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Fundamentals Of Ultrasound Practice > Week 2 > Flashcards

Week 2 Flashcards

1
Q

What is infection?

A

“Invasion of the body by pathogenic microorganisms that reproduce & multiply, causing disease by local cellular injury, secretion of a toxin, or antigen-antibody reaction in the host”

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2
Q

What is infection control?

A

Preventing or initiating infection from occurring

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3
Q

How do we prevent the spread of infection?

A

Hand washing

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4
Q

What is an approximate bacteria count on hands (colonies)?

A

5000-5million colony forming units per square centimetre

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5
Q

What is the percentage of germs that are trapped in deep skin crevices?

A

10-20%

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6
Q

Worst place for germs to hid?

A

Fingernails

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7
Q

How many factors are there in the cycle of infection?

A

6

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8
Q

What are the steps involved in the cycle of infection?

A
  1. Infectious gent/pathogenic organism
  2. Reservoir of infection
  3. Portal of exit from the reservoir
  4. Mode of transmission
  5. Portal of entry to a susceptible host
  6. A susceptible host
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9
Q

What is a pathogenic organism?

A

A microorganism capable of causing disease
- Bacteria, virus, fungi, Protozoa
Causes damage to host cells

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10
Q

What is a reservoir of infection?

A

Somewhere the pathogen can survive and thrive
Provides moisture, oxygen, pH, light, nutrients and adequate temp
Inside human body
Animals, soil, food, water

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11
Q

What is the portal of exit?

A

Pathogen leaves the reservoir through a portal of exit

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12
Q

What types of portal of exits and entry’s are there?

A

Bloodstream, skin, wound, respiratory system

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13
Q

What are the modes of transmission?

A

Contact
Airborne
-droplet
Insects
- flys, mosquitos
Vehicles
-water, blood, drugs, food
Fomites
-bed linen, your watch, eating utensils

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14
Q

What is the portal of entry?

A

Pathogen enters the host though a portal of entry

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15
Q

Who is a susceptible host?

A

Normally a patient with a reduced ability to resist infection dependent on:
-how resistant a person is to the pathogen
-the virulence of the pathogen

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16
Q

What are high risk nosocomial infection/healthcare associated infections (HIA)?

A

Multi drug resistant infections are a high concern
- MRSA & VRE
-Superbug eg CRE

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17
Q

3 facts about HIA
Occur 48hrs or after being admitted to hospital
200,000 patients each year acquire a nosocomial infection in Aus

A

A hospital acquired or healthcare acquired infection

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18
Q

2 most common acquired infections for healthcare workers

A

Hepatitis B- body fluids. Causes sickness
Hepatitis C - bodily fluids or needle stick. Causes liver infection

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19
Q

What are the 2 tiers of precautions?

A

Tier 1: Standard precautions
Tier 2: Transmission-based precautions

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20
Q

What is tier 1?

A

Standard Precautions
Work practices are required to achieve a basic level of infection control
Recommended for the treatment and care of all patients
Include:
Hand washing, aseptic technique, use of PPE, appropriate cleaning of instruments
Implementation of environmental controls/environmental cleaning

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21
Q

What is routine hand washing?

A

15-30 seconds before and after every patient
Every sonographer - every patient

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22
Q

Types of hand washing

A

Routine, aseptic procedures, surgical handwashing

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23
Q

What is aseptic procedures?

A

1 min before any procedure requiring aseptic technique

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24
Q

What is surgical hand washing?

A

First wash for the day 5mins
Subsequent washes 3 mins
(Not generally required to be performed by sonographers)

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25
Q

When and why we should wash our hands?

A

Why: Break the chain of infection & prevent the spread of infection
When: before/after eating
After using toilet
Before/after contact with patients
Before and after use of gloves
After handling any equipment soiled with bodily fluids

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26
Q

What is asepsis and when should the aseptic technique be used?

A

Asepsis: Absence of pathogens that may cause disease
Aseptic technique: Try to reduce the number of pathogens
Prevent or reduce transmission of these pathogens to our patients
Keep and maintain objects and areas free from pathogens

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27
Q

What is clean and sterile asepsis techniques?

A

Clean technique is medical asepsis
Sterile technique is surgical asepsis

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28
Q

What does the clean technique do?

A

Reduce the probability of an infections agent being transmitted to a susceptible host
Hand washing, proper cleaning

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29
Q

What does the sterile technique do?

A

Equipment is treated with gas, heat or chemicals to remove pathogens (CSSD departments are often located near theatres in hospitals)
Complete removal of al organisms
Sterile fields
Sonographic transducers and cords are often enclosed in sterile plastic bags in theatre

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30
Q

What is PPE and what equipment is there?

A

Any piece of equipment that can be used for Health & safety precautions
In a medical setting aids to minimise the spread of infection
Included: Gloves, gowns, booties, goggles, face masks
Different situations call for different PPE

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31
Q

How is PPE used?

A

Put on before contact with patient/before entering room
Use carefully - don’t spread contamination
Remove and discard appropriately immediately after use
Immediately perform hand hygiene

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32
Q

What are tier 2 precautions?

A

Transmission based precautions
Are tier 1 standard precautions plus further barrier-type precautions
These additional precautions are either:
Airborne isolation
Droplet isolation
Contact isolation
Expanded precautions

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33
Q

Additional precautions

A

Applied when standard precautions may not be sufficient to prevent the spread of infection
Remember - CRE, VRE, MRSA
These precautions are tailored to the pathogen, eg droplet isolation for diphtheria, airborne isolation for measles, contact isolation for Ebola

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34
Q

Needle stick injuries

A

Healthcare workers increased risk
Blood-borne disease transmission possible
Observe where used needles go (should be straight in sharps container)
Never recap a needle

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35
Q

What are some blood borne disease transmission’s possible for needle stick injuries?

A

HIV (human immunodeficiency virus)
Hepatitis B
Hepatitis C

36
Q

What are some COVID 19 and Infection Controls?

A

Not going to wok sic
Limiting movement of residents/staff in facilities
Annual flu shot
Isolating residents that are positive to an infection together
Standard, contact & droplet precautions
Frequent cleaning/disinfection
Cough etiquette
Hand washing
Social distancing
Appropriate use of PPE

37
Q

What are standard precautions?

A

Primary strategy for minimising the transmission of healthcare associated infections
A basic level of infection prevention and control to achieve
Must be used at all times for all patients/situations

38
Q

What are the key components of standard precautions?

A

PPE
Aseptic technique
Reusable equipment/instruments
Safe disposal/storage of snaps
Hand hygeine
Respiratory hygiene& cough etiquette
Routine environmental cleaning
Waste management

39
Q

In what situations should you wash your hands or hand rub?

A

Hand wash: Visibly dirty, soiled with bodily fluids, after using the toilet, exposure to spore-forming pathogens is strongly suggested or proven

Hand rub: Routine hygienic hand antisepsis

40
Q

Difference between hand washing/rubbing?

A

Wash: mechanical removal of microorganisms
No antimicrobial activity

Rub: faster
More effective
Better tolerated

41
Q

6 steps of handwashing

A
  1. Palm to palm
  2. Hand over hand fingers intertwined
  3. Palm to palm fingers interlaced
  4. Backs of fingers to opposing Pam’s with fingers interlocked
  5. Rotational rubbing of thumbs clasmped in opposite palm
  6. Fingertips circling palms
42
Q

What order is used to put on/take off PPE?

A

Put on:
Apron & gown
Mask
Eye protection
Gloves

Take off:
Gloves
eye protection
mask
apron and gown

43
Q

What is the aseptic non-touch technique (ANNT)?

A

Protects patients during invasive clinical procedures
Employ infection control measures
Minimise the presence of pathogenic microorganisms
Aseptic technique isn’t the same as sterile
Surgical vs standard

44
Q

What is the aim of ANNT?

A

To prevent pathogenic organisms, in sufficient quantity to cause infection, from being introduced to susceptible sites by hands, surfaces and equipment
Unlike sterile, aseptic is possible/can be achieved in typical hospital and community settings

45
Q

What are he key parts of ANNT?

A

Hand hygiene, glove use, aseptic fields - Critical aseptic fields; ensuring asepsis -General aseptic fields; promoting asepsis, sequencing, environmental control

46
Q

What are the risks of sharps and when do they occur?

A

Risk of injury and potential exposure to blood borne infectious agents
During use (41%)
After use & before disposal (40%)
During or after appropriate or inappropriate disposal (15%)

47
Q

How are sharps used safely and safely disposed of?

A

Handling: Not passed directly from hand to hand, minimum handling, no recapping, bending or breaking after use
Disposal: The person responsible-who has used the single-use sharp,be discarded into an approved sharps container at the point of use, the sharps container must be less than 3/4 full
Use of safety-engineered devices: Needless devices, retractable devices

48
Q

What to do when there is a needle stick injury?

A

Bleed it (encourage bleed) wash it, cover it, report it

49
Q

How to maintain clean reusable equipment/instruments?

A

Cleaning, disinfection, sterilisation, storage & maintainance

50
Q

What is a trophon?

A

Effective high-level disinfection
Uses hydrogen peroxide & breaks it down into small amounts of oxygen and water
Compatible with most transducers
Standards and guidelines recommend

51
Q

Ways to perform Respiratory hygiene and cough etiquette

A

Cover the nose/mouth with tissue when coughing, sneeze, wiping & blowing noses; use tissues to contain respiratory secretions. If no tissue sneeze into inner elbow
Dispose of tissue
Keep contaminated hands away from mucous membranes of eyes & nose
Practice hand hygiene after contact with respiratory secretions & contaminated objects/materials

52
Q

About routine environmental cleaning

A

There is association between poor environmental hygiene& the transmission of infectious agents in healthcare settings
Environmental surfaces can be safely decontaminated
Level of cleaning required depends on the objects involved d and the risk of contamination

53
Q

Types of routine environmental cleaning?

A

Regular cleaning - All surfaces require
Thorough cleaning - After spills & between patients uses of a room or patient-care area, especially in acute-care settings
Additional levels of cleaning - Intensive care units & isolation, especially where there is a risk of MRO transmission

54
Q

What are the 2 types of waste management?

A

Clinical bins
Linen bins

55
Q

What does clinical bins include?

A

Clinical waste
Sharps
Pharmaceutical
Cytotoxic
Radioactive

56
Q

Key principals of waste management

A

Minimum distance to dispose
Safe handling of the waste
No overflow (less than 3/4)
Hand hygeine afterwards

57
Q

What 3 things should you monitor about your patient?

A

Breathing, pallor (colour), signs of distress or pain/fidgeting

58
Q

What are vital signs?

A

Temperature, pulse, respirations, BP, pulse oximetry

59
Q

What are vital signs? (definition) and why do we take them?

A

Observable and measureable signs of life.
To observe changes

60
Q

What are the 8 guidelines for measuring vital signs?

A

Responsibility, equipment, knowledge, approaching the patient, systematic approach, frequency of measurements, analysis & interpretation, communicate findings

61
Q

Explain the guidelines - responsibility, equipment and knowledge

A
  1. Your patient is your responsibility and so is monitoring their health condition
  2. Working equipment. Appropriate to the patient - body habitus
  3. Usual ranges. Other information relevant to patient -conditions. What is their normal?
62
Q

Explain approaching the patient, systematic approach and frequency of measurements

A
  1. Minimise environmental factors. Don’t panic
  2. Be organised & consistent
  3. How often & when to take
63
Q

Explain analysis and interpretation and communicate findings

A
  1. Other influencing factors -increased HR because of stairs? Increased temp because of outside?
  2. Compare to baseline measurements if known. Always record measurements. Tell someone
64
Q

When are vital signs taken?

A

Admission to hospital/unit, as per institutional protocols, before/after surgical procedures, before/after invasive diagnostic procedures, before/after certain medications, when a patients condition changes, when the patient reports non-specific (vague) symptoms of physical distress

65
Q

What are the factors affecting temperature?

A

Exercise, age, hormonal levels, circadian rhythm, stress, external environment

66
Q

What happens when the temperature is too hot or cold?

A

Cold: hairs raised (goosebumps) traps air- insulation, shivering starts -muscles move fast - creates heat, respiration rate increases - warms surrounding tissues, vasoconstriction - less blood near skin surface - less heat loss

Hot: hairs flat - air not trapped - no insulation, sweating starts - sweat (mostly salty water) pours onto skin surface - evaporates - removes heat from skin - cooling effect, vasodilation - lots of blood near skin surface - much heat loss

67
Q

Where can temperature be tested and what is the average temperature of those sites?

A

Oral (36.5Adult)
Aural (tympanic) (36.5-37.5Adult) - Ear
Rectal (37.2-37.5Adult)
Axilla - armpit
Skin (feel)
Infant 0-4yrs: 37.2-37.5
Child 5-13: 36.5-37

68
Q

What preparation occurs when taking a temperature?

A

Inform the patent & ask for permission
Use correct infection control
Patient considerations - ear/mouth/accessible
Document - time, temp, outside of normal? Tell someone!

69
Q

What is pulse?

A

Palpable bounding of the blood flow in an artery
Regulated primarily by the medulla in the brain
Blood is pumped from the heart into the peripheral circulation
Pulse can be felt at areas where an artery is superficial
- Gently compress skin over artery
- Don’t use thumb as has own pulse
- Count beats for 30secs & x2

70
Q

What pulse assessment sites are there?

A

Apical-over the apex of heart (only measured with stethoscope)
Radial - side of wrist just below thumb
Carotid - at neck just lateral to midline
Temporal - in front of upper ear
Femoral - at groin/inguinal region
Popliteal - behind knee
Brachial - over brachial artery at inner surface of elbow

71
Q

What should pulse be evaluated for?

A

Rate (BPM)
Rhythm (regularity)
Strength

Most common arrhythmias are:
Tachycardia (abnormally rapid pulse rate of >100BMP
Bradycardia (abnormally slow pulse rate of <60 BPM

72
Q

Factors affecting pulse rate

A

Age, temp, emotions, exercise, pre-existing conditions, gender, medications, postural changes, fitness levels, hypothermia, severe pain

Normal Adult: 60-100BPM
Normal child: 80-130 BPM
Newborn: 70-190BPM
Foetus: 120-160 BMP

73
Q

What to do when taking pulse?

A

Inform patient & ask permission
Infection control
Patient considerations
Document

74
Q

What is respiration?

A

Process of oxygen & carbon dioxide exchanging that occurs in the lungs
-ventilation - movement of gases(oxygen &carbon dioxide) in/out of lungs
-diffusion - movement of oxygen & carbon dioxide between the alveoli & RBC’s
-perfusion - distribution of RBC’s to & from pulmonary capillaries

Regulated by carbon dioxide & hydrogen ion concentration in arterial blood

75
Q

Important respiration terms

A

Tachycardia- abnormally fast
Bradycardia- abnormally slow
Apnoea- cession/suspension of normal breathing
Hyperventilation- rapid breathing, results in more carbon dioxide removed than produced
Hypoventilation- slow breathing, inadequate ventilation required for gas exchange, causes increased carbon dioxide
Dyspnoea- difficulty breathing
Orthopnoea- difficulty breathing in recumbent position

76
Q

Normal respiration rate and what it should look like

A

In adult: 12-20 breaths per min
In child: 30-60 breaths per min

Should be quiet/effortless & regular in rhythm

77
Q

Factors that affect respiration

A

Exercise, acute pain, medication, anxiety, smoking, body position

78
Q

How to observe respiration?

A

Be stealth like
Observe rise/fall
Observe if breaths are normal, shallow, deep
Observe whether respiratory pattern is even and regular or uneven and irregular

79
Q

About BP and systolic/diastolic pressures?

A

Systolic: (biggest number), measures amount of blood flow the heart pumps out from the left ventricle (peak pressure)

Diastolic (smallest number), occurs near end of cardiac cycle when the ventricles are filling with blood (lowest number), measures the amount of resistance that ejected blood meets due to systemic vascular resistance (relaxed pressure)

Hypertension: high BP
Hypotension: low BP
Measured in millimeters of mercury mmHg

80
Q

Factors that affect BP

A

Age, gender, stress, medications, other - smoking, weight

81
Q

Normal BP rates of different age groups

A

1mth: 85/54
1yr: 95/65
6yrs: 105/65
10-13yrs: 110/65
14-17yrs: 120/75
Middle adult: 120/80
Older adult: 140/90

82
Q

What does BP Assessments require? What sound is made?

A

Sphygmomanometer
Stethoscope

Korotkoff sounds - arterial sounds heard when taking BP

83
Q

BP patient preparation

A

Inform patient
Infection control
Correct equipment
Patient considerations

84
Q

What is pulse oximetry?

A

Cyanotic patient may need oxygen
Pulse oximetry measures the oxygen saturation of the haemoglobin in blood
Normal range >95%

85
Q

Normal body temperature for adult and abnormal temperatures

A

36.1-37.2 degrees celcius
Hyperthermia:hot (pyrexia or PUO- pyrexia of unknown origin e.g don’t know why hot)
Hypothermia: cold

Fundamentals Of Ultrasound Practice (3 decks)

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