Lecture 6 - Asepsis Flashcards
What is asepsis?
Absence of microorganisms that cause disease
What is aseptic technique?
Method to prevent contamination by microorganisms;
“clean” technique
What does it mean if something is sterile?
It is free of all living organisms
What is sterile technique?
Method by which contamination with microorganisms is prevented;
performed in a sterile field
What is a pathogen?
Microorganism that causes infection; can be human or animal
What is infection?
Multiplication of an agent within the tissues that results in cellular injury
What is nosocomial infection?
Infection resulting from hospital treatment;
AKA hospital-acquired infection (HAI)
What is surgical asepsis?
Procedures used to keep the object or area sterile or free of microorganisms.
What are all practices directed to eliminate?
Pathogenic and non-pathogenic microorganisms
What is the most common type of nosocomial infection?
Surgical site infection (SSI)
Surgical site contamination with _____ microorganisms per g of tissue increases risk of SSI.
> 10^5
What is often the source of SSIs?
endogenous flora
How can SSIs be diagnosed?
Will have purulent discharge, inflammation, can isolate microorganism
What are common bacteria that cause SSIs?
Staphylococcus aureus, Streptococcus, Enterobacter, Enterococcus, E. coli
Staph aureus can be found in nares of _____ healthy humans.
20-30%
What are the 3 types of SSIs?
- Superficial incisional SSI
- Deep incisional SSI
- Organ/Space SSI
During what time period can superficional incisional SSIs develop?
Within 30 days of sx
What tissues do superficial incisional SSIs affect?
Skin/SQ
What signs are seen with superficial incisional SSIs?
Purulent drainage, culture, inflammation
During what time period can deep incisional SSIs develop?
Within 30 days of sx; within 1 year with implant
What tissues do deep incisional SSIs affect?
Deep tissue (fascia/muscle)
What signs are seen with deep incisional SSIs?
Purulent drainage, abscess, fever/pain
During what time period can organ/space SSIs develop?
Within 30 days of sx; within 1 year with implant
What tissues do organ/space SSIs affect?
organ or space
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?
- 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?
- Regular hand washing
- Gloves
- Cleaning between patients
- Containment of contamination
- Proper equiment storage and routine cleaning
- Laundry
- Regular hospital cleaning
- Ventilation and air conditioning systems
- Decreasing traffic
- 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?
- Sterilization
- High level disinfection
- Low level disinfection
- Antisepsis
- 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
