Medical And Surgical Aspesis Flashcards
Medical Asepsis and microbial dilution
Deals with reducing the probability of infectious organisms being transmitted to a susceptible individual
-> reducing the total number of organisms is called microbial dilution
3 Levels of Microbial Dilution
Simple cleanliness - proper cleaning, dusting, linen handling, and hand hygiene
Disinfection - the destruction of pathogens by using chemical materials
Sterilization - involves treating items with heat, gas, or chemicals to make them germ free
Antiseptic vs. Disinfectant
Antiseptic - a substance that tends to inhibit the growth and reproduction of microorganisms
Disinfectant - liquid chemical applied to objects to eliminate many or all pathogenic microorganisms
Disinfection is used to clean
Surfaces that cannot be sterilized; tables, floors, walls, and any equipment
Surgical Asepsis
The complete destruction of all organisms and spores from equipment used to perform patient care procedures
Sterile Conscience
Refers to the awareness of sterile techniques and the responsibility for telling the person in charge whenever you contaminate a field or observe the contamination by someone else
Sterile corridor
The area b/w the patient drape and instrument table is maintained as a sterile corridor
Access to this area is limited and permitted to only those wearing sterile attire (radiographer is excluded from here)
Head of the table is not included in the sterile field
Operating Room Rules
- doors must be kept closed during surgical procedures
- only persons directly involved in the procedure may be present
- most not work in OR with open wound or acute infection as that increases the potential for infecting the patient
- must constantly be aware of sterile and non sterile items
- if a sterile items is contaminated it must be replace by a sterile one
3 Zones of the OR Environment
Unrestricted zone - person may enter in street clothing (change room)
Semi-restricted zone - only persons dressed in scrub clothing with hair and shoe coverings on may enter (outer corridor)
Restricted zone - only persons wearing scrub suits, hair coverings, shoe coverings, and masks are allowed
what is a Sterile Field and how do we prepare it
A microorganism free area prepared for the use of sterile supplies and equipment
Can be established using a sterile drape
First step in preparing a sterile field is to confirm the sterility of package supplies and equipment
Packages must be clean and dry to be considered sterile
Inspect the sterile packages for any rips and check the expiration dates
Moving Supples within a sterile field
Never reach across the sterile field
When a radiographer must manipulate the sterile field sterile transfer forceps must be used
Keep the forceps above your waist in sight at all times
After use put them with handles facing out so you don’t disrupt the sterile field
In the event a procedure is postponed what do you do the sterile field
Cover it immediately with a sterile drape
Airborne contamination is just as serious as a break in sterile techniques
Sterile package criteria
They are clean, dry, and unopened
Their expiration date has not been exceeded
Their sterility indicators have changed to a predetermined colour confirming sterilization
Sterile indicators
Are placed inside and outside of each package to be sterilized
When the indicator changes colour it is proof that the contents of the pack have been exposed to the sterilization method sufficiently to change the colour to the indicator
Chemical indicators or biologic indicators
Chemical Sterilization
Involves the Emerson and soaking of objects in a bath of germicidal solution followed by a sterile water rinse
Disadvantage - difficult to control accurately not often used
Advantages - used if objects can’t go into autoclave or gas, effective at destroying microorganisms but will not kill spores
Dry Heat
Such as that in an oven
Advantage - required to sterilize some sharp instruments, certain powders and greasy substances
Disadvantage - time varies from 1-6 hours, temp range of 329-338 degrees Fahrenheit, not commonly used
Conventional Gas
Used for items that would be damaged by high temperatures are usually sterilized with a mixture of gases
Advantage - used primarily for electrical, plastic, rubber items,and optical water
Disadvantages - gases are poisonous and must be dissipated by means of
Packing and Storing Sterile Supplies
- items must be covered completely by the wrapper and security fastened with tape or heat seal that can’t be reused
- contents must be identifiable and evidence of exposure to the sterilization agents must be present
- sterile items are to be stored in the same place, separate from non sterile items
- are must be clean, dust free, vermin free and draft free
- items that have been sterilized in the hospital and stored in a closed cupboard are considered sterile for 30 days
- on an open shelf they are considered sterile for 21 days
- items sealed in plastic bags immediately after sterilization are considered sterile for 6-12 months
Sterile Packing Criteria
Packages must be:
- clean, dry and unexposed
- the expiration date has not been exceeded
- their sterility indicators have changed to a predetermined colour, confirming sterilization
Purpose of a surgical scrub
Remove as many microorganisms as possible from the skin of the hands and lower arms by mechanical and chemical means
How to do a surgical scrub
Change into scrub suit, put on shoe covers, and put on a mask
Make sure your arms are bare to at least 2 inches above the elbow
Put on surgical hat or hood to cover beard
Remove all jewelry
Inspect finger nails and areas around hands to ensure good condition
If necessary don gown before beginning scrub
Wash hands thoroughly and then wash from a clean area to unclean (hands - elbows)
Gas Plasma Technology
Safer method of sterilizing heat and moisture safe items
No toxic fumes, residues, byproducts or residues, and no handling of chemicals
Uses very low heat and moisture
Effectively kills both microorganisms and spores
Cannot sterilize instruments that have long, narrow, lumina
Is can not be used for powders, liquids, or any cellulose materials such as paper, cotton, linen or muslin
Used for: endoscopes, fibre optic devices, microsurgical instruments, and powered instruments
Autoclaving
A device that provides steam sterilization under pressure
Most commonly used sterilization method
Cheap, quick, and most convenient for items that can withstand heat and moisture
Uses very high temperatures 250-275
Indication of sterilization by tape indicator
Skin preparation
2 methods
Mechanical - may include removal of hair and always a friction scrub with antiseptic soap and water, the scrub is sterile and the person performing it must also be
Chemical - performed after the mechanical skin prep, skin around the the area to be penetrated is often pained with antiseptic solution to destroy remaining microbes and acts as a deterrent for further microbial growth, start in small circle and work outwards when wiping
