Surgical Instrument Flashcards
What is a crucial skill for a sterile processing technician?
Proper identification of surgical instruments and their uses
This skill helps prevent errors such as damage, malfunction, and misplacement of instruments.
What are some errors that can occur without proper knowledge of surgical instruments?
Errors include:
* Damage to instruments
* Missing instruments
* Malfunction of instruments
* Instruments displaced out of correct containers
These errors can compromise patient safety and surgical outcomes.
To master the identification of surgical instruments, what should technicians become familiar with?
The various surgical specialties practiced within the perioperative environment
Understanding specialties helps in recognizing the specific instruments used in different surgical procedures.
List the most common surgical specialties.
- General
- Vascular
- OB/GYN
- Neurology
- Orthopedics
- Plastics
- Ear, nose, and throat (ENT)
- Cardiothoracic
- Genitourinary (GU)
- Robotic, endoscopic, and laparoscopic
Familiarity with these specialties is essential for effective instrument identification.
What are some common general procedures?
Inguinal hernia repair, appendectomy, colectomy, colostomy
What are some common vascular procedures?
AV fistula, Thrombectomy, tubal ligation, burr holes, total hip arthroplasty
What are some common procedures related to colectomy?
Greenfield filter, dilatation and curettage, laminectomy, distal radius repair
What are some common procedures related to colostomy?
Abdominal aortic aneurysm, Hysteroscopy, cervical fusion, anterior cruciate ligament repair
What are some common plastic procedures?
Breast reduction, breast augmentation, abdominoplasty, skin graft
What are some common ENT procedures?
Tympanoplasty, myringotomy, stapedectomy, cochlear implant
What are some common cardiothoracic procedures?
Pacemaker, CABG, Thoracotomy, VATS
What are some common genitourinary procedures?
Hydrocelectomy, Prostatectomy, Nephrectomy, Penile Implant
What are some common robotic/endoscopic/laparoscopic procedures?
Laparoscopic cholecystectomy, Laparoscopic robotic hernia, Laparoscopic robotic hysterectomy, Colonoscopy
How can instruments be classified?
Instruments can be classified as suctioning, probing, dilating, retracting, exposing, grasping, cutting, clamping or occluding, and viewing.
What are suctioning devices used for?
Suctioning devices are used to suction blood and other bodily fluids during a surgical procedure.
Common suctioning devices include Fraziers, Pooles, and Yankauer suctioning devices.
What is the purpose of clamping and occluding instruments?
Clamping and occluding instruments are used to clamp off bleeders and provide hemostasis.
What is hemostasis?
Hemostasis is a term used within the perioperative environment that describes the control of bleeding.
Give an example of a clamping and occluding instrument.
An example of a clamping and occluding instrument would be a hemostat clamp.
Other common clamping and occluding instruments include the Kelly and Kocher clamping instruments.
What are cutting instruments used for?
Cutting instruments are used to dissect tissues and cut suture material, drains, and dressings.
What are Metzenbaum scissors used for?
Metzenbaum scissors can be used to cut or dissect delicate sterile tissues.
Other common scissors include straight and curved mayo scissors.
What is the function of grasping and holding instruments?
Grasping and/or holding instruments are used to ‘pick up’ or grasp tissues and other structures within the human body.
What are common forms of grasping instruments?
Many grasping and holding items come in the form of forceps.
Common forceps include Debakeys, Adson, Gerald, and Russian forceps.
What is the purpose of a Richardson retractor?
A Richardson retractor is used to retract or expose an organ or organs in the abdominal cavity for visualization.
What is a rib spreader used for?
A rib spreader may be used to retract or expose the chest area in thoracic surgery.
What are some other common retractors?
Other common retractors include the Army-Navy, Deaver, and Malleable retractors.
What is the role of viewing instruments in surgery?
Viewing instruments allow the surgical team to have exposure to view the area they’re operating on.
What type of lens is used for visualization in minimally invasive procedures?
A 30-degree lens is used to visualize the internal organs in a minimally invasive or endoscopic procedure.
What are dilating instruments used for?
Dilating instruments are used to widen a space, such as a cervix.
Give examples of dilators.
Examples of dilators may include Hegar and Pratt.
What is the purpose of cannulas?
Cannulas may be inserted for drainage of a specific structure within the human body.
What is unique about cannulas?
Cannulas have a lumen through their center.
What should a sterile processing technician be knowledgeable about?
A sterile processing technician should be knowledgeable about eye and dental instruments used within the operative setting.
Why must dental and eye instruments be handled carefully?
Dental and eye instruments have very delicate tips and must be handled carefully to avoid damage.
What is the potential cost of repairing delicate dental and eye instruments?
It can cost thousands of dollars to have these instruments repaired.
How can dental instrumentation be classified?
Dental instrumentation can be classified as noncritical, semicritical, or critical.
What defines critical dental instrumentation?
Critical dental instrumentation penetrates the bone or soft tissue inside the mouth.
What are eye instruments used for?
Eye instruments are used in surgical procedures such as cataracts, detached retinas, and vitrectomies.
What type of water must be used to rinse eye instrumentation?
Deionized or distilled water must be used to thoroughly rinse eye instrumentation.
What is TASS?
TASS stands for toxic anterior segment syndrome, a rare but devastating complication of eye surgery.
What are the major parts of a surgical instrument?
The major parts include finger rings, ratchets, shanks, jaws, and box locks.
What is the function of the jaws in surgical instruments?
The jaws touch human tissue and can be used to dissect tissue or clamp bleeders during surgery.
What characteristic do some jaws of instrumentation have?
Several jaws contain serrations, indicated by their parallel grooved appearance.
What is the purpose of box locks in surgical instruments?
Box locks have a tiny screw to keep the jaws secure and together.
Why are box locks considered the weakest part of a surgical instrument?
Box locks can be extremely difficult to clean.
What is the function of ratchets in surgical instruments?
Ratchets keep surgical instruments closed and prevent them from sliding off tissue or suture needles.
What is a practical example of ratchet use in surgery?
A surgical technician ensures the ratchet is closed when passing a needle holder to the surgeon to prevent the needle from falling.
What are finger rings used for in surgical instruments?
Finger rings are used by the surgeon to grasp and physically open and/or close the instrument.
What is the purpose of shanks in surgical instruments?
Shanks reinforce the instrument to keep it closed and are where the surgeon places their hand.
What are the three common types of surgical instruments?
The three types are disposable, floor-grade, and surgical-grade instruments.
What are disposable instruments?
Disposable instruments are used once and then discarded, often found in emergency departments.
How can disposable instruments be distinguished from reusable ones?
They are clearly marked as being single use.
Why should surgical instruments never be engraved?
Engraving can allow harmful microorganisms to hide in the crevices.
What is the highest grade of surgical instruments?
Surgical-grade instruments are the highest grade and can be decontaminated and sterilized multiple times.
What maintenance is required for surgical-grade instruments?
They should be lubricated daily with a water-soluble lubricant.
What does the FDA mandate for surgical-grade instruments?
They must be stamped with their country of origin.
What are floor-grade instruments?
Floor-grade instruments are marked as made in Pakistan, have limited use, and should not be placed on surgical trays.
What is a characteristic of floor-grade instruments?
They tend to rust and are made with low-quality stainless steel.
What is the most noncorrosive type of stainless steel for instruments?
The 300 series (austenitic) stainless steel is the most noncorrosive.
What type of instruments are made from the 400 series stainless steel?
The 400 series (martensitic) instruments are stain-resistant if not exposed to harsh substances.
Can you provide examples of 400 series instruments?
Examples include forceps, chisels, and scissors.
Why is it critical to protect surgical instruments?
To prevent cost inflation and patient injuries caused by preventable damage.
What is the duty of a sterile processing technician?
To ensure that surgical instruments are well-managed within the sterile processing department.
What should never be used to soak or clean surgical instruments?
Bleach, saline, or any other non-approved detergent or disinfectant.
What should always be followed to protect surgical instruments?
The manufacturer’s instructions.
What is the guideline regarding placing heavy items on surgical instruments?
Never place heavy items on lighter ones.
How should delicate instruments be stored?
In an approved protective container away from other instruments to prevent damage.
What is the recommended method for assembling hinged instruments?
Use metal stringers (instrument holders) for effective and efficient assembly.
How should forceps be packaged?
Nestle forceps closely together.
How should curved instruments be oriented?
Curved instruments should always be curved the same way.
What is the guideline regarding the number of instruments in a container?
Never put too many instruments into a container.
What can be used to extend the life of surgical instruments?
Neutral pH lubricant (instrument milk) according to the manufacturer’s specific directions.
What are complex instruments in sterile processing?
Complex instruments have special requirements for reprocessing. Examples include drills, powered instruments, microscopic instruments, robotic and laparoscopic instruments, endoscopes, and instruments with lumens.
Why can powered instruments be difficult to clean?
Powered instruments contain numerous electrical components that complicate reprocessing without proper training.
What should be done with powered instruments that can’t be immersed in water?
Items such as some batteries and drills should be wiped down with soft cloths and the appropriate disinfectant according to the manufacturer’s instructions.
What are examples of powered instruments?
Examples include sternal saws, dermatomes, dental drills, wire drivers, cebatomes, and orthopedic drills.
How should microscopic instruments be handled during cleaning?
Microscopic instruments should not be mixed with heavy instruments to prevent damage and may require manual cleaning.
What types of instruments are classified as microscopic?
Vascular instruments and instruments used within the orbital cavity are often classified as microscopic.
What are the benefits of minimally invasive surgery?
Benefits include less bleeding, lower chances for infection, smaller scars, and less pain for the patient.
Who may not be good candidates for minimally invasive surgery?
Patients with multiple previous procedures may not be good candidates due to surgical scar tissue obstructing the view of organs.
What is required for minimally invasive surgery?
It requires multiple stab incisions and small instrumentation to visualize the inside cavity.
What is a common outcome for patients undergoing minimally invasive procedures?
Patients typically have shorter recovery times and can often go home on the same day.
What challenges exist in cleaning robotic and laparoscopic instruments?
They have complex tips and components that can make cleaning and decontamination difficult, and some must be disassembled before reprocessing.
What should be done to minimize hidden debris in minimally invasive instruments?
These instruments often feature flush ports for flushing water through them and may have lumens that require careful inspection and cleaning.
What risks are associated with damaged insulation on instruments?
Damage can result in thermal injury to the patient or electrocution of the surgical staff.
How should cameras, light cords, and lenses be handled?
They should be handled carefully to avoid damage, as they are expensive to repair and typically can’t sustain extreme heat.
What is important to consider when cleaning light cords?
Light cords have microscopic fibers and wires that can break if coiled too tightly.
How should camera lenses be processed?
The tips of camera lenses should be separated from other surgical instruments and carefully inspected before processing.
What must be followed when cleaning endoscopes?
Endoscopes must be cleaned and processed according to the manufacturer’s instructions.
What is the primary method for processing endoscopes?
Most endoscopes are processed in Automated Endoscope Reprocessors (AERs).
Why do flexible endoscopes require special training?
Flexible endoscopes are complex and expensive devices that require special training to reprocess.
What is required to ensure the integrity of flexible endoscopes?
Most flexible endoscopes require leak testing to ensure there’s no leaking and that a watertight seal exists.
What should be done if an endoscope fails leak testing?
Endoscopes that fail leak testing should not be used on a patient due to the risk of dangerous pathogens and debris.
What does OSHA require for damaged endoscopes?
OSHA requires all items needing repair to be decontaminated to the maximum extent possible prior to transport for repair.
What is a potential risk of leaving endoscopes in a basin?
Endoscopes should never be left in a basin due to the potential of damage.
What body structures can be visualized with bronchoscopes?
Bronchoscopes are used to visualize the bronchus, including the air sacs and lungs.
What is the purpose of a gastroscope?
A gastroscope is used to visualize the upper digestive tract.
What does a colonoscope visualize?
A colonoscope is used for visual inspection of the large intestine.
What do cystoscopes visualize?
Cystoscopes are used to visualize the urethra or bladder.
What are the main parts of a flexible endoscope?
The flexible endoscope consists of a control body, insertion tube, bending section/distal tip, and light guide connector.
What is the function of the control body in a flexible endoscope?
The control body allows for suction and irrigation and contains the control knobs that rotate the distal tip.
What is the role of the insertion tube in a flexible endoscope?
The insertion tube contains a biopsy post, which is inserted into the patient’s body.
Which part of the endoscope is most prone to fluid invasion?
The bending section/distal tip is the portion most prone to fluid invasion.
What is the light guide connector in a flexible endoscope?
The light guide connector is the portion of the scope that attaches to the light source.
What are the specific steps for reprocessing flexible endoscopes?
The steps include precleaning, leak testing, cleaning, disinfection with a high-level disinfectant, drying, and storage in a clean, dry area.
How can drying of the endoscope be facilitated?
Some facilities use alcohol to facilitate the drying of the endoscope by flushing it down the ports.
What are count sheets used for?
Count sheets are used to inventory complex or general instrumentation that are assembled and packaged for sterilization.
How do count sheets assist the operative team?
They help identify when instruments are missing before a surgical procedure begins.
What happens if an instrument is missing before surgery?
It’s documented to ensure an accurate count of instruments in the room prior to beginning the surgical procedure.
What must be accounted for in a surgical tray?
Every instrument within a surgical tray must be accounted for.
How do count sheets aid sterile processing technicians?
They assist in properly assembling specific surgical instrument trays with the correct instruments.
Where are count sheets often used?
They are often used in the operating room to keep an accurate account of instruments open.
What is done before a surgical procedure begins regarding instruments?
Instruments are counted according to the inventory indicated on the count sheet.
What happens after a surgical procedure regarding instruments?
An inventory is taken again to ensure that the instruments initially accounted for are present after the procedure.
