Setting-up for Surgery Flashcards
– used with glasses
- Antifog mask
used for people with facial hair
- Surgeons hood
main scrub products used at this institution
povidone-iodine
chlorhexidine gluconate
alcohol
Adult animals are generally fasted up to _______ hours prior to surgery, to reduce the risk of regurgitation or vomiting during or after surgery and development of aspiration pneumonia.
12 hours
Adult animals are generally fasted up to 12 hours prior to surgery, to?
reduce the risk of regurgitation or vomiting during or after surgery and development of aspiration pneumonia
Surgical procedures involving the large intestine may require ______hours of fasting to allow emptying of the intestinal tract.
48 hours
Young animals can become ________ if fasted for too long and food intake restriction should be adjusted according to the patient.
hypoglycemic
Free access to water is allowed during fasting and dogs are walked just prior to surgery, to promote defecation and urination. If the animal cannot be walked, the bladder may need to be expressed manually before abdominal surgery.
The most common position is
dorsal recumbency
dorsal recumbency is used in?
several abdominal procedures such as
1. ovario-hysterectomy
2. canine castration
3. gastro-intestinal foreign body removal or cystotomy.
The bladder should be palpated and expressed if full prior to abdominal procedures. If the patient did not urinate before surgery, it may be helpful to empty the urinary bladder manually before an abdominal procedure.
This should not be done in pyometra patients as excess pressure on the abdomen may rupture the uterus.
Emptying the Bladder
clip from xiphoid to pubis and beyond the level of the mammary chain for an ovariohysterectomy
Hair is usually removed from _______ cm on either side of the proposed incision site using clippers and a number 40 blade
10-15 cm
(using a razor) in small animals causes excessive trauma to the skin (microlacerations) and irritation releasing increased numbers of normal bacteria from the cornified layers of the skin. This can increase the risk of incisional infection.
Shaving
Typical skin preparation includes a 5 minute soap scrub followed by the application of alcohol and finally an alcohol based disinfectant such as chlorhexidine.
Commonly used soaps for preparing surgical patients contain __________ as the main antibacterial agent.
chlorhexidine or povidone-iodophors
Two types of preparation patterns:
1) Concentric Preparation:
2) Horizontal Preparation
Skin preparation generally begins at the center of the shaved area, (at the proposed incision site), and continues using a concentric circular pattern until the edges of the shaved area are contacted. Remember never to return towards the incision site with a used gauze. Once hair is touched, the gauze or cotton is discarded and a new gauze is used. This action is repeated over the entire field a minimum of three times.
Concentric Preparation
Skin preparation generally begins at the center of the shaved area, (at the proposed incision site), and continues using a horizontal pattern on either side of the shaved area. One must remember to never return towards the incision site with a used gauze. If hair is touched (at the top or the sides of the incision), the gauze or cotton is discarded and a new gauze is used. This action is repeated over the entire field a minimum of three times.
Horizontal Preparation
Remember: Surgically prepared skin is very clean but is never sterile.
Final Skin Preparation (Performed After Scrubbing, Gowning and Gloving)
The first drape is generally applied at the _____ of the proposed incision site.
cranial edge
Drape 2 is generally applied at the _________ of the proposed incision site since it can usually remain in place without falling until towel clamps are applied. The drape is applied in the same manner as drape 1.
caudal edge
Drapes # 3 & # 4
Clamping Drapes to Skin
Limb draping is often performed in a hanging limb position.
Limb draping
While gowned, the surgeon generally stands. If sitting to perform a procedure, the surgeon should sit on a stool (without back support) to prevent contamination of the elbow area of the gown. Furthermore, the surgeon should prevent contamination of the elbows on the knees.
WHAT NOT TO DO:
* Gloved hands should never drop below the level of the waist line or below the level of the draped surgery table.
* Gloved hands should never be placed close to the neck line, shoulder area or head to prevent inadvertent contamination. Hands should remain at the level of the chest (below the neck line and above the waist line).
* The underarm area of the gown is considered unsterile. Gloved hands should never be rested under the arm pit.
* While draping the patient or moving about the surgery suite, the surgeon should be careful not to contaminate the sterile gown or gloves on unsterile surfaces.
* A stool without back support will prevent contamination if the surgeon sits during a procedure. The elbows are considered sterile and the can be easily contaminated on the back of a stool.
Tips to Remember
* Clip from the xiphoid to the pubis. Remove all hair around the mammary glands. In male dogs, remove all hair around the prepuce and flush the prepuce with an aqueous solution (not alcohol).
* Remember to express the urinary bladder. Palpate the bladder and maintain constant pressure while expressing the urinary bladder rather than applying pulsatile pressure.
* After clipping and vaccuming, remove your labcoat to perform patient preparation.
* Try not to touch the solution bottle tips with gauzes when pouring the preparation solutions. This potentially contaminates the gauze and the bottle tip.
* Remember to wear a hat and mask to enter the surgery suite. Your labcoat should already have been removed.
