T3: Setting Up the Theatre and Anaesthetic Machine Flashcards
What is the aim when setting up the theatre?
- For the theatre to be prepared in such a way that it is fully functional when the patient is brought in.
- It is therefore unnecessary for staff to undertake last- minute fetching and carrying once the procedure is underway.
When setting up the theatre in the morning, what is the first thing that should be done?
Theatre should be damp-dusted w/ clinics preffered disinfectant at correct dilution.
Start at top (lights) and work to bottom
Describe how you would check/set up the anaesthetic machine?
- check the isoflurane level and refill if necessary
- check that the oxygen supply is connected and functional
- check the soda lime and change if necessary
- perform leak test on the anaesthetic machine
- connect the appropriate circuit for the first patient of the day
What things other than damp-dusting and checking anaesthetic machine should you do when setting up the theatre?
- check monitoring equipment (leads, calibrated, power supply, pressure cuffs)
- turn on heat pad
- check lights
- clean bin liner
- any positioning aids ready
- fluid pump is working
- PREPARE SCRUB AREA
How should you clean the theatre between patients?
- switch off equipment (unless N/A some machines left on to hear up)
- all instruments and equipment used in previous procedure removed
- detach light handle
- wipe surfaces w/ lint free cloth
- clean bed on surgery table
- remove rubbish and replace liner
- clean oesophageal stethoscope etc
- check iso/soda lime
- sweep/mop/tidy
What is antisepsis?
refers to the killing of micro-organisms within living tissue, for example treating a contaminated wound.
What does aseptic technique mean?
establishing conditions that prevent the contamination of surgical wounds.
What are the three main sources of infection?
- Environment
- Theatre personnel
- The animal
What are the 3 stages of cleaning?
- Removing gross contamination
- Disinfecting
- Sterilising
3 stages of cleaning:
how do we remove gross contamination?
- using detergents (de-fatting agents) which remove grease and oils
- using mechanical aids such as mops
- pest control (e.g. mouse traps and cockroach baits)
- regular removal of rubbish from the site (e.g. emptying bins)
- This discourages the growth and multiplication of disease-carrying vermin and micro-organisms.
- Removal of obvious dirt and organic materials is essential prior to treatment with many antiseptics and detergents, in order to increase their effectiveness.
3 stages of cleaning:
What does disinfection involve?
- removes and destroys most micro-organisms, except some viruses and heat resistant bacteria and bacterial spores
- eg chlorhex, iodine, alcohol, chlorine
- [] and time of contact essential to effectiveness
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What is an antiseptic and give some examples
- mild disinfectants for use on live tissue
- chlorhex, povidone-iodine, cetrimide
What equipment and requirements should a prep or induction area have?
- seperate from but in close proximity to theatre
- own anaesthetic machine, IV pump
- other equip needed:
- heat nat
- ET tubes/ties
- IV catheter
- antiseptic skin prep and swabs
- needles/syringes
- anaesthetic spray (cats)
- adhesive tape
- monitoring equip
- pump/fluids
- vaccuum cleaner
- rubbish bin
How long after being autoclaved is a surgery pack still sterilised?
up until 3 months past autoclave date
What are the functions of anaesthetic machines?
- Supply oxygen
- supply anaesthetic gases and vapours
- remove carbon dioxide
- inflate animals lungs
What is soda lime used for?
- absorb CO2 breathed out
- colour change occurs as it becomes exhausted, though this should not be relied upon to indicate freshness
- should be changed when 50% becomes coloured
Describe a circle breathing system
components of a circle system include:
- a fresh gas inlet
- an inspiratory one-way valve
- an expiratory one-way valve
- a reservoir bag
- corrugated tubing (both inspiratory and expiratory)
- a Y-piece where the endotracheal tube is attached
- escape valve where scavenger is attached
- soda lime canister
- vaporiser (VIC systems only)
Describe a T-piece breathing system
- used for animals that weigh less than 10kg
- To check for leaks:
close the hole in the end of the bag and the patient connection
allow some gas into the system, and then squeeze the bag to locate any leaks
A bit about flow meters?
- controls flow of gas to patient
- small cyndrical bobbin is displaced upwards when gas is flowing
- flow rate indicated from top of bobbin
- rotation of bobbin indicates gas flow
Descrive a passive scavenger system
- rely on gas moving into a cylinder containing charcoal such as a scavcan that filters the gases, or by a tube going out of the room outside
Describe an active scavenger system?
- connected to a suction pump that then filter out the gases.
Why do we intubate patients?
- to protect and support the patients airway because anaesthesia removes the muscular supports.
- minimise the gas pollution and provide safer anaesthesia by removing anatomical dead space.
Describe how to select the correct ET tube?
- can check distance between nares
- measure from nose to point of shoulder
- make sure not too much over hang from mouth
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How do you clean an ET tube?
washed in disinfectant/detergent, may use pipe cleaner and hang to dry
once dry, wipe over with alcohol
