EXAM 1: Lecture 3 - surgical attire and surgical suite

Question 1

what is clean vs contaminated

Answer 1

clean = free of obvious dirt, debris, etc

contaminated = dirty

Question 2

what is asepsis

Answer 2

removal of pathogenic organisms

Question 3

what is sterile

Answer 3

removal of ALL microorganisms +/- spores

Question 4

what are the 3 barriers of infection

Answer 4

environmental, surgical staff, and patient

Question 5

what is included in the environmental barrier

Answer 5

surgical suite (OR) and equipment/instruments

Question 6

what is included in the surgical saff barrier

Answer 6

surgeon and ancillary staff

Question 7

what is included in the patient barrier

Answer 7

draping and skin prep

Question 8

do all of the people in the OR contribute to contamination potential?

Answer 8

yes!!

Question 9

T/F: increased particles/people in the OR increases the potential contamination

Answer 9

true

Question 10

what is the primary source of contamination from the surgeon

Answer 10

skin debris!

Question 11

what is the surgical attire

Answer 11

scrubs, gowns, head covers, face masks, foot covers, and gloves

Question 12

what is the first barrier against shedding skin debris from humans

Answer 12

scrubs!!!

Question 13

why is having a tank top on or tucking your scrub top in important

Answer 13

it is a continuous barrier from skin

Question 14

what is the second barrier against shedding skin

Answer 14

surgical gowns

Question 15

are surgical gowns sterile

Answer 15

yes!!!

Question 16

what are the 2 types of surgical gowns

Answer 16

disposable and reusable

Question 17

where is the sterile area when you are in your gown

Answer 17

above the waist and below the shoulders

Question 18

should gowns be water resistant

Answer 18

yes! But also comfortable and breathable

Question 19

why do we need head covers

Answer 19

because hair is a major source of bacteria

Question 20

what extra layer should men make sure they wear for surgery

Answer 20

a hood or beard cover

Question 21

other than gowns and caps, what is important to have on when doing surgery

Answer 21

face masks!

Question 22

are face masks an effective bacterial filter

Answer 22

no they are not! They just redirect airflow away from surgical site

Question 23

T/F: You do not need to always wear a mask in the OR once sterile prep is started

Answer 23

false! You always need to

Question 24

are foot covers useful in equine surgery

Answer 24

not really

Question 25

when is double gloving common

Answer 25

in large animal surgery when draping or ortho sx

Question 26

what are the difference between ortho gloves and normal sterile gloves

Answer 26

ortho gloves are thicker

Question 27

why are surgeons hands considered dirty in general???

Answer 27

they handle contaminated wounds, dirty animals, have irritation from scrub, and can have debris under nails

Question 28

what are the goals of scrubbing

Answer 28

remove dirt/oil, remove/kill transient organisms, reduce resident population of bacteria

Question 29

what happens if you over scrub/damage your hands

Answer 29

you can lead to rebound bacterial overgrowth

Question 30

What is the goal of hand disinfection

Answer 30

reduction of ALL bacteria including normal/transient/infectious flora

Question 31

what are the two types of aqueous scrubs for hands

Answer 31

chlorhexidine gluconate and povidone-iodine

Question 32

describe the “features” of chlorhexidine gluconate

Answer 32

immediately bactericidal, residual activity, and potentially inactivated via soap/hand cream

Question 33

what are the “features” of povidone-iodine

Answer 33

possible better activity versus resistant bacteria, poor residual activity, and can cause skin irritation in some people

Question 34

what are the types of alcohol-based rubs

Answer 34

ethanol, isopropanol, or n-propanol

Question 35

describe alcohol-based rubs

Answer 35

60-80% alcohol for effectiveness, rapid and immediate, often used with another antiseptic like chlorhexidine

Question 36

what are the disadvantages of scrub followed by alcohol-based rub

Answer 36

does not further reduce flora, scrub may decrease the efficacy, and scrubs make increase risk of dermatitis

Question 37

explain the process of hand disinfection/scrubbing

Answer 37

wash hands like normal first, clean under nails, scrub with the brush from tips of fingers to the elbows

Question 38

what part of your hand is considered the most clean

Answer 38

fingertips

Question 39

how long should you scrub for

Answer 39

2-5 mins depending on the antiseptic

Question 40

what is the attire for “dirty” surgery

Answer 40

sterile gloves only

Question 41

describe the surgical attire for field surgery

Answer 41

varies, usually no hat or mask, gown over coveralls with gloves, coveralls with sterile sleeves and gloves

Question 42

why should you keep traffic minimal for in/out of the OR

Answer 42

you want to keep the doors closed to keep the “sterile” air in

Question 43

what are the difference between clean and dirty ORs

Answer 43

clean - usually used in orthopedic procedures/anything that uses implants

dirty - usually abdominal surgery or anything that does not require implants

Question 44

what is the best temperature and humidity for an OR

Answer 44

68-73 degrees with 30-60% humidity

Question 45

what is the IDEAL airflow for surgical ORs

Answer 45

laminar air filtering system through a HEPA filter which reduces bacterial counts significantly

Question 46

what is the ideal staffing for an OR

Answer 46

minimum of 3 people (surgeon, tech, anesthetists)

Question 47

what does an OR supervisor do

Answer 47

order, stock items, surgery log, controlled substances