Lecture 7-Surgical OR Flashcards by Josie Curley

T/F

Masks should be worn at all times while in actual OR room

True

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What is the Operating Room Attire?

Protective eyeware
Masks
Caps / hairnets / hoods
Shoe covers
Radiation badges
Gloves

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T/F

In the OR, all hair needs to be covered including facial hair

True

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Where (what zone) are Caps / hairnets / hoods worn

Worn in semi & restricted areas

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What is the condition for removing boot covers?

Removed after exiting OR if clean, but before exiting OR suite if soiled

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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

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What type of gloves should MRT’s wear in the OR

Non-sterile

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Label each area according to thier zones:

a=Zone 1
b=Zone 2
c=Zone 3

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What type of restriction is zone 1?

Unrestricted

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What type of restriction is zone 2?

semi-restricted

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What type of restrictioin is zone 3?

restricted

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What clothing can you wear in zone 1?

street clothes

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What attire should you be wearing in zone 2?

dressed in OR scrubs, hair and shoes covered

(not necessarily a mask)

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What attire should be worn in zone three?

-All worn in zone 2 and scrub dress and mask

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T/F

In the OR, MRT’s do not scrub in.

True

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What are 3 examples of non sterile workers on the surgical team?

Anesthesiologist
Circulating Nurse
RADIOGRAPHERS

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What are 3 examples of sterile people working in the sugical team?

Surgeon
Surgical assistants
Certified Surgical Technologist - CST

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T/F

Doubtful sterile items considered unsterile

True

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Where should the sterile gown be on the body?

Over top of the OR scrubs & apron

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What area of the arm needs to be cleaned for a sterile scrub?

Fingertips to 2” above elbow

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What two things create an Aseptic Environment?

Medical Asepsis + Surgical Asepsis

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What is the difference between medical and surgical asepsis?

-Medical is disinfecting, surgical is complete sterilization

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Give some examples of surgical asepsis in this image:

Surgical tool autoclaved. Gowns, drapes, gloves. Handles on the lights.

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Give some examples of medical asepsis in this image?

-C arm, the leg

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What are the 3 most common Means of the Spread of Infection in the OR?

1. Contaminated instruments or gloves 2. Wet or damp sterile field 3. 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 ## Footnote 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?

1. Up and down 2. In and out (like cross table lateral) 3. Pivot-spin it about 15 degrees either way 4. Tilt (angle side to side) 5. 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 ## Footnote -Example; right knee on A has been revised; put in another prothesis

What are the common OR requests for Imaging?

1. ORIF 2. IM nailing 3. External-Fixator 4. Spinal imaging 5. RETROGRADE UROGRAM 6. CHOLANGIOGRAM 7. 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?

1. Lead screen 2. Lead aprons 3. Thyroid collars - dosimeter on outside 4. 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 ## Footnote Surgeons like 30 because image is smoother

In what ways should the image intensifer be positioned for optimal radiation protection?

1. Image intensifier on top 2. II as close to the patient as possible