Patient Prep

Question 1

When should food and water be removed before surgery?

Answer 1

Healthy adults: 8-12 hours, water at pre med
Healthy <6mnths: 4-6 hours, water at pre med
Neonates: remove both food and water at pre med

Question 2

What are some hair removal options?

Answer 2

Plucking (scrotal sack in cats)
Clipping (preferred option)
Shaving (risk of micro abrasions)
Hair removal cream (higher risk of irritation, expensive, not effective on coarse hair)

Question 3

What are some examples of skin antiseptic scrub solutions?

Answer 3

-Povidone Iodine:
iodine based product, low toxicity, inexpensive, stains
-Chlorohexidine gluconate (hibiscrub)
better residual acitivity, works in presence of organ m., low toxicity except MM!

Question 4

What are some examples of rinsing agents?

Answer 4

-70% Isopropyl alcohol
not suitable for wounds, MM, quickly evaporates (cooling effect&raquo_space; hypothermia risk)
-Sterile water/ sterile saline
assist in removing foamy residue but no anti microbial properties, used for open wounds, MM, broken skin and compound fractures.

Question 5

What are some examples of applicators for skin prep?

Answer 5

Non woven gauze swabs (best), sponges (can be harsh), cotton wool (leaves residue), spray bottle (not suitable for scrubbing action)

Question 6

How do you surgically prep the skin for surgery?

Answer 6

• Use 4% chlorohexidine gluconate in the outward pattern (see pics) for 20/30 seconds using non woven gauze swabs
• Use 70% isopropyl alcohol to remove soapy residue
• Repeat the steps up to 3 times

Question 7

What is hanging limb prep used for?

Answer 7

Orthopaedic and extremities sx

Question 8

How do you surgically prep the hanging limb?

Answer 8

• Inverted glove placed on unshaven foot
• Strong tape used to adhere glove to leg, and vet wrap used to cover completely
• The first scrub must be completed distal to proximal

Question 9

What is the final prep in the OR?

Answer 9

Bowl of chlorohex, alcohol and water. It is applied by a member of the scrubbed surgical team
Applied using forceps and non woven swabs

Question 10

What is an esmarch bandage?

Answer 10

It provides a bloodless field, involves tight wrapping of the bandage around the limb

Question 11

What are some general considerations for patient positioning during surgery?

Answer 11

• Avoid contact with cold metal surface to maintain body temp
• Clean barrier for each patient
• Correct height for operating team
• Positioning should not compromise patient

Question 12

What are some examples of patient positioning aids?

Answer 12

Sandbags, ties, cradles, v troughs, vacuum activated positioning, rolled towels