EXAM 1: Lecture 3 - surgical attire and surgical suite Flashcards
what is clean vs contaminated
clean = free of obvious dirt, debris, etc
contaminated = dirty
what is asepsis
removal of pathogenic organisms
what is sterile
removal of ALL microorganisms +/- spores
what are the 3 barriers of infection
environmental, surgical staff, and patient
what is included in the environmental barrier
surgical suite (OR) and equipment/instruments
what is included in the surgical saff barrier
surgeon and ancillary staff
what is included in the patient barrier
draping and skin prep
do all of the people in the OR contribute to contamination potential?
yes!!
T/F: increased particles/people in the OR increases the potential contamination
true
what is the primary source of contamination from the surgeon
skin debris!
what is the surgical attire
scrubs, gowns, head covers, face masks, foot covers, and gloves
what is the first barrier against shedding skin debris from humans
scrubs!!!
why is having a tank top on or tucking your scrub top in important
it is a continuous barrier from skin
what is the second barrier against shedding skin
surgical gowns
are surgical gowns sterile
yes!!!
what are the 2 types of surgical gowns
disposable and reusable
where is the sterile area when you are in your gown
above the waist and below the shoulders
should gowns be water resistant
yes! But also comfortable and breathable
why do we need head covers
because hair is a major source of bacteria
what extra layer should men make sure they wear for surgery
a hood or beard cover
other than gowns and caps, what is important to have on when doing surgery
face masks!
are face masks an effective bacterial filter
no they are not! They just redirect airflow away from surgical site
T/F: You do not need to always wear a mask in the OR once sterile prep is started
false! You always need to
are foot covers useful in equine surgery
not really
when is double gloving common
in large animal surgery when draping or ortho sx
what are the difference between ortho gloves and normal sterile gloves
ortho gloves are thicker
why are surgeons hands considered dirty in general???
they handle contaminated wounds, dirty animals, have irritation from scrub, and can have debris under nails
what are the goals of scrubbing
remove dirt/oil, remove/kill transient organisms, reduce resident population of bacteria
what happens if you over scrub/damage your hands
you can lead to rebound bacterial overgrowth
What is the goal of hand disinfection
reduction of ALL bacteria including normal/transient/infectious flora
what are the two types of aqueous scrubs for hands
chlorhexidine gluconate and povidone-iodine
describe the “features” of chlorhexidine gluconate
immediately bactericidal, residual activity, and potentially inactivated via soap/hand cream
what are the “features” of povidone-iodine
possible better activity versus resistant bacteria, poor residual activity, and can cause skin irritation in some people
what are the types of alcohol-based rubs
ethanol, isopropanol, or n-propanol
describe alcohol-based rubs
60-80% alcohol for effectiveness, rapid and immediate, often used with another antiseptic like chlorhexidine
what are the disadvantages of scrub followed by alcohol-based rub
does not further reduce flora, scrub may decrease the efficacy, and scrubs make increase risk of dermatitis
explain the process of hand disinfection/scrubbing
wash hands like normal first, clean under nails, scrub with the brush from tips of fingers to the elbows
what part of your hand is considered the most clean
fingertips
how long should you scrub for
2-5 mins depending on the antiseptic
what is the attire for “dirty” surgery
sterile gloves only
describe the surgical attire for field surgery
varies, usually no hat or mask, gown over coveralls with gloves, coveralls with sterile sleeves and gloves
why should you keep traffic minimal for in/out of the OR
you want to keep the doors closed to keep the “sterile” air in
what are the difference between clean and dirty ORs
clean - usually used in orthopedic procedures/anything that uses implants
dirty - usually abdominal surgery or anything that does not require implants
what is the best temperature and humidity for an OR
68-73 degrees with 30-60% humidity
what is the IDEAL airflow for surgical ORs
laminar air filtering system through a HEPA filter which reduces bacterial counts significantly
what is the ideal staffing for an OR
minimum of 3 people (surgeon, tech, anesthetists)
what does an OR supervisor do
order, stock items, surgery log, controlled substances
