airbone disease (tb/ measles/ chicken pox) + close bodily contact+ + removal of staples

Question 1

what is the equipment to take?

Answer 1

N95 mask + yellow gown + non sterile gloves + kidney dish with gauze and stapler removal still in packaging

Question 2

what do you do after gathering the equipment?

Answer 2

check the expiry date on the equipment packaging

Question 3

what do you do after checking the equipment

Answer 3

wear PPE (M>A>G sequence)

Question 4

How to don the PPE (hint: M>A>G sequence)

Answer 4

1) N95 Mask: cup the front of the mask with hand, pull the top strap above ears, then pull the bottom strap to the back of the head) Mould the metal wire to your nose. Check for air-tightness at top and bottom of the N95 mask by breathing out forcefully and feeling for air at the top and bottom perimeters of the mask.
2) Don yellow gown – tie the top knot first, then tie the bottom knot. Ensure overlap of the gown at the back with NO GAPS to prevent exposure of your clothes.
3) Don non-sterile gloves – ensure the gloves go over the white cuffs of the gown.

Question 5

On entering the isolation room, what do you do when you approach the patient?

Answer 5

a) Introduce myself
b) Double-check patient identifiers
c) Explain the procedure to the patient, and inform them that there will be a slight tugging sensation on the skin area when removing the staples
d) Obtain patient consent”

Question 6

How do you remove the ples?

Answer 6

• Open the staple remover packaging. Leave the empty packaging in the kidney dish.
• Place the gauze next to the dummy, on
  your dominant side, as that side is nearer the sharps bin.
• Dominant side with staple remover > removes staples > places them on gauze at same dominant side > empty the gauze at the end into the sharps bin on the same side as dominant hand.
• Remove the 1st wave of alternate staples. Start from the top and go downwards alternately. Insert staple remover under each staple, but DO NOT pull upwards to avoid tugging on the staple while it is still in the wound. Then, press the staple remover to remove the staple. Place each removed staple on the gauze.
• Stop after removing 1st wave of alternate staples. “I will check for the wound healing and integrity
  after removing the 1st round of staples.”
• Continue removing the 2nd wave of alternate staples until all staples are removed.
• Use both hands to carefully carry the gauze over the sharps bin, without dropping any staples. Empty the staples into the sharps bin without touching the staples themselves. Be sure never to
  touch the sharps bin as in real life it is very contaminated.
  a) Try not to throw the gauze into the sharps bin. Gauze should be put back in kidney dish.
  b) However, if some staples stick onto the gauze, do not touch them or try to fling out the gauze. Just throw the entire gauze into the sharps bin. Then explain to the examiner why you did so. “Ideally, I would have not thrown the gauze into the sharps bin, but because the staple got caught in the gauze, I had no choice but to throw the gauze into the sharps bin as well.”

Question 7

How to remove PPE? (Hint: G>A>M sequence)

Answer 7

1. Remove non-sterile gloves using aseptic technique – outside of glove can only touch outside of other glove. Pinch wrist part of 1st glove and pull it down, turning 1st glove inside-out along the way to trap any pathogens. Ball up 1st glove in 2nd-gloved hand. Use exposed finger to insert under the cuff of 2nd glove and pull down to remove 2nd glove inside-out. Discard both gloves into ANY rubbish bin.
   2 . Hand rub (from bottle on trolley) – MUST SHOW 7 STEPS AGAIN.
2. Remove yellow gown with aseptic technique – ensure you do not touch the outer surface of gown at all times! Untie the bottom knot, then untie the top knot. Pull the top strings to remove sleeves HALFWAY on each side. Use fingers of one hand to go under white cuff of opposite sleeve and gently pull the rest of the sleeve out. Hold the gown arms length away from yourself, and ball up
   gown VERY slowly using inner surface (do not fling it out at all times). Discard yellow gown into the BIG rubbish bin because it can’t fit into the small rubbish bin!
   5 . Hand rub – MUST SHOW 7 STEPS AGAIN.
   6 . Remove N95 mask with aseptic technique – ensure you do not cup/touch the front surface of the
   N95 mask at all times! Remove the bottom strap very slowly, if not the N95 mask may flip insideout onto your face which is an immediate failure. Maintain hold on bottom strap with one hand, pulling down on it in front of face to stabilize the mask. Use other hand to remove top strap slowly. Discard N95 mask into ANY rubbish bin.
   6 . Medical hand wash – MUST SHOW 7STEPS AGAIN.