APPROACH TO THE OR

Question 1

What are the 3 components of “surgical conscious”?

Answer 1

Ethical awareness of adhering to strict aseptic/sterile technique

1. Every surgical team member is responsible for his/her own surgical conscious
2. The ultimate goal is patient safety

Question 2

Who are the 6 OR personnel?

Answer 2

Surgeon, Assistant, Circulator, Surgical Technologist, Anesthesia, and Implant/Equipment Rep

Question 3

What’s involved in the Pre-op?

Answer 3

H&P, consent, pre-op clearances

Anesthesia evaluation

Nurse eval

Question 4

What are the first 3 things to happen intra-op?

Answer 4

1. Anesthesia
2. Patient positioning (including bumps, beanbag, appendage positions, and Tourniquet)
3. Surgical Sit cleaning

Question 5

What’s used in the surgical site cleaning?

Answer 5

1st ETOH/Hibiclens, Surgical scrub cleanse
2nd Primary scrub (chloraprep, duraprep, iodine)
3rd Secondary scrub (wait 3 minutes before next step)

Question 6

After the patient is thoroughly cleaned and scrubbed, what’s next?

Answer 6

Drape!

Question 7

What happens just before the surgical procedure?

Answer 7

TIME OUT!

Confirm name, procedure, site, side, abx, appropriate equipment, etc

Question 8

What’s involved in post-op?

Answer 8

Extubation/anesthesia removal

Transfer to stretcher → Admit to recover room (PACU) → Post-op orders → Discuss case with family

Question 9

What’s the difference between sterile and aseptic?

Answer 9

There is none – they’re interchangeable

Question 10

What is aseptic technique?

Answer 10

Only sterile items are used within the sterile field

Question 11

If in doubt about sterility ____

Answer 11

It isn’t sterile

Question 12

If an item becomes contaminated, what does that mean?

Answer 12

All associated items are also contaminated (touch the corner of the table, everything on the table is contaminated)

Question 13

What is the sterile field?

Answer 13

The area that has been prepared for an aseptic procedure

Question 14

What does the term “belly up to the table” mean?

Answer 14

The table edge is the demarcation line of the sterility of the drapes. Everything below the table level is unsterile

Question 15

Can the packaging of sterile items every touch the sterile field?

Answer 15

NOOO

Question 16

How do we open sterile packages?

Answer 16

Open on flat, level surface (i.e. surgical tray)

Peel packages open

Lift items out of packaging (don’t drop them!!)

Question 17

Do you ever reach over a sterile field?

Answer 17

NOOOO

Question 18

Once a bottle is opened and dispensed, what if there is more liquid left in the bottle?

Answer 18

The remaining liquid is considered contaminated

Question 19

What is the surgical attire?

Answer 19

Surgical Cap (all facial hair must be covered!!)

Shoe covers

Eye protection

Question 20

Can you wear any form of jewelry into surgery?

Answer 20

NOOOOOOOOOO

Question 21

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?

Answer 21

Hand washing!

Question 22

Can you ever have nails beyond fingertips, artificial nails, or chipped/cracked nail polish when working in the OR?

Answer 22

NOOOOOOOO

Question 23

Are you sterile after doing surgical scrubbing on your hands?

Answer 23

Nope

Question 24

What are 3 methods for surgical scrubbing? Explain each

Answer 24

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

Question 25

How should you rinse your hands with surgical scrubbing?

Answer 25

Rinse from fingers to elbows

AKA Hands should be elevated so that water runs down arms to elbows

Question 26

If you’re in the OR observing (AKA not scrubbed in) can touch the stuff in blue?

Answer 26

NOOOOOO

Question 27

Who is in charge of the OR room?

Answer 27

RN (responsible for adherence to protocols)

Question 28

Who is in charge of the table?

Answer 28

Scrub tech (don’t touch the back tables unless you ask)