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
Lahey ?
same as car malt ( longitudinal)
26
Right angle ?
for deeper spaces
27
Babcock ?
intestinal put around a blood vessel without pinching on the tissue , put vessel or nerve in the hollow spaces and it wont pinch it
28
Thumb Forceps aka ?
Pickups
29
Thumb Forceps use ?
The instrument should remain at the tips of the fingers for maximum control hold in a pinching motion
30
Thumb Forceps are not called ?
Tweezers * *not tweezers !!! * *
31
Thumb Forceps are not held like a ?
knife
32
Thumb Forceps – “Pickups” examples ?
Adson (Brown) tissue forceps Russian tissue forceps Ferris-Smith tissue forceps Bayonet DeBakey Bonney Rat tooth
33
Adson (Brown) tissue forceps options ?
Without teeth 1x2 teeth 7x7 teeth ** A for suturing **
34
Russian tissue forceps ?
circle of teeth at the tip
35
Ferris-Smith tissue forceps ?
teeth at the tips , cross hatching = more secure when grasping
36
Bayonet ?
offset angle to them
37
DeBakey ?
w and w/o teeth thin strip of teeth though the middle of the tong
38
Bonney ?
...
39
Rat tooth ?
teeth are longer than adsons ( A for suturing and this is for retracting) Rat tooth has larger, interlocking teeth than Adson
40
Scissors examples ?
Metzenbaum Mayo Iris Sharp-Blunt Bandage
41
Metzenbaum ?
scissors Curved or straight Blunt or sharp tips
42
Mayo ?
scissors Curved or straight Blunt or sharp tips heavier fascia or suture sissors,
43
What is the difference between the Metzenbaum and the Mayo scissors ?
length of the handle versus length of the cutting surface ( curves always held to face up)
44
Metzenbaum has a longer _______________ ratio
handle to blade
45
Iris options ?
Curved Straight Angled
46
Iris use ?
two sharp points and for very delicate surgery
47
Bandage scissors ?
slide it under a badge to not cause tissue damage
48
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
thumb and ring finger index and middle
49
The _______ finger does NOT go into the ring ?
middle
50
The curve of the scissor (if it is curved) should be pointed ?
Up! not down
51
Needle Holders examples ?
Crile Mayo Hegar
52
Laparpscopic Instruments ?
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
Needle nose (big bird) grasper ?
big bird - gripper
54
Tissue Dissector ?
TD - push through fascia to separate layers
55
Passing Instruments: Hand it to another in the position it will be ____ by the receiver
used
56
Sterile Technique: Method by which _______ is maintained throughout the duration of an invasive procedure thereby minimizing the introduction of microorganisms into a sterile field.
asepsis
57
Sterile Technique: Healthcare professionals are required to know, understand and follow the procedures for ______________ .
sterile technique.
58
Sterile Technique: ______-________ ________ can be dramatically reduced when careful sterile technique is followed.
Surgical site infections (SSIs)
59
medical errors are _____ lead cause of preventable death
third
60
Principles of Sterile Technique: All items used within a sterile field must be ______
sterile
61
Principles of Sterile Technique: A sterile barrier that has been permeated (wet or torn) must be considered_________ .
contaminated
62
Principles of Sterile Technique: The _____ of a sterile container are considered contaminated once the package is opened
edges
63
Principles of Sterile Technique: Tables are sterile at the ___________ only
table surface level
64
Principles of Sterile Technique: Sterile persons and items touch only ______ areas; unsterile persons and items touch only_______ areas
sterile unsterile
65
Principles of Sterile Technique: Movement within or around a sterile field must not ________ the field
contaminate **back to back passing **
66
Principles of Sterile Technique: All items and areas of _______ ______ are considered contaminated
doubtful sterility
67
Shoes and Scrubs ?
Dedicated OR scrubs Dedicated OR shoes or shoe covers Compression hose **undershirt so the sleeve cannot cross the scrub sleeves **
68
Surgical Cap ?
Don before scrubbing Tighter fit cap okay for short hair More voluminous cap (bouffant) for longer hair
69
Surgical Mask ?
Put on after cap Molded or two ties Both have aluminum strip to bend over nose
70
Hand scrub should have the following effects ?
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
Put on clean scrubs, hat, mask, shoe covers, +/- goggles_____
first
72
Remove what when surgical hand scrubbing ?
Remove rings, watches and bracelets
73
Use nail cleaner under running water to remove _____ ?
debris
74
Use either an _______ or __________ hand rub
antimicrobial soap or an alcohol-based
75
If using an alcohol-based rub, prewash hands and forearms with a ________________, dry. Then apply the product, allowing it to ___ completely before donning gloves
non-antimicrobial soap dry
76
Scrub time is ____ minutes, depending on product
2-6
77
__ minute scrubs are NOT recommended – too abrasive
10
78
_____________ or ________________ ( mores skin reactions) solutions in sterile sponge
Chlorhexadine gluconate povidone-iodine
79
Surgical hand scrub is Combined with a________ for cleansing action
detergent
80
Surgical hand scrub: _______________________ against gram-positive and gram-negative microorganisms
Rapid acting, broad spectrum antimicrobials
81
Surgical Hand Scrub 2 methods ?
Timed (5 minutes) Counted stroke (30 for nails, 20 for each surface of fingers, hands, wrists and arms)
82
Both surgical hand rubs follow a prescribed anatomical pattern, which is ?
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
Rinse starting at fingertips, working toward ________ .
elbows
84
Keep hands above the _____ so contaminated water drips off the elbows
waist
85
Don’t get ______ wet
scrubs
86
Drying Hands technique ?
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
Donning Sterile Surgical Gowns technique ?
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
Two Person Gowning: If scrub tech/nurse gowns you, he/she will ?
Help you put on the gown Adjust your gown cuffs before gloving Help you with gloves
89
Donning Sterile Surgical Gown cont.. ?
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
Closed-Glove Technique (Self-Gloving) ?
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
Assisted Gloving ?
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
Removing Gown and Gloves ?
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
Gowns are considered sterile in front from ______ to _____ level, and the sleeves are considered sterile to _ inches above the elbow
shoulder to waist 2
94
Preparing Operative Site ?
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
Preparing Operative Site: Apply sterile drapes ?
Lint free, antistatic, fluid resistant, abrasive-free, fit contours Towels, sheets, split sheets, fenestrated sheets, stockinette (for extremities) and plastic incision drapes
96
Draping ?
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
Why make a cuff of the drape over your gloved hand ?
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
Draping cont ?
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
Maintaining a Sterile Field: _________ passes sterile instruments and supplies into the sterile field without ____________ anything
Circulator contaminating
100
Maintaining a Sterile Field: Unsterile personnel must stay at least ________ away
12 inches
101
Maintaining a Sterile Field: Passing ?
Front to front or back to back
102
Maintaining a Sterile Field: Contamination of personnel or supplies must be addressed ___________.
immediately
103
Surgeon typically stands on the_____ .
right