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Surgery > Asepsis/ sterility > Flashcards

Asepsis/ sterility Flashcards

1
Q

Definition of asepsis

A

absence of pathogenic microorganism (within hospital environment)

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2
Q

Definition of sterility

A

absence of all living organism & spores in or on inanimate items

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3
Q

Definition of contaminated

A

carrying microorganism

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4
Q

Aseptic technique

A

rules/ protocol to prevent pathogenic organisms from gaining access & establish in surgical wound

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5
Q

Goal for aseptic technique

A

pathogen control & reduction of risk

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6
Q

Source of contaminants

A

Animal: secretion, nasopharynx, oropharynx
inanimate source: fomite, airborne

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7
Q

Methods of transmission

A
  • contact
  • droplets
  • airborne
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8
Q

What is the most likely source of transmission of contaminants in surgery room?

A

personnel

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9
Q

What are resident bacteria?

A

normal flora on the patient

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10
Q

What are transient bacteria

A
  • gain access to surgical site from within the operating room
  • inanimated source
  • animated source
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11
Q

Clean procedure

A
  • do not enter organsystem
  • no break in aseptic technique
  • ex: overiohysterectomy, total hip replacement
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12
Q

What is clean-contaminated procedure?

A
  • enters organ system
  • minor break in aseptic technique
  • ex: enterotomy, gastrotomy, lung lobectomy
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13
Q

What is contaminated procedure

A
  • oral/ anal surgical procedure
  • infected bile/ urine
  • all traumatic wounds
  • major break in aseptic technique
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14
Q

What is dirty procedure?

A

gross contamination or infection external trauma or perforation of a hollow viscus

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15
Q

components of aseptic technique

A
  • isolate patients with infectious disease
  • use PPE
  • clean facilities & instruments between patients
  • regular deep cleaning of environment
  • minimize traffic
  • washing hands
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16
Q

Components of sterile technique in the OR

A

Facilities & equipments
- cleaning & disinfection
- sterilization of the surgical pack
Patients
- preop clipping & scrubbing
Personnel
- maintaining sterility

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17
Q

What are disinfectants?

A

germicidal chemical substance that kill microorganism on inanimate

18
Q

What to do when preparing the surgical instruments & packs

A
  • sterilized in surgical packs
  • marked with an expiration or sterilization date
  • store appropriately
19
Q

What clipper blade should we use for surgically prepping the patient?

A

40 blade

20
Q

What is the intended incision landmark?

A

xiphoid to pubis

21
Q

where are the drapes placed during abdominal surgery?

A
  • cranial to xiphoid
  • caudal to pubis
  • mammary gland
22
Q

What are the margins to clip?

A
  • extend onto thorax
  • caudal to pubis
  • flank folds
23
Q

Goals of the rough scrub

A
  • remove organic debris
  • reduce the numbers of pathogenic organisms
24
Q

What should surgical antiseptics ideally be like?

A
  • kill wide spectrum
  • hypoallergenic
  • no cutaneous absorption
  • strong residual activity
25
Q

What does isopropyl alcohol do?

A
  • rapidly denatures cell wall protein, DNA, RNA
  • widely effective against most microorganisms
  • good immediate action
  • no residual action
26
Q

Shortcomings of using isopropyl alcohol

A

Highly irritating: corneas, wounds, mucous membrane

27
Q

Chlorhexidine

A
  • disrupt cell membrane, precipitate cell components
  • activity
  • excellent residual activity
  • common
28
Q

What is chlorhexidine effective against?

A

gram +. gram - , fungi
- less active against Mycobacteria

29
Q

Why does chlorhexidine have long residual activity?

A

binds to keratin

30
Q

Shortcoming of chlorhexidine

A

neurotoxin, toxic to cornea & eye

31
Q

What is chlorhexidine used for commonly?

A
  • 4% pre-surgical scrub
  • 0.05% for mucous membranes & open wound
32
Q

Function of povidone-iodine

A

iodinates, oxidizes cell component molecules

33
Q

characteristics of Povidone-iodine

A
  • widely effective against most microorganism
  • activity reduced by organic debris
  • good residual activity
34
Q

Short-coming of povidone-iodine

A
  • skin irritation
  • thyroid dysfunction over time
35
Q

What is the goal for preputial wash

A

remove exudate and reduce bacterial load

36
Q

What is preputial wash?

A
  • 2-minute flush
  • chlorhexidine 0.05% more effective
  • chlorhexidine cause less preputial irritation
37
Q

What to do for patient preparation in the OR

A

final prep

38
Q

Goal for sterile/ final prep

A

eliminate bacteria acquired during patient tranfer and new bacteria from patient pores/follicles

39
Q

What does normal hand washing with soap

A
  • will remove transient bacteria
  • will not remove resident bacteria
40
Q

What does mechanical scrubbing action and antimicrobial detergent

A
  • will remove transient bacteria
  • will remove resident bacteria
41
Q

How long does it take to do surgical scrubbing

A

5 minute

Surgery (3 decks)

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