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DU PA Surg Intro

Duke PA Intro to Surgery

to avoid infection procedures should be performed within a sterile field from which all living microbes have been excluded
A sterile barrier that has been permeated must be considered contaminated
the edges of a steril container are considered __ once the package is open contaminated
the area where gowns are considered sterile front, from shoulder to waist level, and the sleeves to 2 inches above the elbow
tables are sterile __ at table level only
sterile persons and items only touch sterile areas
__ must not contaminate the feild movement within or around
rapid-acting, borad-spectrum antimicrobials effective against gram-positive and gram-negative microorganisms Chlorhexidine gluconate or povidone idodine solutions
Each is prepared in combination with a detergent to give a cleaning action along with the antimicrobial effect. Chlorhexidine gluconate or povidone idodine solutions
sterile disposable scrub brushes are impregnated with Chlorhexidine gluconate or povidone idodine solutions
two methods used for surgical scrubbing timed method, counted stroke method
the timed method of surgical scrubbing requires a total of __ minutes 5
the counted stroke method of surgical scrubbing includes __ strokes for the fingernails 30
the counted stroke method of surgical scrubbing includes __ strokes to each surface of the fingers, hands wrists, and arms to the elbows 20
scrub dorsal and palmar surfaces of the hand and wrist with a __ circular motion
direction of hand rinsing for surgical scrubbing fingers to elbows
allow contaminated water to drip off the __ elbows by keeping your hands above your waist
when preparing a surgical site scrub the skin with the antiseptic solution __ beginning at the procedure site and working outward in a circular fashion
when preparing the surgical site, upon reaching the outer boundry __ discard the first sponge and repeat the procedure until all prepared sponges are used.
Do not return to a previously prepped area with a __ contaminated sponge
__ sheets have a window that exposes the procedure site fenestrated
__ are used to circumferentially cover the extremities stockinettes
the process of maintaining a sterile field around the procedure site by covering the surrounding areas and patient with a barrier draping
when draping never __ reach over the patient, always walk around
when draping avoid shaking wrinkles out
anything below waist level is considered non-sterile
if a hole is found on a drape after it is placed cover it with a second drape
if a drape is placed improperly discard it or cover it with a second drape
the sterile field includes the draped patient and any scrubbed personnel
a minimum of __ people are required to do most sterile procedures 2
unsterile personnel must remain at least __ away from the sterile field 1 foot
when passing instruments into the sterile field face the field to avoid accidental contact
there is no __ with sterility compromise
surgical masks are for the protection of the sterile field (and thereby the patient)
For lengthy procedures, or when it is necessary to put the forearms into the sterile field, a __ is required sterile surgical gown
In 1987, the Centers for Disease Control (CDC) developed __ Universal Precautions
considering all patients potentially infected and using proper PPE to protect yourself is called Universal Precautions
1. Use appropriate barrier protection to prevent skin and mucous membrane exposure when __ contact with blood and body fluids of any patient is anticipated
Needles should never be __ recapped or bent after use
Individuals with minor breaks in the skin should restrict __ until the break has healed scrubbing activities
3. Body fluids, human tissue, disposable gowns, gloves, caps, and drapes should be __ placed in containers marked with the appropriate biohazard warnings
never let your hands __ while in the OR drop below your waist
most common reason for fever 1 day post op atelectasis
first sign of hypovolemia tachycardia
most effective means to prevent DVT ambulation
what is the most commonly used casting material plaster of paris
which type of casting material is radiolucent fiberglass
skin can never be __ sterilized
scrubbing renders the hands and arms surgically clean
when scrubbing work from the hands to 2 inches above the elbow
Should any scrubbed area touch a part of the scrub sink, __ rescrub that area again to clean the contamination
surgically dry hands using a blotting motion
preferred method for unassisted gloving, except when changing gloves during a procedure closed-glove method
unassisted gloving method used during a procedure open-glove technique
the sterile wrap-around gown i tied securely __ after gloving is complete
gloves are removed by a __ technique glove to glove, skin to skin
frequently used for hair removal on extremity cases depilatory cream
can leave cuts, abrasions on the skin shave
used to remove hair from the scalp electric clippers
__ determines if hair is to be removed, how much, and the method the surgeon
The surgical scrub prep is done __ after the patient is anesthetized and positioned
removes soap, not to be used on open wounds alcohol
can cause skin irritations and burns, must be rinsed with alcohol after it is applied iodine 2%
not be wiped off because off cidal activity betadine solution (providone iodine)
plastic drapes with adhesive backing available in different sizes either clear or impregnated with betadine incised drapes
used for absorption over the prepped site and to “square off” the op site. Placed with a folded edge at the op site and they must be secured green towels
- top most sheet in draping routine. The sheet is large enough to fully cover the patient with a fenestrated opening larger than the expected op site that has a large reinforced area surrounding the opening procedure sheet
Once placed, __ do not move a drape
Towel clips that have been positioned through the drapes are __ considered contaminated and must not be removed until after the procedure.
the assistant always gloves the other persons __ first right hand
sterile fields are sterile to within __ of the edge one inch
avagard is flammable
surgery reduces resistance to infection
most common cause of wound infections in a surgical patient acute bacterial infection
__ are the most common pathogens Gram (-) bacteria and Staphylococcus Aureus
contamination is the presence of at least one microorganism
inanimate objects capable of harboring or transmitting bacteria. The largest source is the floor fomites
good housekeeping techniques in the OR can reduce microorganisms by __% 90
not a substitute for good sterile technique antiobiotic therapy
If they are used and cared for properly, instruments can last up to __ years 10
either short or long lengths for cutting heavy, deep, tough tissue. The short handle is generally used for the skin knife. #3 Handle
slender handle for delicate cutting #7 handle
the general purpose surgical blade typically used in incising the skin for larger wounds #10 blade
commonly used with the #3 handle as the skin knife #10 blade
a small blade whose cutting edge is close to the tip. The blade is used for fine, delicate cutting #15 blade
when using this blade hold the scalpel handle like a pencil #15 blade
aka stab blade #11 blade
a pointed straight blade used for placing punctures in tissues, i.e. cysts, abscesses. etc. #11 blade
aka hook blade #12 blade
frequently used to make the initial cut in the side of a vessel, to avoid going all the way through the opposite wall. #12 blade
aka suture scissors straight mayo
heavy, blunt tip with a straight blade used for cutting surgical materials straight mayo scissors
used for cutting heavy, thick tissue curved mayo scissors
finer, curved, scissor used to cut and dissect more delicate tissue. “All purpose dissection scissors.” Metzenbaum (Metz)
closes severed ends of bleeding vessels with minimal tissue damage hemostats
short, fine curved clamp for superficial vessels. crile (mosquito)
short, straight tipped clamp slightly longer and heavier than a Crile also used for superficial vessels and may also be used to “tag” suture (hold suture in place prior to tying it and cutting it) halstead
- heavier curved clamp which varies in length and used as a general all-purpose clamp kelly
- fine curved tip clamp medium in length, most commonly used clamp for hemostasis tonsil hemostats
clamp with a right angled tip and medium in length generally used to pass suture around an uncut vessel. Mixter (Right Angle)
holds tissue for retraction grasping clamps
multiple short teeth that do not damage tissue in its grasp. For use on delicate tissue allis
curved; fenestrated blades without teeth used to grip or enclose delicate structure such as intestines, ureters, and fallopian tubes babcock
has a single heavy toothed tip for grasping tough tissue (i.e. fascia, bone, muscle). kocher
sharp, needle-like curved tips used to secure drapes or to hold tissue (i.e. bone). towel clips
used to grasp or pickup tissue and available either with teeth to hold thicker slippery tissue or without teeth to hold delicate tissue with minimal tissue damage Forceps (Pickups)
- single toothed fine short forceps used to hold skin. adson
nontoothed forcep which varies in length and is the general all purpose tissue forcep (not to be used on skin). debakey
angled forcep used commonly in neurosurgery for better visualization. Also known as cautery forceps when used as an extension of the cautery on deep structures bayonet
curved abdominal retractor varying in blade width. deaver retractor
short right angled blade, used on abdominal cases. appendiceal retractor
double ended retractor army navy retractor
either 2 blades held apart by a ratchet or by frames to which various blades may be attached, where one side acts as an anchor and pressure is exerted on the other side self retaining retractor
ratchet style, used for superficial use weitlaner
abdominal retractor to which a bladder blade may be added. balfour
most commonly used suction Yankauer
straight suction with multiple holes for rapid suctioning. frazier (abdominal)
right angled suction varying in shaft length and width. poole (neuro)
Created by: bwyche
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