Skills and Procedures

The Norwood procedure is a critical surgical intervention for infants born with hypoplastic left heart syndrome (HLHS), a severe congenital heart defect. This article provides an in-depth look at the Norwood surgical correction, as illustrated in the medical image, offering a detailed anatomical and procedural breakdown. Designed for medical students and professionals, this guide explores the surgical technique, its significance in treating HLHS, and the anatomical structures involved, ensuring a thorough understanding of this life-saving operation.

The diagram illustrating a heart with tricuspid atresia and its transformation following a Fontan procedure offers a detailed comparison of congenital heart defect anatomy and surgical correction. This medical image serves as a vital educational tool for medical students, cardiologists, and healthcare professionals aiming to understand the structural challenges of tricuspid atresia and the surgical strategies employed to improve circulation. By examining the labeled parts, this guide provides a comprehensive exploration of the heart’s condition before and after the procedure, highlighting the clinical significance of this intervention.

he illustration depicts a central venous catheter (CVC) secured to a patient's skin using suture fixation, one of the most traditional and widely practiced methods for preventing catheter displacement and migration.

The image displays a recently inserted temporary dual-lumen hemodialysis catheter positioned in the left internal jugular vein of a patient. This type of central venous access device serves as a crucial but temporary vascular access option for patients requiring urgent or short-term hemodialysis treatment. The catheter features two color-coded lumens—red for arterial (blood withdrawal) and blue for venous (blood return)—that facilitate the extracorporeal blood circuit necessary for dialysis.

Implanted venous access ports represent a significant advancement in long-term vascular access technology that combines reliable function with enhanced patient comfort and reduced infection risk. As illustrated in the image, these totally implantable devices consist of a reservoir (port) with a self-sealing septum connected to a catheter that extends through the venous system to terminate near the heart. Unlike external catheters, the entire system resides beneath the skin, requiring no external components when not in use.

Tunneled central venous catheters (CVCs) represent a specialized type of long-term vascular access device designed for patients requiring extended intravenous therapy. Unlike standard central lines, tunneled CVCs feature a subcutaneous tract between the venous entry site and the exit point on the skin, providing enhanced infection protection and improved stability. The image illustrates the anatomical positioning of a tunneled CVC, showing its path from the external exit site through a subcutaneous tunnel, into the right subclavian vein, and ultimately terminating in the superior vena cava near the right atrium.

The proper emptying of urinary drainage bags represents a critical component of comprehensive catheter care that significantly impacts infection prevention and overall patient safety. The image illustrates the correct technique for emptying a urinary collection bag, showing a healthcare provider wearing appropriate personal protective equipment (blue gloves) while draining urine from the bag into a calibrated container.

Correct positioning ensures unobstructed urine flow through the catheter and tubing into the collection bag, prevents reflux of urine back toward the bladder, and minimizes the risk of catheter-related trauma. The illustration demonstrates two key principles: preventing compression of the catheter tubing by keeping it free from beneath the patient's body, and positioning the collection bag below bladder level by hanging it on the bed frame.

Proper positioning and secure attachment of urinary drainage bags are essential components of effective catheter management that significantly impact patient comfort, system functionality, and complication prevention. When patients require urinary catheterization, either through indwelling (Foley) catheters or external collection systems, the drainage bag must be positioned correctly to ensure unobstructed urine flow while minimizing the risk of reflux, infection, and accidental dislodgement. The image demonstrates the recommended technique for securing a leg bag to the thigh of an ambulatory patient with a condom catheter.

Implanted vascular access ports represent a significant advancement in long-term intravenous therapy, providing reliable access for patients requiring repeated administration of medications, blood products, or nutritional support. These subcutaneously implanted devices consist of a central catheter connected to a reservoir housed within a durable port body, which is surgically placed beneath the skin, typically in the upper chest area as shown in the image.