APPROACH TO THE OR Flashcards
What are the 3 components of “surgical conscious”?
Ethical awareness of adhering to strict aseptic/sterile technique
- Every surgical team member is responsible for his/her own surgical conscious
- The ultimate goal is patient safety
Who are the 6 OR personnel?
Surgeon, Assistant, Circulator, Surgical Technologist, Anesthesia, and Implant/Equipment Rep
What’s involved in the Pre-op?
H&P, consent, pre-op clearances
Anesthesia evaluation
Nurse eval
What are the first 3 things to happen intra-op?
- Anesthesia
- Patient positioning (including bumps, beanbag, appendage positions, and Tourniquet)
- Surgical Sit cleaning
What’s used in the surgical site cleaning?
1st ETOH/Hibiclens, Surgical scrub cleanse
2nd Primary scrub (chloraprep, duraprep, iodine)
3rd Secondary scrub (wait 3 minutes before next step)
After the patient is thoroughly cleaned and scrubbed, what’s next?
Drape!
What happens just before the surgical procedure?
TIME OUT!
Confirm name, procedure, site, side, abx, appropriate equipment, etc
What’s involved in post-op?
Extubation/anesthesia removal
Transfer to stretcher → Admit to recover room (PACU) → Post-op orders → Discuss case with family
What’s the difference between sterile and aseptic?
There is none – they’re interchangeable
What is aseptic technique?
Only sterile items are used within the sterile field
If in doubt about sterility ____
It isn’t sterile
If an item becomes contaminated, what does that mean?
All associated items are also contaminated (touch the corner of the table, everything on the table is contaminated)
What is the sterile field?
The area that has been prepared for an aseptic procedure
What does the term “belly up to the table” mean?
The table edge is the demarcation line of the sterility of the drapes. Everything below the table level is unsterile
Can the packaging of sterile items every touch the sterile field?
NOOO
How do we open sterile packages?
Open on flat, level surface (i.e. surgical tray)
Peel packages open
Lift items out of packaging (don’t drop them!!)
Do you ever reach over a sterile field?
NOOOO
Once a bottle is opened and dispensed, what if there is more liquid left in the bottle?
The remaining liquid is considered contaminated
What is the surgical attire?
Surgical Cap (all facial hair must be covered!!)
Shoe covers
Eye protection
Can you wear any form of jewelry into surgery?
NOOOOOOOOOO
Visible soil/dirt, contact with any body fluids, entering a surgical room, in between patient contact, before/after meals, after removing surgical gloves – are all indicators of when what needs to occur?
Hand washing!
Can you ever have nails beyond fingertips, artificial nails, or chipped/cracked nail polish when working in the OR?
NOOOOOOOO
Are you sterile after doing surgical scrubbing on your hands?
Nope
What are 3 methods for surgical scrubbing? Explain each
Timed method = Scrubs finger/hands/arm for 2-4 minutes
Count method = Scrub each body part for defined number of strokes
Brushless method = Alcohol based soap
