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