OSCE Flashcards
Perform a normal 7 step hand wash
What are the stages of ‘scrubbing, gowning and gloving’ procedure
- Preparing to scrub
- Pre-scrub wash
- Scrubbing procedure
- Gowning
- Gloving
- Final tie
- Removing gown and gloves
What is Stage 1 of scrubbing, gowning and gloving and what does it involve
- Preparing to scrub
(In real life you would first put on scrubs, theatre shoes, and don a theatre hat, and do a normal hand wash)
- Find and set up equipment: gown packet, sterile gloves packet, surgical mask, eyewear/ visor mask, and silver trolley
- put on surgical mask and eyewear protection
- open the gown packet carefully onto the trolley, tip it out of the packet without touching it
- open the sterile gloves over the gown and allow to drop onto the gown
What stage comes after preparing to scrub?
What are the steps to this procedure
- Pre-scrub wash
- open scrubbing brush and set brush in packet to the side
- run the water, test temperature
- using three doses of scrub solution wash hands for 1 minute (7 steps of hand washing plus twisting action all the way down forearms) keeping hands elevated above elbows
- Apply more scrub solution, then clean nails using nail pick for 1 minute
- use scrubbing brush, sponge side, to scrub all 4 sides of the fingers
- use scrubbing brush, bristle side, to scrub the spaces under the finger nails
- rinse hands and forearms, keeping hands above elbows
(Geeky medics mark scheme)
What step comes after the pre-scrub wash? What are the stages of this procedure?
- Scrubbing procedure
5 mins
Each step of surgical scrubbing consists of FIVE strokes rubbing backwards and forwards
Always keep hands above the elbows
- Palm to palm
- backs of hands
- palm to palm, fingers interlaced
- Clasped fingers
- Thumbs
- fingertips to palm
- Rotating action down to just below the elbow
- Repeat for a second wash only down to two thirds of the forearms this time
- Local hospital policy may dictate a third wash only down to wrists - Rinse, allowing water to run from fingertips to elbows.
Turn tap off with elbows and keep hands up allowing water to drop from elbows - Dry hands using sterile hand towels that you opened earlier - one towel per arm, dry with blotting motion (do not wipe) from finger tips to elbow of one hand. Repeat with new sterile towel for other hand.
What step comes after the scrubbing procedure?
What are the steps involved?
- Gowning
Put hands in the two pockets either side of the gown (see photo)
Step back from trolley and all surrounding people/tables/overhead equipment
Open arms, gown will open up, push arms through sleeves
Keep hands inside cuffs
Theatre circulator will do up your gown at the back
What is it important to remember when putting on a surgical gown, to avoid contamination?
Move well back from surrounding people, tables and overhead equipment so that when the gown opens up it doesn’t touch anything
What 3 screening questions should you ask the patient before administering an IM injection
- do you have any allergies?
- do you have any bleeding disorders?
- are you on any anticoagulants? (May need to simplify this to ‘blood thinners’ for patient understanding)
Can also ask if they have a preference which arm to use (if on regular injections, alternate sites)
What should you tell the patient after an injection
Possible Side effects
pain at the site, bruising, lump/swelling, redness, allergic reaction.
Safety net - advice to seek attention if worsening pain after 48 hours or any difficulty breathing
What are the things to check for in a lumps and bumps exam
- site
- size (measure)
- shape
SURFACE
- appearance of surface is flat/raised/rough/smooth
- colour
- temperature
- pain
SUBSTANCE (feel, look, listen)
- Consistency (soft, firm, hard)
- Fluctuation (put finger either side, press with one, does lump bounce against the other)
- Percussion
- Transillumination
- Reducibility eg hernia
- Compressible eg varicose vein
- Pulsation eg Aneurysm
- Auscultation - bruits/ AV fistula/ bowel sounds?
- Movement - does movement change it eg muscle movement or a cough for a hernia
Surrounding structures
- fixed to skin or structures below?
- invasion to other structures, are borders irregular or regular
How is BMI calculated?
Weight over height squared
Kg / m2
