How should instruments be handled when preparing them for cleaning?
- Surgical intruments should be disassembled if multi-componential and separated accordingly to be cleaned
What are different types of sx packs?
- General pack
- Ortho pack
- Ophthamic pack
- Emergeny pack
- Neuro pack
- Lg animal pack
What are the steps involved in cleaning instruments?
- Rinse in water immediately after sx
- Soak in neutral pH detergent
- Scrub with soft brush
- Ultrasonic cleaner
- Thoroughly rinse & allow to air dry
- Instrument milk on working actions
- Inspect for cleanliness
- Prepare for autoclave
What is written on the autoclave tape?
Initials, date & contents
What type of drape is made for single use?
Before cloth drapes and gowns are sterilized, what must be done to prepare them for the autoclave?
Wash, dry and fold in accordian style, then double wrap
How is the surgery gown folded?
What is asepsis?
Removal of microorganisms from living tissue
What are the 4 techniques to prevent contamination during sx?
- Scrubbing of surgical site
- Scrubbing in surgical assistants
- Sterile sx techniques
- Monitoring for sterility breaks
Exogenous sources of microorganisms include what?
- Sx team
What is an endogenous microorganism considered?
Source from within the patient by bloodstream
When a wound is closed too tightly, it cuts off the circulation to a portion of the body. This is called what?
List factors affecting contamination
- Health of patient
- Degree of tissue damage
- Virulence & # of infectious agents
- Failure in maintaining aseptic technique
What is the difference between sterilization and disinfection?
- Sterilization is destruction of all organisms and their spores
- Disinfection is the destruction of vegetative forms of bacteria, but not the spores
What are the 3 methods of sterilization?
- Thermal energy
Dry heat sterilization is used on what type of object? Give an example
- Objects that cannot get wet
Moist heat sterilization kills _________ and _________ at __________ temperatures and takes __________ time than dry heat
Bacteria; spores; lower; less
When using the autoclave, what are the most important factors involved in complete sterilization?
Ensuring the contents are completely penetrated and penetrated evenly
What are the settings for a standard use of the autoclave?
Minimum of 13 mins w/ a temp of 121oC (250oF) @ 15# of pressure
How long should lg packs be left in the autoclave?
30 - 45 min
What are the settings for a flash sterilizaion?
3 mins @ 131o C (270o F)
What are the forms of chemical sterilization? Give an example of each
- Lq: glutaraldehyde
- Gas: hydrogen peroxide gas plasma
What is the type of gas sterilizant that is dangerous due to it's flammability and toxicity?
Ethylene oxide is based off of what characteristics to be effective?
- Exposure time and temp
- Relative humidity
- Gas [ ]
Hydrogen peroxide gas plasma inactivated what agents?
- Bacterial spores
Does hydrogen peroxide gas plasma require aeration time?
What are factors which effect chemical disinfection?
- Material to be disinfected
- Degree of soil and microbial contamination
- [ ] of disinfectant
- Germicidal potency
Iodine is an effective ____________ agent
What common surgical scrub can cause skin irritation and acute contact dermatitis?
What are benefits of using chlorhexidine?
- Rapid onset
- Long residual activity
- No skin irritation
Alcohol is an effective _____________, but is ineffective against __________ and __________, and cannot be used on __________ because it is cytotoxic.
Antibacterial; spores; fungi; open wounds
What is an example of quaternary ammonium?
This chemical disinfectant has broad bactericidal and virucidal activity but can be cytotoxic.
Glutaraldehyde is commonly used in _____________ and ____________ equipment
Cold trays; endoscopic equipment
What is commonly used for preservation of tissue specimens?
How do you sterilize arthroscopic equipment?
- Cold sterilization: Cidexplus for 20 min & rinse w/ sterile H2O
When prepping for sterilization, what are the steps for a surgical assistant to take?
- Remove jewelry
- Change clothing
- Don cap, mask, & shoe covers
- Perform surgical scrub
- Don sterile gown
- Don sterile gloves
Where should the hands be when performing a surgical scrub?
Above the elbows
What should you always do before performing a surgical scrub?
- Don cap and mask
- Open the gown pack
How long must you perform a hand scrub to perform adequate sterilization?
What are the two methods of gloving and when are they used?
- Open: minor procedures that require hands to be sterile but no gown (bone marrow biopsy, catheterization)
- Closed: used when gowning for sx
What does draping maintain?
A sterile field
What is the draping method using 4 drapes called?
How should a sterile item be opened?
- Outer wrap opened by non-sterile assistant by only touching the outside of the pack
- Inner wrap opened by surgeon or sterile assistant
How do you open items in plastic or paper wraps?
Peel wrapper back slowly, symmetrically, and facing away from the body so sterile personnel can grab
What is strike through?
When a surgical gown is wet with blood or saline, which is permeable to bacteria
Where is sterile saline poured?
Stainless steel bowl that has not been touched by the container