8 - Sterile Technique Flashcards

1
Q

Preparing to scrub includes:

A

Disposable hair net / skull cap

Mask

Eye pro

Scrubs tucked in

Shoe covers on

Sleeves rolled

Chains, rings, watches - off and stored

Name tag

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2
Q

Scrub instrutions

A
  1. Wet brush, work up lather, and lather hand with sponge
  2. Scrub fingertips 30 circular strokes with the brush
  3. Start at either little finger or thumb side of hand; scrub 4 sides of each digit 20 strokes with the sponge
  4. Scrub palm, sides of the hand, back of the hand, web space between thumb and index finger 20 strokes each
  5. Wet the brush any time you need more lather
  6. Apply soap to circumference of the wrist with a sponge
  7. Scrub 4 sides of wrist 20 times using circular strokes
  8. In this manner, continue up the forearm past the elbow
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3
Q

Additional scrub instructions

A

Keep elbows down

Re-scrub if you touch a non-sterile surface

Let water drip off elbows

Rinse in one motion, no see-sawing

Place trash in kick bucket, not in sink

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4
Q

Do you have to be sterile to go past the red line?

A

No, but you do need proper OR attire

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5
Q

What do you do with your hands once in the OR?

A

Keep hands above the waist and at the xyphoid

Keep your hands and arms away from clothing

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6
Q

Where do you dry your hands?

A

In the OR with the help of a scrub tech / nurse

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7
Q

Who will normally “gown” you?

A

A gloved tech

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8
Q

Once you are gowned:

A

Tech will present a glove - slide your hand in, and adjust only after the second gloves is placed

The white of the gown cuff should be completely covered by the glove

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9
Q

Proper conduct in the OR

A

Know your role!

Be helpful but stay in your fucking lane (aka out of the way)

Unscrubbed members do NOT reach over sterile surfaces

If you are not gowned and gloved, do NOT go between 2 sterile members, or between a sterile member and a sterile field

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10
Q

Which areas of the member are considered unsterile?

A

Below the waist

Above the shoulders

Back of the gown

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11
Q

Who usually prepares the patient?

A

Unsterile team member

Positions, shaves, paints the site

Places indwelling urinary catheter

Positions monitors

Ensures IV access is available

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12
Q

Who usually does the draping of the patient?

A

Sterile team member (usually surgeon and first assist)

Ensure only prepped area visible through fenestration

Ensure operative field is well-lit

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13
Q

What is the “blood brain barrier”? (In surgery slang)

A

The drape between the anesthesiologist (unsterile) and the operative field)

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14
Q

What must be done before surgery?

A

Perioperative checklist

TEAM steps

Introduce crew

Instrumentation, special packs discussed

Time-out performed - lead by surgeon

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15
Q

Final step before starting surgery?

A

Surgeon asks anesthesia if patient is ready to start

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16
Q

Any time a package is opened:

A

A count is performed and all must be 100% by the end of the case

17
Q

What is the Mayo stand?

A

The scrub tech’ area

If you want something, ask the scrub tech for it

Pass everything off to them unless otherwise instructed

18
Q

What is usually kept on the back table?

A

Instruments for the case not on the Mayo stand

19
Q

Setting up cautery:

A

Monopolar

Scalpel, grounding pad plugged in

Place grounding pad

Ensure proper (low voltage) settings on cut/coag

20
Q

Setting up suction

A

Secure on drape

Follow cautery with suction to suck up smoke

If using suction with irrigation, filter through sponge to avoid clogging with fat/tissue

21
Q

If someone says you contaminated yourself:

A

You DID. Don’t argue.

Glove:
Circulator will remove contaminated glove, scrub tech will re-glove you.

Sleeve:
Scrub tech can place paper sleeve over your contaminated gown

Gown:
Circulator removes gown / gloves
Scrub tech will re-gown/glove you

22
Q

Moving the patient:

A

Strongest person takes the torso; weaker at the feet

Anesthesia moves the head and counts

23
Q

Where does the pt usually go after surgery?

A

The morgue………well, hopefully not

The PACU, and then back to their respective unit (ICU, tele, med-surg, etc)

24
Q

What is Avogard?

A

Presurgical scrub which may be done in lieu of full surgical scrub IF:

  • full surgical scrub was done for the first case
  • you have not left the operating area
  • not gone to the latrine, eaten, or smoked

Process:

  • one pumpful in palm and work in over hand
  • additional pumpful from wrists to elbows
  • rub into hands/arms until dry
25
Q

What does an annoying pepper do?

A

It gets jalopeno face