Establishing A Sterile Field

Question 1

Types of Scrub solutions

Answer 1

–Chlorhexidine gluconate (Hibiclens)
•Used for scrubbing and skin prep

–Hexachlorophene
•Neurotoxic – not for routine use

–Povidone – iodine
•Used primarily as skin prep; irritating to the skin

–Iodophors
•Less irritating than iodine

–Alcohols
•Causes dryness and flammable

Question 2

Counted method & Times Scrub

Answer 2

–Requires a measured number of brush strokes for each anatomical area scrubbed; Finger tips are 30 the rest are10
–Dictated by the facility policy

-Hands & arms are scrubbed for a prescribed length time
- Most commonly the first scrub of the day is 10 minutes
- Subsequent scrubs are 5 minutes

Question 3

Initial Count

Answer 3

•Counted in the same order for every procedure
•State the name of the item
•Separate each item and visualize
•Each item is counted verbally while visualizing
•Number of each item is recorded by the circulator

Question 4

When to Count

Answer 4

•Opening
•Additional items are placed
•Team changes
•1st closing count
•2nd closing count
•Final count

Question 5

Counts

Answer 5

•Counting Sponges
–All sponges in the back table should be counted
–Be aware of the packaging
–Incorrect packages should be removed from the back table

•Counting sharps
–Needles are counted by the pictures on the packet
–Sharp counts include:
•Hypos
•Blades
•Cautery tips

•Instruments
–Counted as soon as it is opened

Question 6

Types of Drapes

Answer 6

•Mayo cover
–For the mayo stand
–Sterile all around except the part that extends below the table level

•Towels
–Used to outline the operative site
–4 towels are used
–2 inch folded cuffed edge
–Placement
•1st towel placed at the side of the patient nearest the individual applying
•2nd and 3rd – superiorly and inferiorly
•4th – opposite the 1st

•Fenestrated drapes
–Fenestrations or windows designed for exposure of the surgical field
–Ex laparotomy drape

•Split drapes
–Plain sheets with a slit in the middle
–Used for extremity
•Incise drapes
–Adhesive backing
–Impregnated with antiseptic solution

Question 7

Done prior to draping

Answer 7

• Patient is anesthetized
• Foley catheter inserted as necessary
• Positioning is performed
• Dispersive electrode for ESU is applied if needed
• Patient skin prep completed
• Drapes are applied

Question 8

–Chlorhexidine gluconate (Hibiclens)

Answer 8

• Used for scrubbing and skin prep

Question 9

–Hexachlorophene

Answer 9

• Neurotoxic – not for routine use

Question 10

–Povidone – iodine

Answer 10

• Used primarily as skin prep; irritating to the skin

Question 11

–Iodophors

Answer 11

• Less irritating than iodine

Question 12

–Alcohols

Answer 12

• Causes dryness and flammable