Surgical Suite & Attire (3) Flashcards

Dr. Devine

1
Q

What is the difference between clean versus contaminated and dirty?

A

clean: free of obvious dirt, debris, etc

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2
Q

What is the difference between asepsis and sterile? (*)

A

asepsis: removal of pathogenic organisms

sterile: removal of all microorganisms (+/- spores)

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3
Q

What are the barriers of infection?

A

environmental barrier
surgical staff barrier
patient barrier

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4
Q

What is included in the environmental barrier?

A

surgical suite (operating room), equipment and instruments

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5
Q

What is included in the patient barrier?

A

draping
skin preparation

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6
Q

What can contribute so much contamination potential?

A

number of people in the OR

talking, skin exposure, activity/movement

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7
Q

What is the primary source of contamination from the surgeon? What is the goal then?

A

skin debris

cover the body of people nearest to surgical site

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8
Q

What are the components of surgical scrubs?

A
  • first barrier against shedding skin debris from humans - men more than women
  • changed after each case, launder, sterilized

top tucked in! and also cover scrubs when out of surgery suite

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9
Q

T/F: This is acceptable

A

FALSE - open lab coat = no effect

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10
Q

What are the purposes of surgical gowns?

A

water resistant - but comfortable and breathable

lint free

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11
Q

T/F: The cuffs on the surgical gown can either be under your surgical gloves or below it

A

FALSE - should always be underneath the gown

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12
Q

What is the purpose of face masks?

A

redirects airflow away from the surgical site

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13
Q

What is NOT the purpose of face masks?

A

NOT effective bacterial filters - sides are not sealed

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14
Q

T/F: Partially removing the mask causes contamination of it

A

TRUE - also is only effective for less than 2 hours

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15
Q

When are foot covers NOT useful?

A

in reducing contamination to the operating floor in an equine surgery suite

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16
Q

What is the best option for footwear in the surgery suite?

A

dedicated surgery shoes, usually waterproof

17
Q

What are the types of gloves?

A

latex and non-latex (vinyl, nitrile) - sterile, single use

18
Q

What are the special circumstances for surgical gloves?

A
  • orthopedic gloves (thicker)
  • double gloving - LA surgery for draping and ortho
  • sleeves
19
Q

Where are the most likely locations on the hand for a glove puncture wound?

A

thumb and index finger of non-dominant hand

20
Q

Where are a surgeon’s hands the dirtiest?

A

around the fingernails

21
Q

What does scrub do?

A

reduces normal bacterial flora and other skin protective barriers

but increases the chance of colonization by pathogenic bacteria

22
Q

What are the goals of scrubbing?

A
  • remove dirt and oil
  • remove and/or transient organisms
  • reduce resident population of bacteria
23
Q

T/F: Hand disinfection removes only the transient bacteria

A

FALSE - reduction of all bacteria - normal, transient, and infectious/pathogenic flora

24
Q

What hand maintenance should you do to be adequate to perform surgery?

A
  • short finger nails < 2mm
  • clean nails
  • no jewelry
  • moisturized hands
25
What are the types of scrubs?
chlorhexidine gluconate povidone-iodine
26
What are the pros and cons of chlorhexidine gluconate?
- immediately bactericidal - residual activity - potentially inactivated by hand cream and soap
27
What are the pros and cons of povidone-iodine?
- possibly better activity versus resistant bacteria - poor residual activity - can cause skin irritation in some people
28
What are the characteristics of alcohol-based rubs normally post-scrubbing?
rapid and immediate action **prolongs activity** of chlorhexidine - does not further reduce flora
29
How should you disinfect your hands?
clean under nails, first scrub with brush, scrub from tips of fingers to elbows
30
How long should you scrub? How many strokes?
2-5 minutes dependent on antiseptic 20-30 strokes per 25 anatomical parts of the hands
31
What is "dirty" surgery?
using sterile gloves only
32
In field surgery, what is different for surgical attire?
variation - usually no hat or mask, gown over coveralls with gloves, coveralls with sterile sleeves and gloves
33
T/F: Studies have shown there is not much of a difference in bacterial counts in keeping the OR door closed or open
FALSE - have minimal traffic flow and keep doors closed
34
What are some necessary qualities surgery facilities should have?
- easy to clean surfaces - well-placed drains - 68-73 F with 30-60% humidity - air under mild positive pressure - laminar air filtering system - well placed electrical outlets and anesthesia hook-ups
35
Who should be in the surgery area ideally?
anesthetists, technician, surgeon