Test GG, HH Flashcards
what is draping?
covering of the patient with sterile barriers, leaving only minimum skin exposed at the site of operation
what is the purpose of draping?
create and maintain sterile field during operation
problem solving for drape problems
ignore (only in extreme emergencies)
discard and replace
cover
how are drapes secured?
towel clips or staples
what do drapes prevent?
eliminating passage of MO’s between sterile and nonsterile areas
what are the four steps before draping is done?
anesthetized
foley catheter
positioned
prepped
what is the criteria for perfect drape
fluid resistant
abrasion resistant
lint free
flame retardant
what should drapes fit around?
patient
furniture
equipment
non woven-disposable paper
tear resistant
impervious
doesn’t need washing, folding
woven-reusable muslin
cotton
impermeable to liquids
repair holes
needs laundering
steri drape
clear plastic-adhesive backing applied directly over skin
ioban incise drape
impregnated with antimicrobial iodine agent
what is the purpose of iodine in ioban incise drape
slowly released to destroy bacteria produced by skin
fenestrated drapes
opening in drape
What are nonfenestrated drapes used for?
used to square off area
example of nonfenestrated drapes
towels
1/2 sheet
how should you open the drape?
away from you and in area where it will not touch anything when opened
how can you move drape once it is placed?
may be adjusted away from incision area, never towards incision
what should you do if drape is placed incorrectly?
discard
what should the ST do when handing skin towels to surgeon?
stand on the same side as the surgeon
pre op prep steps
transport
position
prep
drape
goals of skin prep
reduce SSI
inhibit rapid growth
reduce resident MO levels
remove transient MO’s
what is the most common cause of SSI?
the normal skin of the patient and surgical team members
principles of prep
note all allergies
inspect skin
define wide area to be prepped
routine preparation
history and physical chest xray blood counts urinalysis enema anesthesiologist
when does checklist for preop start?
time of admission, finished in the holding room or in OR
who’s job is it to finish checklist?
CN
general consideration for pt during prep
cleanliness or dirtiness of patient
anatomical area
texture of skin involved
shaving skin prior to surgery
removes hair from skin surface
decreases hair pulling by adhesive
must not have any nicks
clipper
leaves a short stubble of hair, but causes less micro-abrasions
depilatory cream (nair)
patients may have skin irritation from the chemical, not often used
razor
be sure to use a new one if first one becomes dull
wet shave is always best
how is skin prep always done?
by means of shaving, mechanical washing, chemical disinfection
is pre op cleansing/shaving sterile?
no
When is intra operative skin prep done?
performed after positioning and before the drape
When is pre op prep done?
morning of surgery or in holding area
what is the purpose of intra operative skin prep?
to make the skin as clean as possible
mechanical washin
antiseptic
vigorous scrubbing-not cancer patients
providone iodine (betadine)
never used around ears
can cause contact dermatitis
don’t use with babies
why shouldn’t you use betadine around ears?
can cause deafness if tympanic membrane isn’t intact
chlorhexidine gluconate
may cause allergic reaction
used with caution on mucous membranes
can cause deafness
alcohol
flammable
doesn’t penetrate organic materials
what is the rule with alcohol?
it must be dry before draping
duraprep
harmful to fetuses or neonates
gel prep
gel is applied to cover all skin in designated area, isn’t scrubbed
areas considered dirty
umbilicus stomas traumatic wounds skin ulcers vagina anus
considerations for dirty areas
isolate the area from the surgical site if at all possible
prep areas separately
miscellaneous stuff for prepping
jewelry should be removed
limb holders are discouraged
don’t warm prep solution
how do you start an abdominal prep?
use Q tips first
degreasers
used after shaving head if greasy
hair from a craniotomy
keep for patient!!!
What thread count is woven Muslim?
140 x 2 double thickness
What does the ST need to remember to do for supplies?
Have all supplies ready
Have all supplies in order
Be ready to assist
What happens if the scrub solution pools?
Chemical burn
What requires a Dr. order?
Required when removing hair
Litho draping
UBD
2 diagonal towels
1 towel
Litho drape
Laparotomy draping order
4 towels
Half sheet
Laparotomy sheet
What is a U drape for?
Extremity
7 sterile prep steps
Position supplies - expose patient Open glove Place white towels Scrub area Dry area with towels Paint area Remove all prep supplies
How many towel clips are used with lateral draping?
4 towel clips
