Intro to the OR Lecture Powerpoint

Question 1

Protective eyewear in the OR

Answer 1

Safety glasses or other eye coverings that cover the sides must be worn in all cases, personal glasses are not enough

Question 2

Clothing attire in pre-op and pacu areas vs OR hallway

Answer 2

White coat, do not need hat, mask, or shoe covers vs leave white coat in locker room and have hat, mask (never rest it around neck), shoe covers, safety glasses, scrubs provided by hospital, and masks by time entering operating room

Question 3

Sterility

Answer 3

Degree of acceptable contamination or bioburden of an object at a given point in time, when achieved, a break in technique results in contamination, with the item or surface being declared unsterile, no lesser level on the sterility continuum is acceptable, except when all items in contact with tissues below skin or mucus membranes should be sterile, some surfaces cannot be sterilized such as skin but surgical clean is acceptable, and contamination should be limited except when no other alternatives

Question 4

3 basic principles of aseptic technique

Answer 4

• Sterile field is created for each surgical procedure
• Sterile team members are properly prepared and attired prior to entering the sterile field
• movement in and around the sterile field must not compromise the sterile field

Question 5

Principle applications of sterile technique (9)

Answer 5

• sterile personnel keep well within the field, do not wander or leave field
• movement is kept to a minimum not to disrupt air currents
• nonsterile persons do not reach over the sterile surfaces
• sterile team members must face each other and the field at all times, can pass each other back to back using rolling method, do NOT turn back to sterile field
• Nonsterile items are not used within sterile field, if one item is contaminated, any item coming in contact with that item is also contaminated
• gowns are sterile in the front from axillary line to the waist, and the sleeves to three inches below the elbow
• when in doubt assume breach in sterility
• sterile tables are kept at sterile height
• gown cuffs at the wrist is unsterile and must be covered by gloves at all times

Question 6

Scrubbing technique (8)

Answer 6

• 5-10 min
• remove gross contamination from nails
• begin at fingers using betadine
• cover all surfaces working gradually toward elbows
• rinse from distal to proximal***
• hold arms with hands pointing up
• enter OR without touching anything
• dry with sterile towel, hold away from body

Question 7

Wet scrub vs dry scrub

Answer 7

A wet scrub is always done as the first scrub of the day, vs a dry scrub can be done for consecutive and involves using a hand sanitizer scrubbing up to the elbows and then no towel to dry

Question 8

OR timeline (7)

Answer 8

• Patient arrives in holding area/pre-op
• identification verified
• documentation checked
• anethesia IV starts as well as pre op meds
• patient physically moved to OR bed
• positioned for anesthesia administration
• positioned for surgical intervention

Question 9

Sterile to unsterile pathway

Answer 9

• sterile
• surgically clean
• clean
• contaminated
• unsterile

Question 10

Kelly hemostat function

Answer 10

Arterovenous clamp used to control local bleeding, crushes tissue

Question 11

Halstead Mosquito hemostat function

Answer 11

Arterovenous clamp used to control local bleeding that has delicate jaws for delicate tissue

Question 12

Babcock clamp function

Answer 12

Grasping the bowel

Question 13

Allis clamp function

Answer 13

Skin or bowel cut edges

Question 14

Glassman clamp function

Answer 14

Clamp large areas of intestine to prevent spilling out

Question 15

Adson forceps function

Answer 15

Used for delicate skin tissue closure

Question 16

Backus towel forceps function

Answer 16

Used to secure to the margins of the sterile field, other towels, etc, hold sponges or other prepping materials

Question 17

Straight forceps function

Answer 17

Used when handling contaminated sponges, pads, etc

Question 18

Debakey forceps function

Answer 18

Used to occlude vessels to control bleeding during aortic repairs

Question 19

Rat tooth forceps function

Answer 19

Used for grasping and lifting skin particularly edges to help place sutures to close wounds

Question 20

Russian forceps funciton

Answer 20

Used on bowel or delicate structures but not directly on bowel surfaces, used where blunt tipped pickups needed in abdomen

Question 21

Military retractor function

Answer 21

General use for multiple things

Question 22

Richardson retractor and kelly retractor function

Answer 22

Handheld retractor for general body wall

Question 23

Volkmann retractor (rake) function

Answer 23

Used for skin edge retraction and skin flap creation

Question 24

Wetlainer retractor function

Answer 24

Useful in surgeon working alone to keep wound edges open

Question 25

Deavor retractor function

Answer 25

Used in sometimes GYN surgery

Question 26

Bookwalter Universal Ring retractor function

Answer 26

Self retaining retractor used as fixed abdominal wall retraction

Question 27

Balfort retractor function

Answer 27

Self retaining retractor used to fix abdominal wall

Question 28

Ochsner ribbon retractor function

Answer 28

Malleable retractor that can also help prevent iatrogenic bowel injury by placing under while suturing

Question 29

Tips of curved scissors need to be pointed….

Answer 29

….superiorally

Question 30

Most common suction type in R

Answer 30

Yankaeur

Question 31

Poole suction

Answer 31

Multiple fenestrations used for large cavity full of fluid such as perforated viscus without sticking directly to bowel wall