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Test 1 Flashcards

1
Q

Define asepsis

A

Series of techniques and procedures aimed at excluding all pathogenic organisms from the surgical site

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2
Q

Define sterilization

A

All forms of life and spores are destroyed

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3
Q

Define disinfection

A

Only some forms of life are destroyed (inanimate objects, large objects)
ie floors and tables

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4
Q

Define asepsis

A

Only some forms of life are destroyed (animate objects)
ie animals skin, human hands

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5
Q

Aseptic technique

A

Applied to the surgical suite and patient
Always clean from ceiling to floor and towards exits
Patient and staff prep in other room

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6
Q

Aseptic technique prevents contamination from :

A

Animals skin and fur
Surgeon
Instruments
Room air

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7
Q

Define strike through

A

Microbes gain access to sterile objects via water
Everything in surgery must be dry and cool
Water is the enemy of sterility

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8
Q

OR conduct

A

Talking should be limited
Movement should be limited
Imaginary line of sterile field

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9
Q

What is antiseptic?

A

Prepped animal skin
Scrubbed human skin

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10
Q

What items are considered sterile?

A

Drapes
Instrument field
Gown and linen field (hip to hip, shoulder to shoulder)
Surgical gown and gloved hands
Suture material and blades
Sterile saline
Inside of animal

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11
Q

What is considered disinfected?

A

Items in contact with a disinfectant
ie surgical site

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12
Q

What is considered contaminated?

A

Cap and mask
Gown below waist, back, and wear chin can touch
Outside of packs
Undraped parts
Surgical lights
Anything sterile that touches unsterile
Any item dropped, punctured, or wet

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13
Q

What can sterile surgical assistance do?

A

Receive sterile equipment
Keep table clean and organized
Pass instruments
Maintain homeostasis for the surgeon

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14
Q

Prepping packs and linens

A

Minimal detergent and rinse again before use
Pans and trays for instruments
Box locks and ratchets in open position
Items used first are placed on top (scalpel, towel clamps)

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15
Q

Linens

A

Surgical gowns
Lap sheets
Drapes
Towels

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16
Q

Wrapping packs

A

Size no more than 30cm x 30cm x 50cm
Weigh no more than 5.5 kg
Space between packs ~ 2.5-7.5cm
Wrap TIGHT
Sterile for 2 months if stored correctly

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17
Q

What is written on indicator tape?

A

Contents of pack
Date sterilized
You initals
Group # and letter
2 strips on each pack

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18
Q

Sterilization pouches

A

Paper or plastic
Individual items
Sterilize upright for steam and dry
Sterile for 1 year if stored properly

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19
Q

Types of sterilization monitors

A

Chemical indicator strips
Bowie-dick test
Biological indicators

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20
Q

Chemical indicator strips

A

Change colour when steamed
Place in the centre of packs
Check the strip before the pack is used

21
Q

Bowie-dick test

A

Pre-purchased dense pack with indicator tape in the centre
Place the pack in the most inaccessible location in the auto clave
Verifies steam penetration

22
Q

Biological indicators

A

Used periodically to test sterility and effectiveness of the autoclave
Tests for the most heat resistant bacteria

23
Q

Cotton sterilization

A

Must be double layered and use 2 wraps

24
Q

High thread count sterilization

A

Use 2 single layered wraps

25
Open shelving
Items on open shelving stay sterile for 3 weeks
26
Disposable paper sterilization wraps
Can be cut to size Crepe or non-crepe More durable Expensive Single wrapped 2 way
27
Infrequently used sterile items
Wrap and store in pouches for up to 1 year in a closed cabinet
28
Ethylene oxide
Can prolong shelf life
29
Cleaning and setting up surgical suite
Warm the fluid bag in the autoclave sink Circulating nurse cleans suite before and after lab Move all floor items to near scrub sink before cleaning floors Set up supplies after floor is dry
30
Cleaning the surgical suite after
Circulating nurse’ job Check and restock supplies (expiration dates, refill bottles when 2/3-3/4 empty and new WHMIS label) Order suture materials when 5 packs remain
31
Whose responsibility is patient care during surgery?
The anesthetist
32
Ways we maintain patient temperature
Warm fluids Fluid warmer during surgery White heating pad on induction table Hotdog warmer in surgical suite Bubble wrap and socks Bair hugger postop
33
What does the circulating nurse check before moving patient to surgical suite?
Heating pads Troughs Table ties ready Socks and bubble wrap laid out
34
Once the patient is in surgery :
All legs are tied in a quick release knot and double loop to leg Single loop on the catheter leg Adjust light and table
35
Whose job is it to drape the patient?
Assistant surgeon
36
Controlled drug log - how many mL is each poke in hub loss
0.10mL hub loss
37
Controlled drug important info
No larger than a 22g needle (leakage) Spills are found are signed by witness and calculated by auditing the remaining volume
38
How can instruments be damaged when being cleaned?
By using cleaning solutions that are too alkaline or acidic can cause corrosion Blood can cause corrosion Use of tissue scissors to cut anything other than tissue Use of needle drivers or hemostats to twist wire
39
How can instrument damage be detected?
Close the jaws and check for alignment “Sprung” should be thrown out (don’t close or align) All scissor should cut through 4 layers of gauze
40
What materials are used to clean instruments?
Neutral pH to prevent spotting and corrosion Detergent Rinse with hot water Distilled water for cleaning instruments
41
Why is ultrasonic cleaning useful?
Removes small debris and microorganisms by mechanical energy Formation, expansion, and collapse of air bubbles (16x more effective than manual cleaning)
42
Basic principles of steam sterilization
Heat produced by steam under pressure will coagulate proteins in bacteria and spores Must be adequately packed Instruments are autoclaved open, but closed if they are sharp Packs and trays are placed on their edges so steam can flow downwards
43
Standard time and temperature for steam sterilization
15 minutes at 121°C (250°F) 3 minutes unwrapped at 121°C for emergencies Open autoclave door halfway for 15 minutes to allow drying time Our autoclave runs for 45 minutes and 60 minutes to dry
44
How is cold sterilization used?
Chemical disinfectant Effectiveness varies with system, some may approach true sterilization, but never reach it Use has diminished due to instability of solution after 24 hours
45
Procedure for cleaning instruments at UGRC
Soak in hot water and detergent for 5 minutes Scrub jaws, box, and rings, then rinse with hot water Place in ultrasonic cleaner for 5 to 10 minutes then rinse with tapwater Place an instrument milk for 5 minutes, then place on drying rack (change milk every 7 days minimum)
46
Suture material options
Cassettes Individually wrapped packages Packaged in alcohol Spools
47
Suture materials - cassettes
Cheap but may not guarantee sterility Comes without a needle
48
Suture material - individually wrapped packages
Expensive Comes with or without needle
49
Suture material - spools
Don’t come with a needle Can be re-sterilized with gas or steam Only certain material available in spools (nylon, stainless steel, silk)

Surgery (5 decks)

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