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Principles of Surgery > Surgical Asepsis > Flashcards

Surgical Asepsis Flashcards

1
Q

how long do you fast animals prior to surgery in the following examples:
- healthy patient
- very young patient
- colonoscopy
- emergency

A

healthy: 12h
very young: 4-6h
colonoscopy: 48h
emergency: no fasting

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2
Q

what type of grip should you use for the clipper

A

pencil

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3
Q

how far do you want to clip on either side of the proposed incision

A

typically 10cm

if long hair, large mass removal or reconstruction involved, 15cm

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4
Q

T/F extra clipping is recommended to extend an incision if required

A

T

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5
Q

when do you want to express the patients bladder

A

after clipping but before skin prep (soap scrub)

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6
Q

at what point should you don a hat and mask

A

after clipping and vaccuming the patient and expressing the bladder and before skin prep

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7
Q

what is the order of skin prep

A

1) soap scrub (chlorhexidine) (2 scrubs, total of 5 minutes)
2) alcohol (3 passes)
3) chlorhexidine/alcohol solution (3 passes)

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8
Q

T/F while performing the soap scrub, as long as the soap is in contact with the skin you do not need to physically scrub the skin for the entire 5 minutes

A

T

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9
Q

how should you perform patient prep

A

start at the center of the surgical field along proposed incision line and continue towards the periphery using concentric circles

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10
Q

what is the purpose of the alcohol prep

A

disinfects and dissolves oils

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11
Q

what is the minimum contact time for the chlorhexidine/alcohol prep

A

30 seconds

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12
Q

T/F surgically prepped skin is considered sterile

A

F; it is very clean but is never steril

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13
Q

T/F you do not need to be wearing gloves when you apply the sterile drape to the patient’s surgical field

A

T

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14
Q

what is the purpose of surgical masks? what are they good for? what do they not stop?

A

good for preventing droplets of moisture while talking, coughing or sneezing

do not protect against bacterial contamination caused by breathing

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15
Q

what do you open onto the gowning table? what do you open onto the instrument table?

A

gowning table: gown pack (with drapes) and glove pack

instrument table: instrument pack and laparotomy sheet, suture, blades, any other extras

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16
Q

how long should you scrub for the first procedure of the day and then for subsequent procedures

A

5 min for first; 3-5 for subsequent

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17
Q

what is the order for the gross hand clean

A

1) open pack
2) water
3) soap
4) suds
5) clean nails
6) rinse

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18
Q

how much time should you spend scrubbing you fingers, palms and tops of hands and how much time should you spend scrubbing your wrists and arms

A

fingers, palms and back of hands: 2 minutes each

wrists and arms: 1 minute each

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19
Q

how long are surgical gowns sterile for

A

1 procedure only

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20
Q

T/F after you gown you should bring your drapes to your instrument table to avoid back and forth travel

A

T

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21
Q

what parts of the gown are considered unsterile

A
  • the back
  • the neckline, shoulders and underarm
  • anything above 2 inches above the elbow
  • the cuff
22
Q

what parts of the gown are considered sterile

A
  • 2 inches above the elbow to the level of the wrist cuff
  • chest to the level of the surgical field
23
Q

when would it make sense to double glove or wear thicker gloves

A

orthopedic surgery (increased risk of puncture)

24
Q

if gloves are compromised, they should be immediately replaced using an ________________ technique

A

open-gloving

25
Q

a punctured glove _________ the risk of surgical site infection

A

doubles

26
Q

over what percentage of gloves have a puncture in the thumb or index finger at the end of any surgery

A

12.7-31%

27
Q

how is the final prep performed

A

by a gowned and gloved surgeon using sterile gauze, disinfectant and sponge forceps

28
Q

T/F you do final patient prep after applying drapes

A

F; done after gowning and gloving and before draping

29
Q

T/F you should discard the sterile gauze used for final patient prep in the large metal bowl

A

F: it will throw off your gauze count if you do this

30
Q

how much should you fold over your sterile drape

A

10-15cm

31
Q

how does around the world draping work

A

head -> side -> tail -> side

32
Q

T/F towel clamps are considered unsterile once applied

A

T

33
Q

T/F you add towel clamps over the lap sheet

A

F

34
Q

what is strike through

A

when bacteria can pass through pores in fabric if wet or too thin

35
Q

do cloth or paper lap sheets allow more strikethrough

A

cloth, especially with more washes as the pores increase

36
Q

T/F blood and debris inhibit sterilization

A

T

37
Q

T/F you should use a lubricant bath to protect your instruments from corrosion

A

F; has been shown to increase contamination with repeated use, use lubricant sprays instead

38
Q

what time and temperature should you use on an autoclave in general

A

30 min at 121 C

39
Q

what instruments do you NOT sterilize with the box-locks open

A

towel clamps

40
Q

what does steam sterilization kill in theory

A

bacteria, fungi, spores, viruses

41
Q

what is a drawback of autoclaves

A

need the perfect combination of water, high temperature and pressure to work; some instruments will melt so you cannot use

42
Q

what is the minimum temp and time for flash sterilization and what type of autoclave is needed

A

132 C for 4 min; prevacuum autoclave

43
Q

what is an important consideration regarding cloth packs placed in plastic sleeves

A

the outer cloth is not sterile so you cannot plop the pack out of the plastic onto your surgical field

44
Q

are chemical or biological indicators more reliable? which are more useful?

A

biological more reliable; chemical more useful (no time delay as you do not have to wait for culture results)

45
Q

most chemical sterilization uses what gas

A

ethylene oxide

46
Q

what does plasma sterilization use

A

vapour phase hydrogen peroxide

47
Q

what is a benefit of plasma sterilization vs chemical sterilization

A

plasma sterilization requires no aeration period

48
Q

what is most commonly used for cold sterilization

A

glutaraldehyde

49
Q

what are some examples of uses of cold sterilization

A

“dirty” surgeries or endoscopic equipment

50
Q

how are sterile medical supplies usually sterilized

A

gamma irradiation

51
Q

T/F packs must not be exposed to humidity or water droplets, dust or the floor

A

T

Principles of Surgery (8 decks)

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