Spaulding Classification System
A system evolved by using Dr. E.H. Spaulding that divides clinical gadgets into classes based
on the danger of infection concerned with their use. Critical, Semi-critical, non-crucial
Critical
-Break mucosal barrier or enter tissue
-Sterilized
Semi-Critical
-Come into touch with mucosal barrier however do now not penetrate
-High stage disinfected
Non-essential
-Come into contact with intact pores and skin
-Clean with germicide or low level disinfectant
Methemoglobinemia
-Oxidation of iron within the hemoglobin prevents oxygen sporting capacity
-Side effect of subject matter anesthetics (lidocaine)
-Treatment is methylene blue
,Esophagus
-10 inches in duration
-1 inch in diameter
-four layers (mucosa, submucosa, muscular, serosa)
UES
-Upper esophageal sphincter
-Separates pharynx from esophagus
-Striated muscle
LES
-Lower esophageal sphincter
-Separates esophagus from stomach
-Smooth muscle
-VIP and nitric oxide loosen up sphincter
Achalasia
-Absence of peristalsis and accelerated LES pressure
-Bird beak appearance
-Can be treated with CCBs or dilation or botox or surgical procedure (Heller's myotomy)
Nutcracker Esophagus
, -Condition characterised via high stress (>a hundred seventy five mmHg) propulsive
contractions which are frequently of prolonged length
DES
-Diffuse esophageal spasm
-Uncoordinated/ simultaneous contractions d/t damaged nerves
Scleroderma
-Connective tissue disease which affects collagen production
-Aperistalsis and coffee LES stress
Esophageal Webs
-Circumferential cabinets in upper esophagus
-Cause intermittent dysphagia
Esophageal Rings
-Circumferential cabinets in lower esophagus
Alkaline Caustic Injury
-Liquifactive necrosis
-Complete destruction of entire cell membrane
-Worse than acid
Acid Caustic Injury
-Coagulation necrosis with eschar formation
-Limited depth of injury
Normal Esophageal Manometry
Stomach
-10 to 12 inches long
-6 inches extensive
-four layers (mucosa, submucosa, muscular propria, outer serosa)
Pepsin
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