Asepsis, Pack Wrapping, & Sterilization

Question 1

Sources of exogenous (4) in order to avoid intro of microorganisms during Sx

Answer 1

1. Air
2. Sx instruments
3. Patient’s skin
4. Sx team
   MOST CONTROL HERE

Question 2

Endogenous contamination arises from ____ the patient reaching the wound through their ____.

Answer 2

1. Within the patient
2. Bloodstream

Question 3

Aseptic vs Sterilized

Answer 3

1. Aseptic:
   - Is a condition of sterility
   - NO living organisms present
   - This tech include all steps taken to prevent contamination of a Sx site
   - Scrubbing in also req this tech
2. Sterilized:
   - Absence of all microorganisms and spores

Question 4

Disinfection

Answer 4

Elimination of pathogens, expect spores, from inanimate objects

Question 5

Sterilization

Answer 5

• Process that destroys all viable microbes, including viruses & endospores.
• Absence of all microorganisms and spores.

Question 6

Methods of disinfection & sterilization:
Chemical - How is it preformed?

Answer 6

Performed with certain liquids or gases

Question 7

Methods of disinfection & sterilization:
Physical (3)

Answer 7

Physical methods:
1. Filtration: doesn’t kill, but separates
2. Radiation: gloves & some suture materials from manufacturer
3. Heat - thermal energy: moist heat (autoclave) & dry heat.

Question 8

Water hardness is…
Distilled water has how many minerals?

Answer 8

1. Is dependent on how many minerals are dissolved into it. Well water is ‘harder’ due to the amount of minerals it has.
2. Distilled water has NO minerals

Question 9

Disinfectant effectiveness depends on… (7)

Answer 9

1. Type of microorganism
2. Organic matter present
3. Contact time & temp
4. Degree of contamination
5. Amount of protein present
6. Other compounds being used
7. Concentration & quality of chemical

Question 10

Bleach! Name some great facts about it (7)

Answer 10

1. Chlorine based
2. Cleans & disinfects
3. Corrodes metals
4. Deteriorates fabrics
5. Irritant
6. Inactivated by fecal matter!!
7. Temp & pH of water alter efficacy

Question 11

Phenols. Tell me about it! (4)

Answer 11

1. Common household disinfectants
2. Work in presence of organic matter
3. Relatively safe:
   - Can cause skin irritation
   - Poisonous if ingested (esp to cats!)
4. Infrequently used in vet med

Question 12

What occurs in the Patient prep area?

Answer 12

1. Prepping patient for Sx
2. “Dirty” Sx:
   - Dentals
   - Abscesses
   - Debridement
   - Anal glands
3. Only scrub in Sx room should be the FINAL scrub

Question 13

What is a personnel scrub area?

Answer 13

• Area contains scrub sink & table to gowning/gloving
• Sometimes the gloving/gowning will take place in the Sx due to space

Question 14

What are some equipment that are “moveable’s”? (4)

Answer 14

Some equipment in the Sx suite is moveable
- Mayo instrument stand
- Anesthetic machine
- Patient monitoring equipment
- “Kick” bucket

Question 15

What should OR storage look like? (3)

Answer 15

1. Cabinets that store Sx equip & sterile packs should be raised from the floor
2. Have doors that can be closed to protect contents from dust, pet hair, & contaminants
3. The better protected, the longer the sterility of the packs

Question 16

Cleaning the OR

Question 17

Shelf life of…
1. Woven or nonwoven
2. Peel away pouches

What are other ways of knowing how long something can be sterile?

Answer 17

1. 2 weeks
2. 7 weeks
   -OR- predetermined date/ID’s how long item considered sterile

Question 18

Examples of event related expiration: (3)

Answer 18

1. Environmental perspective
2. Damaged in any way - non-sterile
3. Excessive handling, dust

Question 19

Type of autoclave:
Gravity air displacement

Answer 19

• Most common
• Steam introduced into top of the chamber forces air to the bottom
• Distilled H2O must always be used to prevent rust to the metals

Question 20

Another type of autoclave:
High vacuum sterilizer

Answer 20

1. Forces steam into sterilizing chamber
2. Steam penetrates pack quicker
3. Steam vacuumed out after complete

Question 21

Autoclaves use ___ to kill microorganisms

Answer 21

Steam under pressure

Question 22

Proper sterilization depends on… (3)

Answer 22

Proper:
1. Operation
2. Pack prep
3. Loading

Question 23

Maintain a surgical conscience!
What does this mean for you? (6)

Answer 23

1. Sterile drapes are used to est a sterile field.
2. All items within a sterile field should be sterile.
3. Sterile fields should not be left unattended.
4. Sx team must stay aware of sterile vs non-sterile areas at all times.
5. Keep convos (& visits) to a minimum.
6. REPORT ANY KNOWN BREAKS IN ASPEPTIC & STERILE TECHS IMMEDIATELY!!!

Question 24

Ethylene Oxide Sterilization
What is it?
How should the chambers be vented?

Answer 24

1. Colorless gas at room temperature. It is extremely flammable, explosive, & toxic
2. OUTSIDE the work area!!

Question 25

Possible injuries associated with ethylene oxide sterilization (5)

Answer 25

1. Skin burns
2. Resp irritation
3. Vomiting
4. Head aches
5. Birth defects