Aseptic Techniques Flashcards
1
Q
What is aspesis?
A
Freedom from infectious material
2
Q
What is medical asepsis?
A
Reduction in the number of microorganisms
3
Q
What is the single most important component of medical asepsis?
A
Handwashing
4
Q
What is surgical asepsis?
A
Microorganisms have been completely removed or destroyed from the equipment and environment by means of sterilization
5
Q
When should medical asepsis be practiced?
A
Always
6
Q
When should surgical asepsis be followed?
A
For invasive procedures
7
Q
What are the aseptic techniques that radiographers should adhere to?
A
- Sterile draping
- Sterile packs
- Sterile scrubbing
- Sterile gowning and gloving
- Sterile procedures
8
Q
What is a sterile field?
A
The area is free of all microorganisms
9
Q
How is a sterile field established?
A
Using sterile draping
10
Q
What is a sterile drape?
A
A sterile packaged drop cloth that isolates an area from contamination
11
Q
What does a sterile drape cover?
A
A surface
12
Q
What are general rules for sterile draping?
A
- Only use drapes within expiration
- Only use sealed packages
- Open packages adhering to sterile techniques
13
Q
What happens if a sterile drape becomes wet?
A
It becomes unsterile
14
Q
How are sterile drapes opened?
A
Away from the person opening it
15
Q
Once opened what is done with a sterile drape?
A
Its gently dropped onto the sterile field from about 6 inches above the field at a slight angle
16
Q
What are sterile packs?
A
Packages that are commercially prepared for a specific procedure that will contain the necessary sterile items
17
Q
What may be in a Sterile pack?
A
Gauze, syringes, forceps, basins, and items that will be routinely used
18
Q
What are types of sterile packs?
A
- OR sterile packs
- Minor procedure packs
- Special procedure packs
19
Q
How is a sterile pack opened?
A
- Hold the pack in the left hand
- Unfold one corner of the wrap at a time and secure each corner in the palm once opened
- Hold the final corner with the right hand to completely cover the hand with the wrap
- Once pack is fully exposed, set it on the sterile field
20
Q
What is surgical scrubbing?
A
The thorough cleaning of the hands and forearms before sterile gloving
21
Q
What are two types of sterile scrubs?
A
- Numbered stroke method scrub
- Timed scrub
22
Q
What is the minimum amount of time a surgical scrub should be done?
A
5 minutes- 2.5 minutes per hand
23
Q
What scrubbing techniques should be applied when surgical scrubbing?
A
- Hands should be inspected for breaks in the skin
- Masks and surgical cap put on before scrubbing
24
Q
What forms of cleaning solutions should be used for surgical scrubbing?
A
- Liquid or foam soaps
- Impregnated scrub brushes or sponges
- Brush-free surgical scrub
25
What are the most common products for surgical scrubs?
Liquid or foam soaps that are used in conjunction with water and dry scrub brushes/sponges
26
What is the most common antimicrobial agent in soaps?
CHG (chlorhexidine gluconate), iodopher or PCMX (parachlorometaxylenol)
27
What is a common component of antimicrobial agents?
They are very drying and with repeated scrubbing can cause skin damage
28
What are impregnated scrub brushes/sponges?
Scrub brushes/sponges that are preloaded with CHG, iodophor or PCMX and are water-aided
29
What aseptic techniques should non-scrubbed personnel follow during surgical procedures?
- remove rings, watches and bracelets
- wear long sleeved clean scrub suit
- wear clean surgical cap or hood that covers hair
- wear closed shoes
- wear masks covering mouth and nose
- Stay at the periphery of the OT
30
What is the surgical scrub procedure?
- Make sure all cleaning supplies are available
- remove all jewelry, including watches
- Wash hands and arms with antiseptic soap
- Scrub the side of each finger, between the fingers and back and front of hand for 3 minutes
- Scrub the arm with the hands higher than the elbows 3 inches for 1 minutes
- Repeat the process on the other hand and arm
- Dry hands with sterile towel
31
What is the order the hands should be washed as part of the surgical scrub procedure?
1. Palm to palm
2. Right palm over the left dorsum and left palm over the right dorsum
3. Palm to palm fingers interlaced
4. Backs of fingers to opposing palms with fingers interlocked
5. Rotational rubbing of right thumb clasped in left and vice versa
6. Rotational rubbing, backwards and forwards with clasped fingers of right hand in left palm and vice versa
32
When is surgical gowning and gloving done?
After surgical scrubbing
33
What are two methods of gowning?
- Self gowning
- Gowning another
34
What are two methods of gloving?
- Self gloving
- Gloving another
35
What do sterile gowning and gloving focus on?
Surgical asepsis
36
How is self gowning done?
1. Dry hands
2. Pick up gown
3. Let gown unfold
4. Open to locate sleeve/arm holes
5. Slip arms into sleeves
6. Hold arms out and slightly up
7. have circulator pull gown on
37
What are the two methods for self gloving?
Open and closed gloving method
38
What are the open gloving method steps?
- Grab one glove by the unsterile cuff, open it up and pull it on the hand by pulling the cuff
- Grab the second glove by the sterile fingers and slip onto hand
- Put sterile hand on sterile side of the cuff and unfurl down second hand
39
What are the closed gloving method steps?
- Grab one glove with hand inside sleeve of sterile gown
- Spread the glove over the entire hand and pull the sleeve to get the glove over the fingers
- Repeat steps above on second hand only touching sterile parts
40
What are the principles of sterile techniques?
- Only sterile items are used in the sterile fields
- Sterile fields must be continually monitored
- Sterile field created as close to the time of use as possible
- Sterile person should avoid unsterile items
- Anything below the level of the table or waist is considered unsteril
41
If the sterility of an object is in doubt what should be done?
It should be considered unsterile and removed, replaced or covered
42
What part of the gown are considered sterile?
One the sleeves and front from the waist up
43
What part of the gown are considered unsterile?
Back of the gown and area below the waist
44
How must persons in sterile gowns pass each other?
Back to back
45
What does the sterile field include?
The patient, table, anything covered with a sterile drape and personnel wearing sterile attire
46
What is the sterile corridor?
The area in the OR between the patient drape and the instrument area
47
What should be avoided in the sterile area?
Passing anything over a sterile corridor
48
What are some sterile responsibilities of a radiographer?
- Sterile dressing changes
- Tracheotomies
- Chest tubes
- Urinary catheters
- IV and IA lines
- Pacemakers
- Operating room radiography
49
How should all patient dressing should be treated?
As if they are infected
50
What techniques should be used when removing, applying and disposing of dressing materials?
Sterile techniques
51
What is purulent?
Pertaining to pus
52
What is a tracheostomy?
A surgical incision into the trachea to provide an airway
53
How is suction used in tracheostomy?
To remove secretions
54
Who typically performs tracheostomy suctioning?
By the nurse, but the radiographer should be able to respond in an emergency to assist
55
What is auscultation?
The process of listening to sounds produced within the body
56
What is a stoma?
An opening into the body from the outside created by a surgeon
57
What is a stethescope?
An instrument used to transmit low-volume sounds such as a heartbeat tot he ear of the listener
58
What are chest tubes?
Tubes introduced into the pleural space under sterile conditions to remove air and/or fluid from the pleural space
59
What do insertion sites for chest tubes depend on?
The intrapleural substance that needs to be removed
60
Where are chest tubes draining fluid usually placed?
Into the fifth to sixth intercostal space
61
What are the parts of a chest drainage system?
- Collection chamber
- Water seal chamber
- Suction control chamber
- Optional 4th chamber
- Water seal
62
What is the purpose of the collection chamber?
Collects fluids from the lungs
63
What is the purpose of the water seal chamber?
Contains water and prevents air from entering the cavity from the outside
64
What is the purpose of the suction control chamber?
Contains water to regulate the amount of suction that removes unwanted air and fluid
65
What is the purpose of the water seal?
To prevent the pressure buildup
66
Where must chest drainage systems always be kept?
Below the level of the patient's chest
67
What care should the RT take when x-raying chest tubes?
- Careful not to disturb the tube
- Never clamp or cause kinks in the tubing
- Careful not to pull on the tube to dislodge it
68
When are CXRs taken for chest tubes?
Before, during and after insertion of a chest drainage tube
69
Why are CXRs taken for chest drainage systems?
To evaluate placement and to assess the progress of the removal of air or fluids
70
What is Atelectasis?
Collapsed lung
71
What is hemothorax?
Blood in the pleural space
72
What is Pneumothorax?
Accumulation of air or gas in the pleural space
73
What is pneumonia?
An infection that inflames the air sacs in one or both the lungs
74
What is a catheter?
A tube for injecting or removing fluids
75
What is a indwelling catheter?
A catheter that remains in place
76
What is a foley catheter?
Catheter that remains in the bladder by a balloon inflated with air or water
77
What is a straight catheter?
A straight catheter that does not contain a balloon for inflation
78
Where is an indwelling catheter placed?
Tip of the catheter is in the urinary bladder, tubing taped to the inside of the leg and end attached to a drainage bag
79
What system of sizing are used for catheters?
French system
80
What are the sizing of catheters?
2.6 to 5.9 mm (8 Fr to 20 Fr)
81
What are the purposes of urinary catheters?
- empty the bladder
- bypass obstruction
- relieve the retention of urine
- irrigate the bladder and introduce drugs
- allow accurate measuring of urine output
- relieve incontinence
82
What is urinary catheterization?
A flexible, hollow tube that's passed through the urethra into the bladder
83
Where must the urine collection bag remain?
Lower than the patient's bladder to prevent the reflux of urine back into the bladder
84
What are the purposes of a foley catheter?
- Bladder emptying
- Relieve bladder retention
- Irrigate bladder
- Introduce drugs into the bladder
- Permit accurate measurement of urine output
- Relieve incontinence
85
What is voiding cystourethrogram?
A radiographic procedure that visualizes the bladder and urethra before, during and after voiding
86
What is used in VCUG?
A contrast material introduced via the catheter
87
What does a VCUG reveal?
An abnormality of the bladder that causes a reflux of urine back towards the kidneys
88
What are the two types of IV/intra-arterial lines?
-central venous lines
- arterial lines
89
What are CV lines?
Open lines inserter into a large vein for the purpose of allowing easy access to the circulatory system on a continuing basis
90
What are CV lines used for?
- Administration of chemo drugs
- Provide parenteral nutrition
- Administer long term drugs
- Manage fluid volume
- Drawing of blood and blood transfusion
- Monitor cardiac pressure
91
What are common types of central venous lines?
- Swan Ganz
- Intracath
- Hickman
- Broviac
- Arrow-Howes triple lumen
- PIC (peripheral inserted)
92
What are arterial lines?
Used for removing or drawing blood and allowing a constant measurement of blood pressure
93
What are common arterial lines?
- Radial arterial lines
- Femoral arterial lines
94
What images are taken to check the placement of IV lines?
CXR, portable CXR and fluoroscopy
95
What position are patient placed in when lines are placed?
Trendelenburg
96
What is the Trendelenburg position?
Patient position in which the patient lies supine and the head is 30-40 degrees lower than the feet
97
What are pacemakers?
Electromechanical devices that are inserted under the patient's skin to regulate heart rate
98
What patients are typically candidates for pacemakers?
Patients with symptomatic bradycardia
99
How does a pacemaker work to relieve bradycardia?
By sensing heartbeats of the patient and pacing the heart when it does not initiate a beat on its own
100
What are C-arm radiographic units?
A specific type of portable x-ray unit that is able to rotate 360 degrees around a patient
101
What are C-arms routinely used for?
In the OR for hip pinning procedures and pacemaker insertions
102
What is angiography?
Radiographic procedures used to visualize blood vessels after the introduction of contrast material
103
What is Arthrography?
Examination of a joint using x-rays after the injection of opaque contrast material
104
What is Hysterosalpingography?
An x-ray procedure that uses a contrast dye to image the inside of the uterus and fallopian tubes
105
What is the Lithotomy Position?
Common position used for surgical and medical procedures where the patient is in dorsal decubitus position with the hips and knees flexed and thighs abducted and externally rotated
106
What is a neonate?
A newborn baby up to 1 month old
107
What is PICU?
Pediatric Intensive Care Unit
108
What is VCUG?
Voiding Cystourethrography
