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chapter 57
Surgical Asepsis and Asissting with Surgical Procedure Notes
| Question | Answer |
|---|---|
| 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
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