Lecture 6 - Asepsis Flashcards by Bianca Zayas

What is asepsis?

Absence of microorganisms that cause disease

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What is aseptic technique?

Method to prevent contamination by microorganisms;

“clean” technique

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What does it mean if something is sterile?

It is free of all living organisms

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What is sterile technique?

Method by which contamination with microorganisms is prevented;
performed in a sterile field

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What is a pathogen?

Microorganism that causes infection; can be human or animal

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What is infection?

Multiplication of an agent within the tissues that results in cellular injury

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What is nosocomial infection?

Infection resulting from hospital treatment;

AKA hospital-acquired infection (HAI)

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What is surgical asepsis?

Procedures used to keep the object or area sterile or free of microorganisms.

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What are all practices directed to eliminate?

Pathogenic and non-pathogenic microorganisms

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What is the most common type of nosocomial infection?

Surgical site infection (SSI)

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Surgical site contamination with _____ microorganisms per g of tissue increases risk of SSI.

> 10^5

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What is often the source of SSIs?

endogenous flora

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How can SSIs be diagnosed?

Will have purulent discharge, inflammation, can isolate microorganism

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What are common bacteria that cause SSIs?

Staphylococcus aureus, Streptococcus, Enterobacter, Enterococcus, E. coli

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Staph aureus can be found in nares of _____ healthy humans.

20-30%

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What are the 3 types of SSIs?

Superficial incisional SSI
Deep incisional SSI
Organ/Space SSI

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During what time period can superficional incisional SSIs develop?

Within 30 days of sx

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What tissues do superficial incisional SSIs affect?

Skin/SQ

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What signs are seen with superficial incisional SSIs?

Purulent drainage, culture, inflammation

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During what time period can deep incisional SSIs develop?

Within 30 days of sx; within 1 year with implant

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What tissues do deep incisional SSIs affect?

Deep tissue (fascia/muscle)

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What signs are seen with deep incisional SSIs?

Purulent drainage, abscess, fever/pain

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During what time period can organ/space SSIs develop?

Within 30 days of sx; within 1 year with implant

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What tissues do organ/space SSIs affect?

organ or space

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What signs are seen with organ/space SSIs?

Purulent drainage, abscess, fever/pain

SSIs increase _____ and _____ rates.

morbidity, mortality

SSIs occur in _____% of humans

10-15

SSIs occur in _____% of small animals.

1-18

SSIs occur in _____% of equines.

1-50

What are prophylactic antimicrobials?

Brief course of antimicrobials administered immediately before a surgical procedure.

What is the aim of prophylactic antimicrobials?

To reduce bacterial load at surgical site

What type of antimicrobial do you want to use prophylactically?

Broad spectrum, IV; | Repeat as needed if long surgery time

What are sources od microorganism transmission in human hospitals?

Hospital staff (airborne, droplet, contact), instruments, environment

What are sources of microorganism transmission in veterinary hospitals?

Contact of patients with one another, surgery (contact from skin or nasopharynx to surgical wound)

What is the cycle of infection?

organism --> reservoir --> portal of exit --> transmission --> portal of entry --> vulnerable hosts (infection) --> organism

What are 2 sources of contamination?

1. Animal to animal | 2. Fomites

How can animal to animal contamination occur?

Skin, hair, nasopharynx, orifices

What is a fomite?

Any inanimate object that can carry a pathogen

What are some examples of fomites?

Walls, floors, furniture, door handles, grooming equipment, buckets

Air particles account for _____% microbial contamination of sx wounds.

80-90

What is the goal of hospital asepsis?

To minimize infection in surgery; Decrease sources of contamination Block transmission of microorganisms

What are some ways that pathogens can be reduced?

1. Regular hand washing 2. Gloves 3. Cleaning between patients 4. Containment of contamination 5. Proper equiment storage and routine cleaning 6. Laundry 7. Regular hospital cleaning 8. Ventilation and air conditioning systems 9. Decreasing traffic 10. Isolation of patients

T/F: Packs that are wet or damaged are considered contaminated.

True

How should you cough/sneeze in the OR?

Face forwards, sneeze/cough into mask and do not touch it

Why should you limit talking in an OR?

Talking releases droplets containing bacteria

T/F: Turbulent airflow decreases contamination

False

Scrubbed personnel can only handle _____ items.

sterile

Non-scrubbed personnel can only handle _____ items.

non-sterile

Non-scrubbed personnel should not _____ or _____ the sterile field.

touch, reach over

Gowned personnel should always face _____ and towards the _____.

forward, sterile field

What parts of a gowned personnel are not sterile?

sides, below waist, back, more than 2" above elbow

What does sterilization do?

destroys all microorganisms

T/F: Sterilization destroys bacteria, viruses, and spores

True

T/F: Only objects can be sterilized (not you or assistants)

True

What does high level disinfection destroy?

most pathogens

What can be disinfected at the high level, generally?

Objects that contact the skin or MM

What objects can be disinfected at the high level?

Endoscopes, dental instruments, ET tubes

What does low level disinfection destroy?

most pathogens

What can be disinfected at the low level, generally?

Objects that contact the skin or MM

Low level disinfection applies to objects that are _____ associated with surgery.

not

What objects can be disinfected at the low level?

Laryngoscopes, ultrasound probes, stethoscopes

What does antisepsis destroy?

most pathogens

What can be cleaned antiseptically, generally?

Animate (living) objects

With antisepsis, microbes are killed during _____, but the skin is not _____.

surgical scrubbing, sterilized

What is cleaning?

Physical removal of debris

What can be used in cleaning?

Detergents, soap and water

What does cleaning do?

Removes bacteria, but does not kill or inactivate viruses/bacteria

What are the levels of asepsis from most intense to least?

1. Sterilization 2. High level disinfection 3. Low level disinfection 4. Antisepsis 5. Cleaning

What type of counter/surfaces do you want in a surgery facility?

Impervious, easy to clean

What temperature and humidity do you want the surgery facility to be?

62-68 deg F, <50% humidity

What should scrub sinks have?

stainless steel, antiseptic dispenser

What type of walls and floors should be in the OR?

Smooth, non-porous

How should air flow be in the OR?

From the OR toward corridor or adjacent areas

What type of lights should the OR have?

High intensity, low heat, no glare

What type of operating tables should the OR have?

Stainless steel, adjustable