Lecture 7-Surgical OR Flashcards
T/F
Masks should be worn at all times while in actual OR room
True
What is the Operating Room Attire?
- Protective eyeware
- Masks
- Caps / hairnets / hoods
- Shoe covers
- Radiation badges
- Gloves
T/F
In the OR, all hair needs to be covered including facial hair
True
Where (what zone) are Caps / hairnets / hoods worn
Worn in semi & restricted areas
What is the condition for removing boot covers?
Removed after exiting OR if clean, but before exiting OR suite if soiled
Where/how many radiation badges are worn in the OR
-2
-1 under apron (at waist) – whole body dose and 1 on thyroid collar – for fluoro techs
What type of gloves should MRT’s wear in the OR
Non-sterile
Label each area according to thier zones:
a=Zone 1
b=Zone 2
c=Zone 3
What type of restriction is zone 1?
Unrestricted
What type of restriction is zone 2?
semi-restricted
What type of restrictioin is zone 3?
restricted
What clothing can you wear in zone 1?
street clothes
What attire should you be wearing in zone 2?
dressed in OR scrubs, hair and shoes covered
(not necessarily a mask)
What attire should be worn in zone three?
-All worn in zone 2 and scrub dress and mask
T/F
In the OR, MRT’s do not scrub in.
True
What are 3 examples of non sterile workers on the surgical team?
Anesthesiologist
Circulating Nurse
RADIOGRAPHERS
What are 3 examples of sterile people working in the sugical team?
Surgeon
Surgical assistants
Certified Surgical Technologist - CST
T/F
Doubtful sterile items considered unsterile
True
Where should the sterile gown be on the body?
Over top of the OR scrubs & apron
What area of the arm needs to be cleaned for a sterile scrub?
Fingertips to 2” above elbow
What two things create an Aseptic Environment?
Medical Asepsis + Surgical Asepsis
What is the difference between medical and surgical asepsis?
-Medical is disinfecting, surgical is complete sterilization
Give some examples of surgical asepsis in this image:
Surgical tool autoclaved. Gowns, drapes, gloves. Handles on the lights.
Give some examples of medical asepsis in this image?
-C arm, the leg
What are the 3 most common Means of the Spread of Infection in the OR?
- Contaminated instruments or gloves
- Wet or damp sterile field
- Microorganisms blown onto surgical site
When should the mobile unit be disinfected for the OR?
PRIOR to entry into suite
If the C arm is above the patient, what type of bag should cover it?
COVER image intensifier with sterile bag if directly over field
If the C arm is below the patient, or in a lateral position, what type of bag should cover it?
A non sterile bag
If a mobile unit is needed in the OR, what is it covered with?
Site covered with sterile towel
Make sure to tuck your shirt in so that the shirt does not go over the sterile field with mobile equipment
In the OR, what part of a surgical bag should you hold?
The inside of the surgical bag
What is the red arrow pointing to?
The sterile cooridor
Can MRTs go in the sterile coridoor?
No; we are not sterile
T/F
Surgical table is sterile only on the surface
True
T/F
Movement under the sterile drape is not acceptable
False;Movement under the sterile drape is acceptable
What are the different directions that the C arm moves in?
- Up and down
- In and out (like cross table lateral)
- Pivot-spin it about 15 degrees either way
- Tilt (angle side to side)
- Arc-(can also extend the arm away from you)
T/F
Imaging in the OR can be Portable or mobile
True
Where is the x ray tube, and where is the II in C-arms? Why is this the best position?
Tube under the table, II above the table; less scatter to the operator, table absorbs some low radiation, II is closest to the patient
What direction of motion is this showing?
In and out motion
What direction of motion is this showing?
Pivot
What direction of motion is this showing?
Tilt
What direction of motion is this showing?
Arc
What position is this showing? How do you get the tube in this position?
Rainbow position
II needs to be on the bottom before you can extend it out this way
If we had to stand right beside the C arm where is the best spot to stand (lateral)?
If we had to stand right beside the C arm, the best side to stand on is on the II side
What is this picture demonstrating?
A compound angle
How do you image for hip pinning in the OR?
Understand the concept
-Bring C arm in as if you are going to do a cross table lateral hip
-Center to the hip on the lateral, when you move the AP the II will be further, and that is okay. Leave it at the height of the lateral
Why is the arm up during hip pinning?
centering over the hip and then flipping to lateral, so it needs to be out of the way
What surgery is being preformed here?
Hip pinning
Watch the following video on hip pinning
https://youtu.be/jdPnM8B8DTQ
What is being shown here?
HDS
Dynamic hip screw
-Going through the middle of the femoral neck
T/F
We do not have to be in OR with Bipolar surgeries
True
What is this showing?
Femur Rodding/IM Nailing
What is this showing?
Bipolar Hip repair
T/F
MRTs are only required to be in the OR for revisions when it comes to orthepedic surgeries
True
-Example; right knee on A has been revised; put in another prothesis
What are the common OR requests for Imaging?
- ORIF
- IM nailing
- External-Fixator
- Spinal imaging
- RETROGRADE UROGRAM
- CHOLANGIOGRAM
- Pacemaker insertions
What surgery is required?
External fixator needed
What is done for patients that have an allergic reaction to metal prothesis?
Have to take joint out and put in antibiotic leads
What surgery has been done here?
Artificial disc replacement
What surgery has been done here?
Lamina/discectomy/fusion surgery
What imaging has been done here?
CHOLANGIOGRAM
What imaging has been done here?
RETROGRADE UROGRAM
Should you sheild the patient in the OR?
Yes, if possible
What are the radiation protection devices used in the OR?
- Lead screen
- Lead aprons
- Thyroid collars - dosimeter on outside
- Stand as far away from patient, tube, and beam as possible (Min 3 m – right angle to patient)
What are the three aspects of radiation protection?
TIME – DISTANCE – SHIELDING
T/F
It is always safer to be at a 90 degree angle on the side of the x ray tube.
False; It is always safer to be at a 90 degree angle on the side of the Image intensifier
What image pulse rate is better for radiation protection, a 15 or 30 pulse rate?
A 15 pulse rate
Surgeons like 30 because image is smoother
In what ways should the image intensifer be positioned for optimal radiation protection?
- Image intensifier on top
- II as close to the patient as possible