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chapter 57

Surgical Asepsis and Asissting with Surgical Procedure Notes

Permeable means? allowing a substance to pass or soak through
Dehiscence means? separation of wound edges or rupture of a would closure
an infection is an invasion of body tissue by microorganism which then proliferate and damage tissues
Surgical Asepsis Complete destruction of organisms on instruments or equipment that will enter the patients body
antiseptic substance that kills microorganisms
microorganisms living organisms that can be seen only with a light microscope
cicatrix early scar tissue that appears pale, contracted, and firm
pathogens disease causing microorganisms
spores a thick walled dormant form of bacteria very resistant to disinfection measures
sanitization reducing the number of microorganism to a relatively safe level
Disinfection destruction of pathogens by physical or chemical means
asepsis freedom from infection or infectious material
contamination becoming non-sterile by contact with any non-sterile material
Disease a pathologic process; having a descriptive set of signs and symptoms
sterilization complete destruction of all forms of microbial life
medical asepsis destruction of organisms after they leave the body
edema swelling between layers of tissue
Before instruments can be used in surgery.. it must be sanitized, disinfected, and sterilized in that order.
Sterilization process is to ensure that all.. debris has been removed so cleansing properties can penetrate every surface
cleaning of an instrument should be done? immediately after using, if impossible, items should be rinsed under cold water and placed in detergent solution
Bodily fluids or contaminants should never be allowed to dry on surgical equipment
gloves must be warn while sanitizing
sharps instruments should be separated while cleaning
sanitization reduces the number of organisms to a safe level and disinfection kills pathogens or renders them inactive
The cleansing area should be divided into 2 area dirty/ and clean to prevent errors
the sterilization room should include a sink, receiving basins, cleaning agents, brushes, utility gloves, autoclave wrapping paper, autoclave envelopes/tape, sterilizer indicators, disposable gloves, and biohazard waste container
PPE for autoclave include heat-resistant gloves, fluid resistant gloves, lab. coat/impervious gown, face shield and or goggles
sterilization can be achieved by moist heat in an autoclave, by gas, or with chemicals,
written sterilization procedures must be in place
What is the best sterile method> autoclave; higher then boiling point heat, combined with moisture, once steam hits all surfaces every microorganism is killed, once the camber cools, the steam condenses and explodes the cells of microorganisms
recommended temperature for an autoclave is 121-123 C or 250-255 F
unwrapped items should be sterilized in an autoclave for? 20 minutes
small wrapped items should be sterilized in an autoclave for? 30 minutes
large/tightly wrapped items should be sterilized in an autoclave for? 40 minutes
what are the three auto clave cycles gravity (fast exhaust) cycle, liquid (slow exhaust cycle), prevacuum cycle
Gravity cycle in an auto clave sterilizes stainless steel, and glassware. autoclave fills with steam and held at required temp. for a period of time. a valve is opened returns the chamber to atmosphere pressure. dry times added (sum) used in physicians office
liquid cycle in an autoclave prevents sterilized equipment from boiling. steam exhaust slowly at the end of the cycle to allow liquids to cool
prevacuum cycle in an autoclave porous materials (soaks through) chamber is partially evacuated before steam enters for more penetration; not available on all machines
if steam temps. are to high it is dried out and advantages are minimized
to wet steam could cause incomplete sterilization
Wrapping materials must be permeable to steam and resistant to contaminants, shouldn't be used if it has a hole
Wrapping must allow the pack to be opened without contaminating it
when wrapping wrap hinged instruments in the open position
when wrapping sharp instruments place gauze sponge around sharp tips
when using bags to wrap instruments insert jaws 1st for easy handling
labeling a wrapped instrument sterilization date, your initials, permanent marker
polypropylene is? plastic material and resistant to heat transfer and requires more time to sterilize
2 basic types of sterilization indicators chemical indicators (autoclave tape), biologic indicators (bacterial spore strips)
chemical sterilization indicators contain a chemical dye changes color when exposed to steam, not absolute indication of proper time/technique, indicates high temp. must completely chance color or reveal autoclaved
Biologic sterilization indicators facilities of policy's about frequency, spore strip indicator contains a temp. sensitive dye, placed in the largest pack in center, some use Bacillus stearothermophilus, destroyed at 250F and 121 C, ampule sent to lab to analyze for microbial growth
evaluations and record keeping must be done at intervals specific to autoclave use
once the pressure gauge of an autoclave reads 0 open the door 1.4 inch
do not place sterile packs on cold surfaces to avoid cross contamination due to condensation
if the integrity of the sterilization is in question consider it to be non-sterile
muslin/autoclave paper packs are considered sterile for 28 days
polypropylene bags are considered sterile for up to 6 months
gas sterilizations are unrealistic to use in a physicans office due to long processing times, ventilation requirements, and health hazards
common surgeries for primary care office suturing, cyst removal, incision and drainage I&D of abscesses, collection of biopsy specimens
an electrosurgical unit uses high frequency currents to cut through tissue and coagulate blood vessels
Grounding pad; carefully inspect the pad, cable, and skin before the procedure
grounding pad; place the pad close to the operative site
grounding pad; the pad must be tight against the patients skin
ground pad; apply to a fleshy area, not a boney area, not over body hair, or not over metal implants/ pacemaker inspect after procedure
laser surgery may now be used for excisions of lesions, removal of warts/moles, cauterization of blood vessels, cosmetic procedure
microsurgery uses a microscope to perform delicate surgeries
endoscope medical device with miniature camera mounted on a flexible tube with a light source that is used to examine the inside of a cavity
cryosurgery uses a low temp. probe to kill tissue by freezing it on contact
cryosurgery is used to treat cancers of the skin, prostate, liver, pancreas and kidneys
patient prep; to alleviate patient fears be sure to explain the surgery thoroughly and give the patient time to discuss any concerns
patient prep; direct questions outside of your knowledge to the physician and be sure to relay them
preoperative preparation; blood/urine tests, consent form, recent illnesses, medications, allergies noted
preoperative preparation may also include a shave prep, cleansing enema, food/drink restriction, special bathing, and sedatives
patient prep; the patient will be asked to empty their bladder on the day of surgery and put on the gown requested, vital signs will be recorded
preoperative instructions; have consent forms signed
preoperative instructions; give the patient preoperative instruction
preoperative instruction; telling the patient to bring someone who can drive them home after surgery
preoperative instructions; telling the patient to leave valuables at home
preoperative instructions; call the patient a day ahead to confirm the special instructions
before signing the consent form, the patient must have a discussion with the physician that indicates what procedure will be done, why it will be done, potential risks/ benefits, alternative treatments, risks and benefits for that,
discussion of the informed consent will be fully documented
copy of consent form must be included in the patients recorded
treatment must not exceed the scope of the consent form
the patient cannot sign while under the influence of and sedatives
if sterile packets are open for more than 1 hour it is not longer sterile
even wrapped sterile items cannot be used if dropped
if a sterile object comes into contact with non sterile surface it is considered non-sterile
talking must be limited to avoid bacteria spreading through air currents
sterile team members must face eachother
the sterile field must remain in your view in order to be considered sterile
Created by: Jasmine143