Aspesis

Question 1

What is the difference between asepsis and antisepsis?

Answer 1

Asepsis— prevent/minimize wound contamination by destroying organisms before they enter the wound

Antisepsis - killing of bacteria father they have entered the wound

Question 2

Difference between disinfection and sterilization?

Answer 2

Disinfection — use of germicidal substances to kill most microorganisms

Sterilization — process of destroying all microorganisms (bacterial, fungal, and spores)

Question 3

How do you prepare a patient for surgery?

Answer 3

+/- bath 24hours pre-op
Clip hair
Vacuum loose hair
Primary (rough) scrub to remove dirt and debris

Question 4

How do you sterile prep the surgical site ?

Answer 4

Scrub technique must prevent contamination of prep material

Germicidal soap scrub 
Circular motion from the site to periphery 
Scrub  GENTLY 
5 minute contact time 
Final prep solution

Question 5

What is the primary source of bacteria during surgery?

Answer 5

YOU

More people + more activity = more bacteria

Question 6

4% chlorhexidine and 15% povidone iodine both proved 70-80% bacterial reduction. In with which solution does regrowth occur more rapidly?

Answer 6

Povidone iodine

Question 7

How much contact time do you require when you scrub?

Answer 7

3-5mins

Question 8

T/F: open gloving is preferred to closed gloving because there is much less risk of breaking aseptic technique

Answer 8

False

Closed gloving is preferred

Question 9

Anyone scrubbed should keep their hands between the level of _________________________ to maintain sterile technquie

Answer 9

Waist and axillae

Question 10

When placing quarter drapes, ideally the surgeon should stay a minimum of _____ “ form the edges of the operating table

Answer 10

12

Question 11

T/F: the top drape should cover the entire instrument table

Answer 11

True

Question 12

This this a break is aseptic technique or a beak in asepsis?

Raising your ands above shoulders

Answer 12

Break in aseptic technique

Question 13

This this a break is aseptic technique or a beak in asepsis?

Raising your hand and touching your mask

Answer 13

Break in asepsis

Question 14

What are the physical sterilization methods?

Answer 14

Thermal energy
Filtration - liquids (eg millipore filter)
Radiation
-gamma radiation

Question 15

What are the chemical sterilization methods?

Answer 15

Plasma
Ethylene oxide
Disinfectants

Question 16

What is the most common method of sterilization?

Answer 16

Steam (autoclaving)
-saturated steam heat under pressure

Destruction/desaturation of cellular proteins

Question 17

What are disadvantages of steam sterilization?

Answer 17

Cannot be used for some materials
Dulls sharp instruments
Cycling time

Pack size limitations

Question 18

How does a gas plasma sterilization work?

Answer 18

Peracetic acid vapor phase
Plasma phase
- ionized or partially ionized gas
-produced by passing electromagnetic energy through a mixture of stable gases

Fast turn around

Question 19

Why must you aerate materials sterilized by ethylene oxide?

Answer 19

Irritant
Carcinogen/teratogen

Should be aerated for 8-12hours

Question 20

What is the use of “cold” disinfectants ? What are the products used?

Answer 20

Wash and disinfect surfaces, not suitable for surgical instruments

Chlorhexidine, iodophors

Glutaraldehyde (scopes)

Question 21

When preparing a pack for sterilization, the pack should not be more than ____” thick

Answer 21

12

Question 22

What is the shelf life of a heat sealed paper/transparent plastic pouch pack?

Answer 22

1 year

Question 23

What is the shelf life of 2layer pack with nonwoven polypropylene fabric?

Answer 23

8 weeks

Question 24

What is the shelf life of a 2 layer cloth pack?

Answer 24

4 weeks

Question 25

T/F: wound lavage reduces risk of infection by removing bacteria and lose tissue fragments from the wound

Answer 25

True

Question 26

T/F: you should try to make your incision as small as possible to prevent bacterial contamination of the site

Answer 26

False

Give ample length to the incision to prevent tissue trauma

Question 27

What is intermediate delayed hemorrhage?

Answer 27

Within 24hrs of surgery

Question 28

What is secondary delayed hemorrhage ?

Answer 28

More than 24hours after surgery — usually result of ineffective ligation

Question 29

What are the consequences of hemorrhage ?

Answer 29

Obscures surgical field (technical errors)

Increase rate of infection

Hematoma formation — painful and interferes with normal wound healing

May be life threatening

Question 30

How should you deal with hemorrhage during surgery?

Answer 30

Stay calm

More bleeding can be controlled by applying pressure while deciding how to manage

• hemostatic forceps (crush vessel and stimulate clot formation
• topical hemosatic agents — scaffold to promote clot formation
  Gelfoam/surgical/hemablock

Ligature/electrocoagulation/vascular clips/primary vascular repair