Revision Questions Flashcards
1
Q
5 prime requirements in the construction of a theatre
A
Hard wearing Easily cleaned Non-porous Safe environment (round edges, non-slip) Infection control measures (higher air pressure, filtered air, restricted access)
2
Q
What temp should theatre be maintained at?
A
20 degrees celcius
3
Q
Does an air filter keep the pressure of a theatre higher or lower than other rooms? Why?
A
Higher. To reduce movement of airborne bacteria
4
Q
How many doors should a theatre have?
A
2 maximum
5
Q
How can a theatre be safe?
A
Corniced edges
Waterproof and recessed plugs
6
Q
Equipment used to clean the theatre can be used all over the hospital. TRUE or FALSE?
A
FALSE.
7
Q
What PPE must be worn by all personnel entering theatre?
A
Hat
Mask
Fresh scrubs
8
Q
Surgical personnel must know what boundaries?
A
Sterile and non-sterile boundaries
9
Q
What kind of heating system should a theatre have?
A
Under floor or concealed wall heating
10
Q
What is the disadvantage of having radiators in theatre?
A
Difficult to clean effectively.
11
Q
What type of overhead lights do you get in theatre?
A
Fixed or portable
12
Q
What ventilation systems can be used in theatre?
A
Positive ventilation system
Air conditioning
13
Q
What is a positive ventilation system?
A
Provides a minimum of 12 air changes per hour
14
Q
Explain the role of the circulating nurse.
A
Transfer/position patient Prepares ancillary equipment Assists vet to glove/gown Set up monitoring equipment Set up IV fluids Opens instruments for vet aseptically Records information
15
Q
Explain the role of the scrubbed nurse.
A
Must know procedure Anticipate surgeons' needs Passes instruments/swabs Retracts tissues Cuts sutures Prepares instrument trolley Counts swabs Apply firm pressure to bleeding with swab
16
Q
Who does the surgical team consist of?
A
Surgeon Anaesthetist Scrubbed nurse Circulating nurse Radiologist Lab technician
17
Q
List 12 common breaks in aseptic technique.
A
Touching the Face Respiratory infection Soiled gowns Skin conditions Exposed hair Loose fitting mask Jewellery Long/dirty fingernails Wet hands Touch contamination Torn gloves Wet drapes Opening contaminated gut Leaning over sterile field Unnecessary conversation Too many visitors
18
Q
Diathermy equipment - how is the heat produced?
A
High frequency electrical current
19
Q
Diathermy equipment - what’s it for?
A
Cutting or coagulating tissues by heat application.
20
Q
Diathermy - what do continuous waveforms do?
A
Cut tissue
21
Q
Diathermy - what do interrupted waveforms do?
A
Coagulation
22
Q
Diathermy - why use it?
A
Rapid control of haemorrhage
Reduces surgical time
Enables clear visualisation of surgical field
Reduces amount of suture material needed.
23
Q
What are the 2 types of diathermy?
A
Monopolar
Bipolar
24
Q
Monopolar diathermy…
A
Involves use of finger switch pencil for cutting/coagulation
Patient must be ‘earthed’
Earth wire sits within plate placed under patient and connected to diathermy unit
Earth wire transfers current to harmless place. Eg. the floor
Must be good contact between the earthing plate and the patient or current will pass along patient/surgeon
25
Bipolar diathermy...
Current passes through tips of the of the forceps across the tissue
Earthing plate not required
Current activated via use of foot pedal
Coagulation achieved by applying forceps directly to bleed
26
Uses of suction apparatus.
Aspiration of oropharynx and nasopharynx
Suction of fluids/blood during procedure
Thoracocentesis following surgery
27
Define "Emergency Surgery" and give an example.
Life threatening condition or trauma.
| Eg. GDV
28
Define "Necessary (Urgent) Surgery" and give an example.
Not immediately life threatening but requires attention promptly.
Eg. Fracture repair
29
Define "Elective Surgery" and give an example.
Patient normally healthy, and younger.
| Eg. Castration
30
Why might a surgery be delayed?
Investigative procedures required
Fluid Therapy or transfusions are required
Other injuries require tx prior to surgery
Stabilisation of the patient
Wound debridement
Antibiotic cover
Client considerations. Eg. cost
31
Explain what a "clean" wound is.
A wound made aseptically, does not enter contaminated viscus, no break in sterile technique
32
Explain what a "clean-contaminated" wound is.
A wound made aseptically, the wound enters the oropharynx, respiratory, alimentary or urogenital tracts
33
Explain what a "contaminated" wound is.
A major spill of contaminated material or/break in sterile technique, entry into viscus with bacterial load (i.e. colon/rectum)
34
Explain what a "infected" wound is.
Surgical site known to be infected
35
Effective theatre cleaning for prior to start of surgical procedures.
Use damp cloth with dilute disinfectant to dust all surfaces.
36
Effective theatre cleaning for between procedures.
Wipe down surfaces using disinfectant solution
Mop if necessary (if gross contamination)
Sweep
Dispose of any waste in appropriate bins (sharps/clinical waste/doops/general waste)
Remove instruments from theatre and place in cold water.
37
Effective theatre cleaning for at the end of surgical procedures.
Terminal disinfecting - washing all surfaces with disinfectant, hoovering, sweeping and mopping with disinfectant solution.
38
Describe the theatre cleaning protocol that should be carried out once weekly.
All equipment removed
Floors and walls scrubbed using disinfectant and detergent
Allow for contact time and to dry
All equipment wiped over with disinfectant
39
Name 10 general surgery instruments.
```
Greys cross action towel clip
Backhaus towel clip
Scalpel handle
Metzenbaum scissors
Mayo scissors
Spencer wells artery forceps
Halstead mosquito artery forceps
Plain dressing forceps
Rat toothed forceps
Allis tissue forceps
Spay hook
Olsen hegar needle holders
```
40
Name 4 types of needle holders.
Olsen hegar
Mayo hegar
Gillies
McPhails
41
How are Olsen hegar needle holders strengthened?
Tungsten carbide
42
How are instruments reinforced with tungsten carbide different from other instruments?
Gold coloured handles
43
Name 10 orthopaedic surgery instruments.
```
Rongeurs
Plate benders
Chisel
Osteotome
Gauge
Ferguson bone holding forceps
Haygrove bone holding forceps
Liston bone cutting forceps
Gelpies self retaining retractor
Periosteal elevator
Graft passer
Curette
```
44
Name 10 dental instruments
```
Periodontal elevator
Dental elevator
Explorer
Periodontal probe
Extraction forceps
Burr
Mouth gag
Scaler
Scalpel handle
Curette
Drill
Rasp
```
45
Name 10 opthalmic instruments.
Castroviego scissors
Iris scissors
Stevens tenotomy scissors
```
Bennet cilia forceps
Chalazion forceps
Capsule forceps
Capsularhexis forceps
Microcorneal forceps
```
Kirby Expressor loop and hook
Barraquer speculum
William speculum
46
What is sterilisation?
Destruction of all micro-organisms including their spores.
47
Disinfectant guarantees the destruction of bacterial spores. TRUE or FALSE?
False.
48
What are the 2 subcategories of sterilisation?
Heat sterilisation
| Cold sterilisation
49
What is heat sterilisation?
Steam under pressure using an autoclave
50
How does the steam get above 100 degrees celcius?
The pressure inside the autoclave in increased, therefore increasing the temperature of the steam.
51
Why does steam need to be above 100 degrees celcius inside the autoclave?
Some bacteria, spores and viruses are resistant to high temperatures.
52
What temperature must be reached inside an autoclave to sterilise instruments?
121 degrees celcius
53
How long does it take to sterilise instruments when the temperature is:
121 degrees
126 degrees
134 degrees
15min
10min
3.5min
54
What items can be sterilised in an autoclave?
```
Instruments
Drapes
Gowns
Swabs
ET tubes
Glasswear
```
55
What items would be damaged by an autoclave?
Fibre optic equipment
Lenses
Disposable plastics
56
What rules must be observed while using an autoclave?
Space between items to allow steam to circulate
Don't block inlet/exhaust valves
Instruments must be free of grease/organic matter
Only use distilled water
57
Name 4 sterility indicators for autoclave.
TST strips (time, pressure, temperature)
Browne's tubes (temperature)
Bowie-dick tape (temperature)
Spore tests (sterilised and then tested for bacterial growth)
58
What is cold sterilisation?
The chemical ethylene oxide is used
59
What risks does ethylene oxide pose?
Toxic
Irritant
Highly flammable
60
How does ethylene oxide work?
Inactivated DNA of pathogenic cells so unable to reproduce.
| Effective against bacteria, fungi, viruses and spores.
61
What can ethylene oxide be used to sterilise?
```
Fibre optic equipment
Disposable catheters
Anaesthetic tubing
Plastic syringes
Optical instruments
Battery operated/high speed drills
```
62
What temperature must the room be for the ethylene oxide to work?
20 degrees minimum
63
How long does it take for the ethylene oxide to work?
12 hours
64
Name 4 sterility indicators for ethylene oxide.
Indicator tape
Indicator stickers
Spore strips
Dosimeters
65
Describe how you would prepare a pair of artery forceps for reuse from receiving the intstrument from the operating room through to sterilisation in an autoclave.
Wear appropriate PPE (apron and gloves)
Soak the instrument in cold water. Ensure handles are open to allow water to move freely around ratchet and jaws
Prepare the instrument cleaner in accordance with manufacturer instruction
Scrub the instruments using a brush specifically designed for the purpose
Rinse with cool running water and a brush for 3 minutes to ensure all traces of cleaner are removed
Place instruments in to the ultrasonic cleaner
Rinse instruments with cold running water
Dry the instruments thoroughly using a soft clean paper towel or cloth
Check the instruments for any damage
Lubricate the hinge joint
Apply the protective cover to sharp ends
Insert instrument in to packaging the correct way round with ratchet open
Insert appropriate indicator
Remove excess air from the packaging
Secure the package, airtight seal
Label using a permanent marker (instrument name, operator initials, date of sterilisation
Double wrap item using same steps as above
Place in autoclave ensuring the machine is not over packed and steam can move freely around entire package
Ensure item is not packed under heavier items
Check level of distilled water and top up as necessary
Set at appropriate cycle of 134 degrees celcius.
66
What does ASIF stand for
Association for the Study of Internal Fixation
67
List 10 orthopaedic implants
Dynamic compression plate
Venibles plate
Sherman plate
Reconstruction plate
Cortical screw
Cancellous screw
Sherman screw
Kirshner wire
Arthrodesis wire
Rush pin
Steinman pin
68
What are opthalmic instruments made of?
Titanium
69
List 5 properties of a operating table.
```
Adjustable height
Tilt-able
Drainage facility
Rubber/stainless steel top
Heating facility
```
70
List 4 positioning aids.
Sandbags
Foam pads
Ties
Troughs
71
List some ancilliary equipment
Monitoring equipment (oesophageal stethoscope, pulse ox, multi-parameter, etc)
Overhead light
Drills
Positioning equipment
