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surgical nursing > Unit 3: surgical equipment and instruments > Flashcards

Unit 3: surgical equipment and instruments Flashcards

1
Q

What are the SVMA practice standards for surgical suites

A

Must have a separate room for surgery in all clinics built or remodelled after 2004
If there is not a separate single purpose surgery room, a written protocol describing how asepsis is maintained must be presented
A recovery area must also be provided where a patient may be frequently observed following anesthesia (but need not be separate from animal compartments)

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2
Q

What should the ideal surgical suite include

A

A surgical facility should strive to create the safest enviro for the patient
The american animal hospital association (AAHA) recommends three distinct and separate areas for a surgical facility
The preparation area
The scrub area
The surgery room

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3
Q

What is the prep area used for

A

Should be adjacent to the surgery room
Used for patient preparation (e.g., clipping and initial scrub) and the storage of surgical supplies
Ideal to have a separate anaesthesia machine for the prep room
To prevent cross contamination from occurring when the machine is moved from one room to another
Procedures that are considered clean but not sterile or that are classified as dirty should be performed in this area

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4
Q

What is the scrub area and what is it used for

A

Large enough to hold a scrub sink
Room to put on gown and gloves
May also be where the autoclave is located

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5
Q

What is a surgical suite

A

Separate dedicated room used only for aseptic surgical procedures
Should be easy to clean
Large enough that personnel can easily move around the surgery table without contaminating the surgical field or the surgeon

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6
Q

What are some characteristics of a surgical suite

A

Large enough that personnel can easily move around the surgery table without contaminating the surgical field or the surgeon
Should be free of clutter
Only required surgical equipment should be kept in the surgery suite
Cabinets should be made of non porous material with doors
Protects sterile supplies from dust, debris, and other contaminants
Should have a door into room that can be closed
Air pressure should be greater in the surgery room than rest of veterinary facility
Higher air pressure pushing air out of the surgical suite → this will reduce the ability of the airborne bacteria to move into the surgical room from the other areas of the clinic

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7
Q

What is permanent equipement

A

Equipment that is attached to the floor, wall or ceiling in the surgical room

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8
Q

What are some examples of permanent equipment

A

Surgical lights
Surgery table
Radiographic view box/computer
Anesthetic machine
- Although they should not leave the surgery room, in many facilities they are required to serve a dual purpose and are moved to other areas of the hospital

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9
Q

What should you do with movable equipment for the surgical suite

A

These items must be cleaned and disinfected thoroughly before being returned to the surgery room

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10
Q

Movable equipment items include

A

Monitoring equipment
Heating pads
IV drip stand
Instrument table, mayo stand
Suction
Cautery unit
Kick bucket

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11
Q

How do you clean surgical equipment

A

The surgery room should never be dry dusted this may aerosolized the dust and bacteria
All equipment should be wiped daily before surgery with the appropriate cleaning or disinfecting solution
Important to follow the manufacturer’s instruction
This information should include the equipments compatibility with chemical germicides
Whether it can be immersed for cleaning
How it should be decontaminated

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12
Q

What is perioperative equipment

A

Many pieces of equipment besides surgical instruments are critical to the success of a surgical procedure
Whether related to providing patient comfort, assisting the surgeon, or monitoring anaesthesia, each item is an integral part of the process

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13
Q

What is perioperative equipment

A

Patient warming devices
Surgery lights
Surgery table
Electrosurgery
Suction machines
Surgical instruments

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14
Q

What should you do before placing an animal on a heating pad

A

Unless otherwise indicated in the instruction manual – ALWAYS place a towel between your patient and the warming device to prevent thermal burns!

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15
Q

Circulating warm-water blankets are commonly used for surgical patients why

A

The heated surface helps prevent the loss of body heat to a cold metal surface
Diminishes hypothermia

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16
Q

What are hard heating pads and what are the advantages

A

Made of acrylic plastic glass, (plexiglass) connects to many currently available circulating water pumps
The main advantage to the is style of heating system is that the plexiglass is puncture proof

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17
Q

What is a hot dog warming blanket

A

Uses electricity to warm the pad but does not pose the same threat for thermal burns as traditional heating pads
Has a sensor in the pad to regulate the what generated
Not puncture proof but are not harmed if punctured

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18
Q

What is a forced air warmer

A

(ie bair hugger)
The pad is placed around the patient, then inflated with warm air
The constant flow of warm air is very effective at maintaining or increasing patients body temp
Not puncture proof, but there is less risk of puncture because the pad is not placed near the animal until the patient is anesthetized

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19
Q

What deos surgical lights include

A

Adequate lighting is imperative
Ceiling- or wall-mounted lights are much better than the standing floor models
Removable light handles that can be autoclaved
The surgeon or surgical assistant can then place the handles on the lights, allowing either person to adjust the lights directly

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20
Q

What are the types of surgical tables

A

A tabletop can be solid surface or can be designed in a split surface style

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21
Q

What is the advantage of a solid surface surgical table

A

The solid top model is generally less expensive and can be more difficult to work with because fluids pool on the tabletop and can soil the patient

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22
Q

What are the advantages of a split surgical table

A

A tray under the space in the table to collect any fluid that may run off the surgical field
The ability to be adjusted to help maintain the patient (especially large, deep chested dogs) in dorsal recumbency

23
Q

What should a surgical table be able to do

A

Surgery should also have the capability to be raised and lowered and to tilt in one direction
Hydraulics or electric power can be employed to accomplish variation in height
Manual effort is generally required to tilt the table

24
Q

What is electrosurgery

A

The use of electricity, transmitted through a special hand piece, to cut or coagulate vessels
Signal use or reusable cautery hand pieces
Charred material may be build up on the tip of the hand piece, impeding the flow of current
It may be cleaned by scrapping with a scalpel blade (away front eh sterile field) or by using a commercially available scratch pad

25
Q

What is Monopolar electrosurgery

A

A ground plate must be placed under the patient
A water or saline saturated sponge should be placed on the ground plate between the patient and the plate
Alcohol is never used to saturate the sponge because it may lead to patient burns or even fire
Can be used to make the surgical incision
An incision created with an electrosurgery unit takes longer to heal because of the charring of the tissues

26
Q

What is Bipolar electrosurgery

A

Utilizes a hand piece that resembles a thumb tissue forceps
No round plate is needed
As the hand piece is activated, the current passes from one tip to another

27
Q

Monopolar electrosurgery can be used how

A

The handpiece can be activated, and the tip of the hand piece can directly touch the tissue or vessel that needs cauterising
A hemostat can be placed on the tissue or vessel that needs to be cauterised
- The hemostat is then elevated off the surgical field so that the only metal touching the patient is the tip of the hemostat
- The cautery handpiece tip can then be touched to the hemostat as the hand piece is activated

28
Q

What is suction

A

Defined as the ability to remove fluid or air from an area by a manual or a mechanical device

29
Q

What can you use for suction

A

Can be performed with a syringe, a bulb syringe, or a mechanical pump
Mechanical pump is commonly used in surgery
Suction can be used when working in body cavities to remove excess fluid

30
Q

When do you use suction in orhtopedic surgeries

A

Lavaging a joint
Flushing a septic site
Removing bone dust created while drilling screw holes for a fracture repair

31
Q

Why do you have to be careful with suction levels

A

Care must be taken to use appropriate levels of vacuum
A sufficiently strong vacuum that meets the needs of the surgical procedure without being excessive is the goal
Inappropriately low vacuum settings will not adequately suction the fluid and debris on the field and will prove to the frustrating
In abdominal procedures, if the vacuum level is too high, omentum may become entrapped in the suction tip and may be damaged

32
Q

What is the elcrtical suction machine

A

Electric power: uses a motor to generate the vacuum or a central vacuum system may be used

33
Q

What deos electrical suction machiens need

A

Both require some sort of bottle or receptacle for the collected fluid
Usually, the cover of the bottle has some type of float or safety drive that will not allow fluid into the working mechanism of the suction machine of the bottle becomes too full
Different designs of suction tips
Suction tubing is available in 6- and 10-foot lengths

34
Q

What should you do with suction tubing

A

The tubing is usually prepackaged and sterilized for single-time use
After the package is opened onto the sterile field, one ended o the tubing is attached tot the suction tip and the other end is dropped off the field to be connected to the nonsterile suction unit
Because of the length of the tubing and the difficulty in cleaning it appropriately, the tubing should be discarded after surgery
If for some reason the tubing is not used after being opened, it can be resterilized
Ethylene oxide sterilization must be used because this vinyl tubing will not withstand steam sterilization

35
Q

What is important to knwo about basic surgical isntruments

A

Are a major investment: important that instruments must be sued for their designed purpose
Improper use can damage or destroy instruments
Instruments are generally made of stainless tell, although some disposable models may be made of plastic

36
Q

What is the jaw or tip of a surgical isntrument

A

Can be traumatic or atraumatic
Can be straight or curved
Can have serrations
Horizontal, vertical, or a combination
Teeth or arrangement of the teeth can be 1x2, 2x3, and so on
Can also be arranged in rows
The tulips or jaws can easily become damaged
Teeth and serrations of the tips of jaws should be thoroughly evaluated after each use to observe any defects that may have resulted from use
Blades are available on most types of scissors as curves or straight
Blades can have sharp or blunt tips

37
Q

What is the box lock of a surgical isntrument

A

where the hinge is)
Present only on instruments with ring handles
Is the joint or hinge of the instrument
Absorbs great stress when the instrument is in use
Must be inspected carefully to detect any cracks or evidence of degradation
Most difficult part of the surgical instrument to clean

38
Q

What is the shank of a surgical instrument

A

(or shaft)
The body of the instrument
Runs from box lock to finger rings
Is usually the longest area
The longer the shank, the greater the closing force on the jaws

39
Q

What is the ratchet of the surgical isntrument

A

Found only on instruments with ring handles
A device with interlocking teeth that will lock an instrument jaw in a closed position
Degradation of this part of the instrument is usually seen as the inability of the ratchet to remain locked
Difficult part of surgical instrument to clean

40
Q

What are the ring handles of the surgical instruments

A

Serve as the means for using and controlling the instrument
Proper handling of an instrument with ring handles is achieved by placing the thumb and ring finger in the rings
Neither ring should advance beyond the first knuckle of the thumb or finger
The index finger can rest on the shank to help stabilise the instrument

41
Q

What is a groove director

A

Designed to aid the surgeon in making incisions on the linea alba
Provides a channel that the scalpel can follow to avoid accidental incising of the abdominal viscera

42
Q

When is a bowl in an instrument pack

A

Some instrument packs include a sterile bowl
The bowls can be used for holding saline for lavage or for storing sharps during the procedure to help keep the instrument table safe and clean

43
Q

What are intestinal clamps and when are they used

A

The types used in a procedure depends on the intended outcome of the tissue being clamped
Tissue that is not viable or that is being removed can be clamped with a more traumatic clamp
Tissue that merely needs to be manipulated but will remain in the patient needs to be handled with care

44
Q

What is a needle punch biopsy

A

Equipped with either a cutting or a core biopsy needles
Available as manual and automatic devices
Take a small piece of tissue (approximately the size of pencil lead) for microscopic evaluation
Ultrasound guided biopsies of internal organs, including liver, speel, kidney and prostate, are often performed with theses instruments

45
Q

What are bone holders

A

Clamps designed to hold bone fragments together until permanent fixation can be achieved
Cen have pointed, toothed or serrated tips

46
Q

What are periosteal elevators

A

Used to prepare the fractured bone for permanent fixation
Used to elevate the periosteum form the bone so that the implants can be placed
Used for making gingival flaps in dentistry

47
Q

What are bone rongeurs

A

Used to break up bits and pieces of bone for grafting purposes
Pieces of bone too small to reattach to the animal are broken down into small pieces and packed around the fracture lines to encourage new osteoblast formation and promote whaling

48
Q

What are bone curettes used for

A

Used to harvest bone graft material or to shape and scrape bony surfaces

49
Q

What are hand chuck for orthopaedic surgeries

A

A hand chuck is designed to hold and drive intramedullary pins for repair of a fracture of for other orthopedic procedures requiring the use of pins
The hand chuck is a manual drill

50
Q

What are some internal fixation implants for fractures

A

Intramedullary pins
Pin cutter
Orthopedic wire
Bone plates and screws
Depth gauge
Prethreding tap
Screwdriver
Drill and tap sleeves
Countersinks
Plate benders

51
Q

What are some ways surgical power tools can get power

A

Pneumatic
- Compressed nitrogen or air via power cord or hose
Electric
- Via wall plug– hose doesn’t detach from hand piece
Battery
- Rechargeable battery pack inserted into hand piece – no hoses or cords
Handpieces are never immersed in liquid

52
Q

When are power drills used

A

Fracture repair requires the use of a power drill to place implants

53
Q

What are some specialised drills

A

Neurosurgery requires the use of a specialized drill to remove the vertebral bony body
Power saws

54
Q

Ophthalmic surgery instruments

A

These instruments are extremely delicate and expensive and should be handled with great care
Because of the nature of the tissue for which these instruments are routinely used, the tips are very fine, the shafts tend to be shot, and the mechanism of use may be box lock or squeeze handle

surgical nursing (10 decks)

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