3. Surgical Equipment and Instruments Flashcards
What are the SVMA practice standards for surgery room, and recovery rooms?
Must have a separate room for sx in all clinics built/remodeled after 2004
if no separate single purpose sx room, a written protocol describing how asepsis is maintained must be presented
A recovery area must also be provided where patient may be frequently observed following anesthesia (but need not be separate from animal compartments)
What is an ideal laout of the surgical suit?
American animal hospital association recommends 3 distinct and separate areas for a sx facility
1. preparation area
2. scrub area
3. sx room
In addition, SVMA has specific requirements in the practice standards regarding surgical facilities that are a vet hospital must meet to pass inspection and to receive authorization to offer surgery
What is the ideal preparation area?
Should be adjacent to sx room
Used for patient prep (clipping and initial scru) and storage of surgical supplies
ideal to have a separate anesthesia machine for prep room - to prevent cross-contam from occurring went he machine is moved from one room to another
Procedures that are considered clean but not sterile or that are classified as dirty should be performed in this area
What is an ideal scrub area?
lg enough to hold a scrub sink
room to put on gown and gloves - may also be where autoclave is located
What is an ideal surgical suite?
separate dedicated room used for only aseptic surgical procedures
should be easy to clean
large enough that personnel can easily move around the surgery table w/o contaminating the surgical field or the surgeon
should be free of clutter - only req surgical equipment should be kept in sx suite
Cabinets should be made of nonporous material with doors - protects sterile supplies from dust, debris and other contaminants
should have a door into room that can be closed
air pressure should be treating in sx room than rest of facility - higher air pressure pushes air out of room > reduces ability of airborne bact to move into surgical room from other areas of clinic
What is some examples of permanent equipment?
equipment fixed to the floor, wall or ceiling in sx
non-movable pieces like sx lights/table, radiographic viewbox/computer
anesthetic machine - although they should not leave sx room, many facilities they are required to serve a dual purpose and are moved to other areas of the hospital
What are some examples of movable equipment
able to be transported to other areas of the hospital
these items must be cleaned and disinfected thoroughly b4 being returned to the sx room
movable equipment items include:
monitoring equipment
heating pads, IV drip stand
instrument table, mayo stand
suction
cautery unit
kick bucket
How is equipment cleaned?
sx room should never be dry dusted because this may aerosolize dust and bacteria
all equipment should be wiped daily b4 sx w/ appropriate cleaning or disinfecting solution
important tof follow the manufacturer’s instructions
important to follow equipment-specific maintenance instructions
info should include the equipment’s compatibility w/ chemical germiides, whether it can be immersed for cleaning, how it should be decontamed
What are perioperative equipment?
many pieces of equipment besides sx instruments are critical to success of a sx procedure
Whether related to providing patient comfort, assisting the surgeon, or monitoring anesthesia, each item is an integral part of process
ex. patient warming devices, sx lights/table, electrosurgery, suction machines, surgical instruments
What are patient warming devices?
ALWAYS place a towel btw ur patient and the warming device to prevent thermal burns
Circulating warm-water blankets are commonly used for sx patients - heated surface helps prevent the loss of body heat to a cold metal surface, diminishes hypothermia
What is a hard heated pad?
made of acrylic plastic glass like plexiglas, connects to many currently available circulating water pumps
the main advan to this style of heating system is that plexiglass is puncture proof
What is a hot dog warming blanket?
uses electricity to warm the pad but does not pose the same threat for thermal burns as a traditional heating pad
has a sensor in the pad to regulate the heat generated
not puncture proof but are not harmed if punctured
What are forced warm air devices?
ex. bair hugger
pad is placed around the patient, then inflated w/ warm air
constant flow of warm air is very effective @ maintaining or inc patient’s body temp
not puncture proof, but there is less risk of puncture bc pad is not placed near the animal until patient is anesthetized
What are the components of surgical lights?
adequate lighting is imperative
ceiling or wall-mounted lights are much better than standing floor models
removable light handles that can be autoclaved
surgeon or surgical assistant can then place handles on lights, allowing either person to adjust lights directly
What are the components of a surgery table
table top can be solid surface or can be designed in a split-surface style
Solid-top model is generally less expensive and can be more difficult to work w/ bc fluid pool on table top and can soil the patient
Split-top table has double advantage of - tray under space in table to collect any fluod that may run off the surgical field
the ability to be adjusted to help maintain the patient (especially lg, deep-chested dogs) in dorsal recumbency
can have heated tabletop
sx tables should also have capability to be raised/lowered/tilted
What is electrosurgery?
use of electricity, trasmitted thru a special hand piece, to cut or coagulate vessels
single-use or reusable cautery hand pieces
charred material may build up on the tip of the hand piece, impeding the flow of current- may be cleaned by scraping w/ a scalpel blade (away from sterile field) or by using a commercially available scratch pad
What is monopolar electrosurgery
a ground plate must be placed under the patient, water- or saline-saturated sponge should be placed on ground plate btw patient and plate, alcohol NEVER used to saturate bc patient burns/fires, can make sx incision -takes longer to heal bc of charring of tissue
What is bipolar electrosurgery?
utilizes a hand piece that resembles a thumb tissue forceps
no ground plate needed
as hand piece is activated, current passes from one tip to another
WHat are the 2 ways monopolar electrosurgery can be used?
- hand piece can be activated, tip of hand piece can directly touch the tissue or vessel that needs cauterizing
- hemostat can be placed on the tissue or vessel that needs to be cauterized
hemostate is elevated off sx field so only metal touching patient is tip of hemostat
cautery hand piece tip can then be touched to hemostat as the hand piece is activated
What is suction, in surgical equipments and instruments
defined as the ability to remove fluid or air from an area by a manual or a mechanical device
Can be performed w/ a syringe, a bulb syringe, or mechanical pump - mechanical pump is commonly used in surgery
suction can be used when working in body cavities to remove excess fluid
When might you use suction?
orthopedic surgery to lavage a joint, flush a septic site, remove bone dust created while drilling screw holes for a fracture repair
