Clinical Skills Year 1 Flashcards
What is the weakest part of any suture line?
The knot
What is a throw?
Wrapping ends of suture around each other and tightening each end
What is a square knot?
2 throws, will unwrap if tension applied
What is a secure square knot?
minimum of 4 throws
What is a tail or end?
the cut ends of suture
What is a surgeons knot?
A surgeon’s throw with secure square knot on top
What is a surgeons throw?
long strand of suture is wrapped around needle holder TWICE in the first throw
When is a surgeon’s knot used?
When 1st throw loosens before the second throw can be placed to secure knot
Why is an additional throw required with surgeons knot?
because it is more difficult to tighten the knot with the double wrap
What is a granny knot?
when knot is finished, its ends form cross to the suture bite (BAD)
What is a half hitch?
Square knot where 1 strand stands straight up & the other is flat
What causes half hitching?
1 end is pulled harder or in higher direction than the other
How to avoid granny knots?
place needle holders on incision & wrap suture around them
How to avoid half hitching?
keep hands close to tissue & apply equal tension to each end when tightening
What causes a granny knot?
Wrapping suture from outside center of knot or not alternating steps when performing hand ties
Why do we not use a surgeon’s knot all the time?
It causes an increased tissue reaction due to being a bigger knot
When do we use a simple interrupted suture pattern?
Used for skin closure or in various tissues when careful apposition of incision edges are desired
What is the cruciate suture pattern used for?
Commonly used for skin closure
Which suture patterns are used infrequently on skin when tension is present?
Horizontal mattress pattern, vertical mattress pattern, Ford interlocking
Which suture patterns do you start in backhand position?
Vertical mattress, Utrecht
What are the near bites in near far patterns for?
They improve skin apposition
What are the far bites for in near far patterns?
They manage tension present in the skin
Why is handwashing important?
To prevent spread of microorganisms to patient & prevent acquiring an infection from your patient
What is the number 1 factor in preventing hospital acquired infections?
Washing your hands
When do we wash our hands?
- When hands are visibly dirty
- Before patient contact
- After patient contact
- After handling pet food/treats, animal wastes, contaminated surfaces
- Before donning gloves for an invasive procedure (ex: IV catheters)
- After removing gloves
When do we use handrubs instead of handwashing?
When handwashing isn’t an option or when you want to avoid excess drying of skin from soap
Why is healthy skin important?
Prevents colonization with microorganisms that are not normal residents of your skin
How long should handwashing take?
At least 20 seconds
What is the recommended alcoholic volume of a handrub solution?
At least 60% alcohol
Why do we don non-sterile gloves?
To reduce risk of spreading microorganisms from your hands to the patient & to reduce risk of acquiring and infection from your patient
When do we don non-sterile gloves?
If there is risk of contact with blood, wounds, bodily fluids, or invasive devices (IV catheter)
When do we don sterile gloves?
Invasive procedures like catheters/tubes, open wound management, & minor surgeries
What does K mean?
Kilo (1000)
What does h mean?
Hecto (100)
What does dk mean?
Deka (10)
What does d mean?
Deci (0.1)
What does c mean?
Centi (0.01)
What does m mean?
Milli (0.001)
What does µ mean?
Micro (0.000001)
What should you do while performing all rapid emergency panel tests?
Wear non-sterile gloves
What is PCV?
Packed cell volume; rapid estimate of the red cell component of blood
How full do you fill microhematocrit tubes?
3/4 full
How long do you spin microhematocrit/PCV tubes for?
3-5 mins
How do you line up a PCV tube?
Top of clay plug with bottom line (0), then move it until the top of the plasma line lines up with the 100 line, then read top of red fluid line (this is the PCV)