UNIT 2: Surgical Radiology Flashcards
Who are the personnel that don sterile gowns and gloves and work within and around the sterile field?
-Surgeon
-Surgical Assistant (often a surgeon or surgical resident)
-Physician assistant
-Scrub nurse
-Certified surgical technologist (CST)
Which personnel do not enter the sterile area but perform vital tasks within the operating room?
-Anesthesiologist or CRNA
-Circulator nurse
-Radiographers
-Biomedical technicians
-Monitoring techs
-Equipment specialists
Operating room- Restricted Attire
-Street clothes should never be worn
-Clean scrubs should be donned at the beginning of each shift in the OR suite
-Soiled attire must be changed immediately and NEVER worn outside the OR
-Protective eyewear must be worn when contamination is possible
-Shoe covers should be worn in the OR suite
-Masks should be worn at all times in the OR
-Caps need to cover and contain hair at all times
-Gloves should be worn when contact with blood or body fluids is anticipated
Operating room: Semi-restricted Attire
-Street clothes should NEVER be worn
-Clean scrubs should be donned at the beginning of each shift
-Wet or soiled scrubs need to be changed immediately and NEVER worn outside the OR
-Scrubs should never be worn more than once before washing
-Shoe covers should be worn upon entering the non-restricted area and removed before exiting the department
-Caps should be worn to cover all hair
-Mask is NOT necessary outside the OR suite and should never be worn around the neck
Maintaining the Sterile Field
-Non-sterile team members should NEVER reach over a sterile field
-Sterile fields should be covered with a sterile drape if not in use
-C-arms and mobile x-ray units should NEVER be positioned over an unprotected sterile field
-ANY break in sterility needs to be communicated with the surgical staff immediately
Principles of Aseptic Technique
-Only sterile items are used within the sterile field
-Only sterile persons handle sterile items
-Nonsterile persons touch only nonsterile items
-Movement around a sterile field must not contaminate it
-Items of doubtful sterility must be considered nonsterile
-When a sterile barrier is permeated it is considered contaminated
-Sterile gowns are sterile in front from the shoulder to the level of the sterile field and at the sleeves from the elbow to the cuff
-Tables are sterile only at table level
T or F: Radiographers should not walk between two sterile fields (the sterile corridor)
True
T or F: Always turn your back toward the sterile field
False, never turn your back to the sterile field
T or F: Radiographer should not lift the sterile drapes above the table level
True
T or F: You can position the tube over a sterile field even if the field isn’t covered
False, it must be covered
Cleaning the Equipment
-Should be cleaned after each use and before leaving the OR suite if possible
-Cleaning solution should be approved by both the hospital AND the equipment manufacturer
-Cleaning solution should NEVER be sprayed in the OR
-Underside of c-arm should be inspected for blood or fluid that may have dripped underneath or splashed up from the floor
-Equipment that is not used often should be cleaned once a week AND prior to a surgical case
How far away from the patient should you be in the OR?
Minimum of 6 ft
Radiographers should wear an apron with at least ____ lead equivalent
0.5mm
The greatest amount of scatter occurs on the _____ side of the fluoroscopic machine which is usually located ____ the table
Tube, Under
The least amount of scatter occurs at ___ degrees to the primary beam
90
It is the responsibility of the ____________ to provide or ensure protection of all personnel in the room
radiographer
T or F: Patient’s gonads should be shielded when possible
True
SSD for c-arm procedures should NEVER be less than ___ inches
12
Bronchoscopy
-A bronchoscope is inserted into the airways through the nose or mouth to allow for visualization of the airways
-Biopsies are often done with the use of fluoroscopic guidance
-Procedure may be performed bedside in the unit, in the endoscopy suite, in the fluoroscopy suite, or in the OR
-Procedure is considered CLEAN but NOT sterile
-No sterile field
-C-arm does not require draping
Surgical Line Placement
-Fluoroscopic guidance for placement of various catheters, drainage tubes, and medical devices
-PICC line
-Central Venous Catheter
-Surgical Drains
-Port-a-cath
-Dialysis catheters
-Procedure may be performed bedside in the unit, in the fluoroscopy room, or in the OR
-Procedure is performed under aseptic technique
Surgical Discectomy and Fusion
Hip Pinning
Femur Nailing
Tibial Nail
Humerus
Femoral/Tibial Arteriogram
-Patient is supine with affected leg exposed from hip to toe
-The c-arm should have free movement along the entire length of the leg
-C-arm enters perpendicular to the patient
-Mask image: first image taken with bones displayed
-Subtraction or road-mapping feature used to remove all structures except the contrast
Kyphoplasty
Define Aseptic Technique
principles involved with manipulation of sterile and nonsterile items to prevent or minimize microbiologic contamination
Define Contamination
presence of pathogenic microorganism
Define Restricted Area
operating rooms, clean core or sterile storage areas
Define Semi Restricted Area
area of peripheral support, such as hallways or corridors leading to restricted areas
Define Sterile
substance or object that is completely free of living microorganisms and is incapable of producing any form of organism
Define Unrestricted Area
areas in which street clothes are permitted, such as outer hallways, family waiting areas, locker rooms, and employee lounges.
Define asepesis
absence of infectious organisms
Define sterile field
area around the incision site created using sterile drapes, including mayo stand and back table
What is sterile technique?
a method used in surgery to prevent contamination of the wound and operative
site
• all instruments are sterilized
• all OR personnel wear scrubs, head cover, mask, shoe covers
• sterile field members don sterile gown and sterile gloves after performing surgical scrub
What is surgical conscience
The “inner voice” for conscientious practice of aseptic and sterile techniques at all times
the surgical hand scrub
performed by all who will be donning sterile gown and gloves antimicrobial soap and brush step by step process (5 minutes)
Back Table
-sterile instruments, supplies, drapes, etc.
-placed away from doors, on operative side positioned 90 degrees to OR bed after draping
-items arranged in specific order
Mayo Stand
-sterile instruments and supplies
-contains items to be used for the procedure
-positioned in various places depending on the procedure
Prep Table/Prep Stand
-usually for non-sterile items and tasks
-flat surface for variety of uses: writing, items that may be needed, instrument pans
-sterile prep tray placed on table for sterile skin prep
Ring Stand
-usually sterile but may be used in non-sterile manner
-holds basin
-single or double
-used for irrigation solutions, soaking instruments, specimen(s), etc.
Kick Bucket
-always NOT sterile
-used for discarded sponges, containment of fluid
-positioned within close proximity of scrub person
OR Light
-illumination of the sterile field
-unsterile but requires sterile handle to move and adjust
Non-sterile person stays at least ___ inches away from sterile areas and sterile people
12
X-Ray Viewing Box
-on/off switch operates light
-x-rays slide into groove at top of each panel
-some facilities use a computer based system called PACS (picture archiving and communication system)
