Surgery

Question 1

STP02
During a surgical procedure, the veterinary surgeon requires some additional
instruments.

a. You have been asked to put on a pair of surgical gloves using the open gloving
method (assume you are already scrubbed up).
b. You are then required to select the instruments and place them on the correct
section of the grid provided.

Note: The instruments have previously been cleaned.

NB. You are allowed a maximum of two pairs of gloves.

Answer 1

1. Ensure all jewellery is removed
2. Nails well-manicured, clean and unvarnished. False nails are not permitted
3. Ask assistant to open glove packet
4. Take inner glove packet
5. Outer packet not touched
6. Place inner glove packet onto sterile surface
7. Unfold packet to expose gloves
8. Pick up first glove
9. Touch only inner folded down surface
10. Pull correct glove halfway onto first hand
11. Leave cuff folded back
12. Hook thumb under the fold of the cuff
13. Slide gloved fingers under the cuff of the other glove (outer surface)
14. Slide fingers of the un-gloved hand into the fingers of the second glove
15. Pull folded cuff of the glove down to cover the wrist
16. Place fingers of the entirely gloved hand under the cuff of the first, semigloved hand
17. Unhook the thumb
18. Pull folded cuff to glove down to cover the wrist
19. Clasp hands together
20. Hands to remain above waist after gloving completed
21. Hands gloved using correct left and right gloves
22. Maintain sterility of gloves during the procedure
23. From the instruments correctly fill the 10 spaces

Question 1

STP01
You have been requested to assist the veterinary surgeon with an exploratory
laparotomy.

You have just surgically scrubbed your hands and arms in preparation to assist with this procedure.

Put on the disposable sterile surgical gown and gloves using the closed method.

NB. You will be allowed a maximum of two gowns and two sets of gloves.

Answer 1

1. Ensure all jewellery is removed
2. Nails well-manicured, clean and unvarnished. False nails are not
   permitted
3. Ask assistant to open the gown packet
4. Candidate to take inner gown packet
5. Outer packaging not touched
6. Candidate to place inner gown packet on to sterile surface and open inner packet
7. Grasp the folded gown from the trolley
8. Lift the gown up and away from the trolley
9. Holding the neck allow the gown to fall open away from the body
10. Guide arms through the sleeves of the gown
11. Hands remain inside the sleeves of the gown
12. Keep hands at shoulder level and away from the body
13. Instruct assistant to pull the gown over the shoulders touching only the inside of the gown
14. Ask assistant to fasten neck fixation
15. Ask assistant to fasten inner back ties
16. Instruct assistant to take hold of the paper tape on the longer waist
    tie touching only the paper tape
17. Ask assistant to extend the tie and take it around the back and to
    the opposite side of the gown
18. Grasp and pull the longer waist tie so that the paper tape comes
    away and is left with the assistant
    19.Fasten the waist ties at the side
19. Keep both hands within the cuffs of the gown
20. Maintain sterility of gown throughout gowning procedure
21. Ask assistant to open the glove packet
22. Candidate to take inner glove packet
23. Outer packaging not touched
24. Candidate to place inner glove packet on to sterile surface
25. Turn packet upside down (so fingers of gloves are pointing towards the candidate)
26. Unfold packet to expose gloves
27. With either first hand, pick up appropriate glove by the rim or fold of
    the cuff
28. Turn the hand over so the glove lies on the palm
29. Grasp the uppermost rim of the glove with the other covered hand
30. Pull the glove over the first hand, encapsulating cuff fully
31. Pick up the remaining glove by the rim or fold with ungloved hand
32. Turn the hand over so the glove lies on the palm
33. Pick up the uppermost rim of the glove with other gloved hand
34. Pull the glove over the second hand, encapsulating cuff fully
35. Adjust the fingers and the cuffs as necessary to ensure a snug fit
36. Clasp hands together
37. Hands to remain above the waist after gloving completed
38. Hands gloved using correct left and right gloves
39. Maintain sterility of gloves and self throughout gloving procedure

Question 2

STP03
Prior to a surgical procedure, you have been requested to:
a) Select instruments and place them on the correct section of the grid provided
b) Pack and label the instrument indicated by the examiner, ready for sterilisation
using an autoclave today.

Note: The instruments have previously been cleaned.

Answer 2

1. From the instruments provided correctly fill 10 spaces
2. Cover the sharp end of the instrument securely
3. Select appropriately sized packing material
4. Insert instrument into autoclave packaging
5. Instrument to be inserted the correct way round (i.e. handles are presented first when packaging is open)
6. Remove excess air from bag
7. Secure package
8. Double wrap in appropriate sized autoclave packaging
9. Remove excess air from bag
10. Secure the packaging
11. Select permanent marker pen
12. Label package with the instrument name
13. Label package with own initials
14. Label package with date of autoclaving or date for re-autoclaving
15. Write on appropriate portion of packaging without piercing bag (i.e. flap,
    plastic or Bowie-Dick tape)
16. Instrument packed appropriately and ready for sterilisation

Question 3

STP04
Prior to a surgical procedure, you have been requested to:
a) Select instruments and place them on the correct section of the grid provided
b) Pack and label the drape indicated by the examiner, ready for sterilisation using
an autoclave today.

Note: The instruments have previously been cleaned.

Answer 3

1. From the instruments provided correctly fill 10 spaces
2. Fold the drape using a recognised methodology
3. Select appropriately sized packing material
4. Select TST indicator strip
5. Insert a TST strip inside the folded drape
6. Insert drape into autoclave packaging
7. Remove excess air from the bag
8. Secure package
9. Double wrap in appropriate sized autoclave packaging
10. Remove excess air from bag
11. Secure the packaging
12. Select permanent marker pen
13. Label package with name of contents
14. Label package with quantity of drapes
15. Label package with own initials
16. Label package with date of autoclaving or date for re-autoclaving
17. Write on appropriate portion of packaging without piercing bag (i.e. flap,
    plastic or bowie-Dick tape)
18. Drape packed appropriately ready for sterilisation with the correct
    inclusion of the TST strip

Question 4

STP05
You are required to clean, dry and lubricate some instruments following a surgical
procedure.
You should then leave them ready to be packed for sterilisation.

Answer 4

1. Put apron on
2. Put gloves on
3. Fill a bowl with an appropriate amount of cold water
4. Add instrument cleaner to the bowl of water to make the correct concentration
5. Dispose of consumables
6. Place instruments in a bowl for the initial soak
7. Inform the examiner that the instruments would be left to soak for the
   appropriate length of time
8. Remove instruments from the initial soak bowl and place into a clean tray
9. Clean instruments with a stiff nylon brush under cool or warm running water
10. Ensure there is no visible debris on the instruments
11. Place instruments into another clean tray
12. Check and comment on the suitability and level of the ultrasonic cleaning
    solution
13. Place the instruments into the basket appropriately
14. Ensure all instruments are fully immersed in the cleaning solution
15. Put the lid on the ultrasonic instrument cleaner
16. Turn on the ultrasonic instrument cleaner
17. Set the temperature on the ultrasonic instrument cleaner to an appropriate
    temperature
18. Set the time on the ultrasonic instrument cleaner to an appropriate time
19. Inform the examiner that you would wait for the cycle to be complete
20. Leave the ultrasonic instrument cleaner appropriately before removing the
    clean instruments
21. Remove the basket from the ultrasonic cleaning machine
22. Carefully remove instruments from the basket
23. Rinse instruments individually under running water
24. Inspect each instrument for deterioration or damage
25. Dry all instruments individually
26. Apply water soluble lubrication to all joints/moving parts
27. Leave instruments ready to packed with the joints closed and any ratchets
    closed by one click