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DU PA Surg Intro
Duke PA Intro to Surgery
| Question | Answer |
|---|---|
| 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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