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Patient Evaluation > Surgical Instruments / Sterile Technique Donning / Surgical Gowns and Gloves > Flashcards

Surgical Instruments / Sterile Technique Donning / Surgical Gowns and Gloves Flashcards

1
Q

Towel Clips ?

A

penetrating

non-penetrating

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2
Q

Sponge stick ?

A

mostly disposable now

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3
Q

Knife Handles ?

A

no blade loaded

use hemostat to pick up blade ( never use fingers) - take blade off and throw it out after procedure

long blade - for deep in a cavity

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4
Q

Knife Blades sizes ?

A

10 and 15 used most

top - abdominal incision

bottom - face incision

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5
Q

Holding the Scalpel ?

A

The scalpel is held with thumb, middle and ring finger while the index finger is placed on the upper edge to help guide the scalpel.

Long gentle cutting strokes are less traumatic to tissue than short chopping motions.

The scalpel should never be used in a “stabbing” motion.

**index finger on top **

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6
Q

Bovie purpose ?

A

To cauterize

To cut/dissect

**cauterize

different tips and it is heat and it seals off small bleeders **

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7
Q

Retractor examples ?

A

Army-Navy

Richardson

Goelet

Deaver abdominal

Senn

Volkman Rake

Balfour abdominal

Bookwalter

Williams

Kocher

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8
Q

Army-Navy ?

A

two flat ends and used in minor and major surgery to move tissue out of the way (fascia) - common

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9
Q

Richardson ?

A

handle to it or two ends

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10
Q

Goelet ?

A

more curve to it, come in pairs for each side of incision

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11
Q

Deaver, abdominal ?

A

deeper for down in the abdomen

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12
Q

Senn ?

A

rake on one end and flat on the other, plastic surgery, tiny ones for face

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13
Q

(Volkman) Rake ?

A

different teeth for better grip

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14
Q

Balfour abdominal ?

A

hold open abd. cavity ( three sides to it)

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15
Q

Bookwalter ?

A

biggest type of instrument , but not as common now cause laparoscopic surgery ( makes a nice circle around the edges)

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16
Q

Williams ?

A

self retaining

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17
Q

Forceps aka ?

A

Hemostats, “stat”

Clamps

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18
Q

Forcep examples ?

A

Kelly – straight

Kelly – curved

Crile – straight

Crile - curved

Carmalt

Halstead mosquito

Heaney hysterectomy

Allis

Lahey

Right angle

Babcock

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19
Q

Kelly forceps ?

A

common, straight or curved -

serrated on distal half of the jaws and smooth on the proximal, grabbing tissue

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20
Q

What is special about the Crile forces ?

A

it is all serrated throughout

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21
Q

Carmalt ?

A

ridges are in a different direction ( longitudinal ) -

help blood flow better?

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22
Q

Halstead mosquito ?

A

fine tipped, S or C,

Mosquitos are tiny and so are these

pinching off bleeders ( bigger ones you cant just Bovie)

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23
Q

Heaney hysterectomy ?

A

larger than M

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24
Q

Allis ?

A

curves at distal ends of the tip, forcibly grasp tissues and do some retraction,

space inbetween and they just pinch at the tip, some teeth as well

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25
Q

Lahey ?

A

same as car malt ( longitudinal)

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26
Q

Right angle ?

A

for deeper spaces

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27
Q

Babcock ?

A

intestinal

put around a blood vessel without pinching on the tissue , put vessel or nerve in the hollow spaces and it wont pinch it

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28
Q

Thumb Forceps aka ?

A

Pickups

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29
Q

Thumb Forceps use ?

A

The instrument should remain at the tips of the fingers for maximum control

hold in a pinching motion

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30
Q

Thumb Forceps are not called ?

A

Tweezers

  • *not tweezers !!!
  • *
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31
Q

Thumb Forceps are not held like a ?

A

knife

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32
Q

Thumb Forceps – “Pickups” examples ?

A

Adson (Brown) tissue forceps

Russian tissue forceps

Ferris-Smith tissue forceps

Bayonet

DeBakey

Bonney

Rat tooth

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33
Q

Adson (Brown) tissue forceps options ?

A

Without teeth

1x2 teeth

7x7 teeth

** A for suturing **

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34
Q

Russian tissue forceps ?

A

circle of teeth at the tip

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35
Q

Ferris-Smith tissue forceps ?

A

teeth at the tips , cross hatching = more secure when grasping

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36
Q

Bayonet ?

A

offset angle to them

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37
Q

DeBakey ?

A

w and w/o teeth

thin strip of teeth though the middle of the tong

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38
Q

Bonney ?

A

…

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39
Q

Rat tooth ?

A

teeth are longer than adsons

( A for suturing and this is for retracting)

Rat tooth has larger, interlocking teeth than Adson

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40
Q

Scissors examples ?

A

Metzenbaum

Mayo

Iris

Sharp-Blunt

Bandage

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41
Q

Metzenbaum ?

A

scissors

Curved or straight

Blunt or sharp tips

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42
Q

Mayo ?

A

scissors

Curved or straight

Blunt or sharp tips

heavier fascia or suture sissors,

43
Q

What is the difference between the Metzenbaum and the Mayo scissors ?

A

length of the handle versus length of the cutting surface ( curves always held to face up)

44
Q

Metzenbaum has a longer _______________ ratio

A

handle to blade

45
Q

Iris options ?

A

Curved

Straight

Angled

46
Q

Iris use ?

A

two sharp points and for very delicate surgery

47
Q

Bandage scissors ?

A

slide it under a badge to not cause tissue damage

48
Q

When holding scissors… the ____ and the ____ finger are inserted into the rings of the scissors while the ______ and ______ fingers are used to guide the instrument

A

thumb and ring finger

index and middle

49
Q

The _______ finger does NOT go into the ring ?

A

middle

50
Q

The curve of the scissor (if it is curved) should be pointed ?

A

Up!

not down

51
Q

Needle Holders examples ?

A

Crile

Mayo Hegar

52
Q

Laparpscopic Instruments ?

A

Needle nose (big bird) grasper

Tissue Dissector

Scissors

Trocar

** all attached to an external handle

all can become a bovie tip if they connect to cautery **

53
Q

Needle nose (big bird) grasper ?

A

big bird - gripper

54
Q

Tissue Dissector ?

A

TD - push through fascia to separate layers

55
Q

Passing Instruments: Hand it to another in the position it will be ____ by the receiver

A

used

56
Q

Sterile Technique: Method by which _______ is maintained throughout the duration of an invasive procedure thereby minimizing the introduction of microorganisms into a sterile field.

A

asepsis

57
Q

Sterile Technique: Healthcare professionals are required to know, understand and follow the procedures for ______________ .

A

sterile technique.

58
Q

Sterile Technique: ______-________ ________ can be dramatically reduced when careful sterile technique is followed.

A

Surgical site infections (SSIs)

59
Q

medical errors are _____ lead cause of preventable death

A

third

60
Q

Principles of Sterile Technique: All items used within a sterile field must be ______

A

sterile

61
Q

Principles of Sterile Technique: A sterile barrier that has been permeated (wet or torn) must be considered_________ .

A

contaminated

62
Q

Principles of Sterile Technique: The _____ of a sterile container are considered contaminated once the package is opened

A

edges

63
Q

Principles of Sterile Technique: Tables are sterile at the ___________ only

A

table surface level

64
Q

Principles of Sterile Technique: Sterile persons and items touch only ______ areas; unsterile persons and items touch only_______ areas

A

sterile

unsterile

65
Q

Principles of Sterile Technique: Movement within or around a sterile field must not ________ the field

A

contaminate

**back to back passing **

66
Q

Principles of Sterile Technique: All items and areas of _______ ______ are considered contaminated

A

doubtful sterility

67
Q

Shoes and Scrubs ?

A

Dedicated OR scrubs

Dedicated OR shoes or shoe covers

Compression hose

**undershirt so the sleeve cannot cross the scrub sleeves **

68
Q

Surgical Cap ?

A

Don before scrubbing

Tighter fit cap okay for short hair

More voluminous cap (bouffant) for longer hair

69
Q

Surgical Mask ?

A

Put on after cap

Molded or two ties

Both have aluminum strip to bend over nose

70
Q

Hand scrub should have the following effects ?

A

Immediate reduction in the resident bacteria

Sustained effect to maintain a reduced bacterial count under surgical gloves

Cumulative effect with each additional application of the antiseptic

Persistent effect providing progressive reduction of bacteria with additional applications

**have sustained affect so later case you can just put advair on and not necessarily resorb all over again **

71
Q

Put on clean scrubs, hat, mask, shoe covers, +/- goggles_____

A

first

72
Q

Remove what when surgical hand scrubbing ?

A

Remove rings, watches and bracelets

73
Q

Use nail cleaner under running water to remove _____ ?

A

debris

74
Q

Use either an _______ or __________ hand rub

A

antimicrobial soap or an alcohol-based

75
Q

If using an alcohol-based rub, prewash hands and forearms with a ________________, dry. Then apply the product, allowing it to ___ completely before donning gloves

A

non-antimicrobial soap

dry

76
Q

Scrub time is ____ minutes, depending on product

A

2-6

77
Q

__ minute scrubs are NOT recommended – too abrasive

A

10

78
Q

_____________ or ________________ ( mores skin reactions) solutions in sterile sponge

A

Chlorhexadine gluconate

povidone-iodine

79
Q

Surgical hand scrub is Combined with a________ for cleansing action

A

detergent

80
Q

Surgical hand scrub: _______________________ against gram-positive and gram-negative microorganisms

A

Rapid acting, broad spectrum antimicrobials

81
Q

Surgical Hand Scrub 2 methods ?

A

Timed (5 minutes)

Counted stroke (30 for nails, 20 for each surface of fingers, hands, wrists and arms)

82
Q

Both surgical hand rubs follow a prescribed anatomical pattern, which is ?

A

Nails

Four surfaces of each finger

Palmar and dorsal surfaces of hands and wrists in a circular motion

4 sides of forearms up to elbows

83
Q

Rinse starting at fingertips, working toward ________ .

A

elbows

84
Q

Keep hands above the _____ so contaminated water drips off the elbows

A

waist

85
Q

Don’t get ______ wet

A

scrubs

86
Q

Drying Hands technique ?

A

Grasp corner of towel

Do not shake out towel, but lean forward so that as it falls it does not touch scrubs

Dry each right finger, then right hand and arm with one half of towel

Repeat on left fingers, hand and arm, using other half of towel

Discard towel appropriately – dropping it into waste from waist height

87
Q

Donning Sterile Surgical Gowns technique ?

A

Grasp gown on inner neck surface

Step back from table and allow it to unfold

Slide arms in, being careful of surroundings

Do not push hands through cuffs

Circulator (nonsterile) attaches Velcro at neckline and ties the back

88
Q

Two Person Gowning: If scrub tech/nurse gowns you, he/she will ?

A

Help you put on the gown

Adjust your gown cuffs before gloving

Help you with gloves

89
Q

Donning Sterile Surgical Gown cont.. ?

A

After donning gloves

Grasp paper card in one hand and short tie in other

Hand card to circulator or scrub nurse

Slowly spin around

Pull long tie from card, tie long end and short end

90
Q

Closed-Glove Technique (Self-Gloving) ?

A

Keep hands inside cuffs

Open sterile paper of glove package

Grasp the folded cuff

Lay it on palm, fingers pointing up forearm

Pull the glove onto hand

Repeat on other side

91
Q

Assisted Gloving ?

A

Scrub nurse adjusts your cuffs

Scrub nurse holds right glove open with two hands

Push your hand in, downward, in a fluid motion

Use your right hand to help open the left glove

Don left glove

Gloves should cover cuffs of gown

92
Q

Removing Gown and Gloves ?

A

Untie side ties

Grasp gown at chest/shoulders

Pull away from you, releasing neck Velcro and back tie

Roll contaminated outer gown inward

Discard appropriately

Remove gloves – Glove to Glove, Hand to Hand

93
Q

Gowns are considered sterile in front from ______ to _____ level, and the sleeves are considered sterile to _ inches above the elbow

A

shoulder to waist

2

94
Q

Preparing Operative Site ?

A

Remove hair with clippers, if necessary (no razors)

Antiseptic soap applied to procedure site first, working outward in a circular fashion toward periphery

On reaching outer boundary, discard the first sponge and repeat with a new sponge

Apply sterile drapes

95
Q

Preparing Operative Site: Apply sterile drapes ?

A

Lint free, antistatic, fluid resistant, abrasive-free, fit contours

Towels, sheets, split sheets, fenestrated sheets, stockinette (for extremities) and plastic incision drapes

96
Q

Draping ?

A

Hold drapes high enough to avoid touching unsterile areas

Walk around the table to drape the opposite side (don’t reach over the patient)

Don’t shake out drapes, let them drop

Make a cuff of the drape over your gloved hand

97
Q

Why make a cuff of the drape over your gloved hand ?

A

Protects your glove from touching an unsterile area

Folded edge towards incision

  • Provides a uniform outline
  • Prevents instruments and sponges from falling between layers
98
Q

Draping cont ?

A

Any part of the drape below waist level or table level is considered unsterile

Towel clips fastened through drapes have contaminated points

If a hole is detected in a drape that has been placed, cover it with a new drape

99
Q

Maintaining a Sterile Field: _________ passes sterile instruments and supplies into the sterile field without ____________ anything

A

Circulator

contaminating

100
Q

Maintaining a Sterile Field: Unsterile personnel must stay at least ________ away

A

12 inches

101
Q

Maintaining a Sterile Field: Passing ?

A

Front to front or back to back

102
Q

Maintaining a Sterile Field: Contamination of personnel or supplies must be addressed ___________.

A

immediately

103
Q

Surgeon typically stands on the_____ .

A

right

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