diastolic BP

  1. Tell the patient his readings and thank him

  1. Document in patient’s files

  1. Communicate well with patient and address his concerns

Examiner’s global score

0 1 2 3 4

Write the Blood pressure Scale:
Subject / Lab Title / Instructor / Date
Fully Catheter / Fully Catheter

Station: urinary catheterization checklist

Examiner’s global score

0 1 2 3 4

When to use Fully Catheter?
Subject / Lab Title / Instructor / Date
Fully Catheter / Fully Catheter

Station: urinary catheterization checklist

  1. Check your patient name- Identify yourself to the patient- Explain the procedure and position

  1. Check the presence of sterile equipment

  1. Wash your hands and wear sterile gloves

  1. Test the balloon of the catheter

  1. Sterile drapes

  1. Female insertion:-
  2. Expose the meatus with the non-dominant hand
  3. Clean using forceps and sterile cotton from the front to the back. From outside to inside
  4. Ask the patient to bear down
  5. Insert 2.5 -5 cm of catheter after lubrication with sterile lubricant until urine is out then advance the another 2,5 cm
  6. Connect to urine bag
  7. Fix the catheter balloon with saline

  1. Male insertion
  2. Retract foreskin and hold the penis below the glans
  3. Clean in a circular manner from above down ward 3 times
  4. Hold the penis and after lubrication insert the catheter perpendicular way
  5. Advance about 15-17 cm until the urine is out
  6. Connect to urine bag
  7. Fix the catheter balloon with saline

  1. Check fixation of the catheter then fix to the thigh or lower abdomen to keep it not so stretched

  1. Keep the urine bag at a level below the bladder

  1. Thank the patient.

Examiner’s global score

0 1 2 3 4

What is the common complication of Fully Catheter?
Subject / Lab Title / Instructor / Date
NGT / NGT

Station: NGT insertion checklist

Examiner’s global score

0 1 2 3 4

Give 3 indications for using NGT?
Subject / Lab Title / Instructor / Date
NGT / NGT

Station: NGT insertion checklist

  1. Routine hand washing

  1. Introduce your self to the patient

  1. Identify yourself

  1. Check the presence of equipment

  1. Explain the procedure and take a consent

  1. Patient position:-
The patient in sitting or semi sitting position
  1. Determine the length and size of the tube
  2. Assess the patient condition, nostrils and mouth

  1. Wash your hands and wear a clean gloves

  1. Technique of insertion:-
  2. Lubricate the tube
  3. Give the patient a glass of water
  4. Gently insert the tube through the nostrils
  5. Ask the patient to swallow
  6. Check that the patient able to take breath and no chocking or cyanosis is observed
  7. Ask the patient to continue swallowing
  8. Check the position with injection of 30 cc air and hear air bubbles by stethoscope at the epigastric area
  9. Then aspirate 5-10 cc of gastric secretions then test the PH
  10. Fix the NG tube with plaster tape to the nose of the patient

  1. Thank the patient.

Examiner’s global score

0 1 2 3 4

What are absolute contraindications of NGT?
Subject / Lab Title / Instructor / Date
Speculum / Speculum

Station: Pervaginal examination checklist

Speculum / Speculum
1-Check your patient name- Identify yourself to the patient- Explain the procedure and position
2-Check the presence of
A-Private place to the patient
B-Sterile equipment
3-Wash your hands and wear clean gloves
4-- Inspection of the external genitalia
Hair distribution- warts-rashes-ulcerdischarge, or bleeding
5- Palpation:-
Tenderness, mass
6- Explain to the patient what she will feel ,then put lubricant jell on the speculum
7- Insert the speculum and open it inside the vagina and fix its position by closing the screw
8- Examine the cervix for discharge ,ulcers, polyps or any mass protruding
9- Remove the speculum with the blades closed after opening the screw
10- Check the speculum for any discharge or bleeding

Examiner’s global score

0 1 2 3 4

What are absolute contraindications of PV?
Subject / Lab Title / Instructor / Date
PV / PV

Station: Pervaginal examination checklist

  1. Check your patient name- Identify yourself to the patient- Explain the procedure and position

  1. Check the presence of
  2. Private place to the patient
  3. Sterile equipment

  1. Wash your hands and wear clean gloves

  1. Put lubricant jell

  1. Vaginal examination
A-Inspection of the external genitalia
Hair distribution- warts-rashes-ulcer…discharge, or bleeding
B- Palpation:-
Tenderness, mass
6- Insert right index and middle fingers
7- Palpate anterior ,posterior and lateral walls of vagina
8- Examine the cervix
Cervix should feel firm, rounded and smooth
9- remove the gloves and chick any blood or discharges
10- thanks the patient

Examiner’s global score

0 1 2 3 4

Subject / Lab Title / Instructor / Date
PR / PR

Instructions: Carry out a rectal examination on the plastic model and talk through the various

Steps involved.

Time allowed: 6 minutes.

Examiner’s global score

0 1 2 3 4

Give 3 indications for PR?
Give 3 Differential Diagnosis?
Subject / Lab Title / Instructor / Date
PR / PR

Instructions: Carry out a rectal examination on the plastic model and talk through the various

Steps involved.

Time allowed: 6 minutes.

1. Check your patient name- Identify yourself to the patient- Explain the procedure and position
2. Indicates need for chaperone
3. Indicates appropriate position for patient to take
4. Wear gloves
5. Inspects anus and surrounding skin
6. Lubricates index finger of right hand
7. Gently inserts finger into anal canal
8. Indicates need to test anal tone
9. Rotates finger through entire circumference
10. Palpates prostate gland
11. Gently withdraws finger and examines glove
12. Cleans off lubricant on the anus and anal margin
13. Disposes of gloves appropriately
  1. Thanks the patient

Examiner’s global score

0 1 2 3 4

Give the Importance of PR?
Subject / Lab Title / Instructor / Date
BMI / BMI

Station: Body Mass Index checklist

Examiner’s global score

0 1 2 3 4

Write BMI Scale:-
Subject / Lab Title / Instructor / Date
BMI / BMI

Station: Body Mass Index checklist

  1. Introduce your self Identify your patient , Explain the procedure, take permission

  1. Wash hands

  1. Height

  1. Check equipment (adjust the scale by forwarding the head piece up right)

  1. Position the patient: facing you with his heel and back of the head touching the graduated mark, allow the hands to hang freely beside the patient

  1. Lower the head piece to make contact with the top of the patient’s head

  1. Take record and remove the head piece

  1. Allow the patient to get down and tell him his reading

  1. Body weight

  1. Check equipment (adjust weighing scale at zero)

  1. Remove shoes and heavy objects, Allow the patient to climb the scale

  1. Balance the scale while the patient on it

  1. Read the weight, Tell the patient his weight

  1. Calculate the body mass index

  1. Interpretation of the results

  1. Document in patient’s files

  1. Communicate well with patient and address his concerns

Examiner’s global score

0 1 2 3 4

Write BMI Scale:-
Subject / Lab Title / Instructor / Date
ETI / ETI

Station: ETI

  1. Routine hand washing.

  1. Introduce yourself to the patient

  1. Identify your patient name

  1. Explain the procedures and take consent

  1. Check required equipment and test the balloon of the tube

  1. Patient position:-
  2. (Sniffing Position) – the head is extended. A folded towel may be placed under the patients shoulders and neck to assist with positioning

  1. Suction the patient (no longer than 30 seconds)

  1. Oxygenate patient for 1 minute with 100% Oxygen

  1. Laryngoscope handle is held with the left hand

  1. Insert the laryngoscope blade in the patients right side of the mouth

  1. Lift the laryngoscope blade in an upward motion

  1. Visualize the vocal cords

  1. Using the right hand, insert the endotracheal tube until you see the cuff pass through the vocal cords(use a stylet if needed) .

  1. Remove the laryngoscope carefully from the patients mouth

  1. Remove the stylet from the endotracheal tube

  1. Ventilate the patient with two breaths

  1. Observing the chest rise and fall with each ventilation

  1. Confirm placement: Listen for bilateral air entry and air bubble in the stomach

  1. Inflate the endotracheal tube’s cuff with 10cc of air

Subject / Lab Title / Instructor / Date
ETI / ETI

Station: ETI