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How should instruments be handled when preparing them for cleaning?
- Gently
- Surgical intruments should be disassembled if multi-componential and separated accordingly to be cleaned
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What are different types of sx packs?
- General pack
- Ortho pack
- Ophthamic pack
- Emergeny pack
- Neuro pack
- Lg animal pack
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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
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What is written on the autoclave tape?
Initials, date & contents
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What type of drape is made for single use?
Paper
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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
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How is the surgery gown folded?
Inside out
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What is asepsis?
Removal of microorganisms from living tissue
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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
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Exogenous sources of microorganisms include what?
- Air
- Instruments
- Supplies
- Skin
- Sx team
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What is an endogenous microorganism considered?
Source from within the patient by bloodstream
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When a wound is closed too tightly, it cuts off the circulation to a portion of the body. This is called what?
Physiologic tourniuet
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List factors affecting contamination
- Health of patient
- Degree of tissue damage
- Virulence & # of infectious agents
- Failure in maintaining aseptic technique
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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
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What are the 3 methods of sterilization?
- Filtration
- Radiation
- Thermal energy
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Dry heat sterilization is used on what type of object? Give an example
- Objects that cannot get wet
- Instruments
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Moist heat sterilization kills _________ and _________ at __________ temperatures and takes __________ time than dry heat
Bacteria; spores; lower; less
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When using the autoclave, what are the most important factors involved in complete sterilization?
Ensuring the contents are completely penetrated and penetrated evenly
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What are the settings for a standard use of the autoclave?
Minimum of 13 mins w/ a temp of 121oC (250oF) @ 15# of pressure
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How long should lg packs be left in the autoclave?
30 - 45 min
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What are the settings for a flash sterilizaion?
3 mins @ 131o C (270o F)
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What are the forms of chemical sterilization? Give an example of each
- Lq: glutaraldehyde
- Gas: hydrogen peroxide gas plasma
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What is the type of gas sterilizant that is dangerous due to it's flammability and toxicity?
Ethylene oxide
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Ethylene oxide is based off of what characteristics to be effective?
- Exposure time and temp
- Relative humidity
- Gas [ ]
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Hydrogen peroxide gas plasma inactivated what agents?
- Mycobacteria
- Bacterial spores
- Fungi
- Viruses
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Does hydrogen peroxide gas plasma require aeration time?
No
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What are factors which effect chemical disinfection?
- Material to be disinfected
- Degree of soil and microbial contamination
- [ ] of disinfectant
- Germicidal potency
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Iodine is an effective ____________ agent
Antimicrobial
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What common surgical scrub can cause skin irritation and acute contact dermatitis?
Povidone-iodine
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What are benefits of using chlorhexidine?
- Rapid onset
- Long residual activity
- No skin irritation
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Alcohol is an effective _____________, but is ineffective against __________ and __________, and cannot be used on __________ because it is cytotoxic.
Antibacterial; spores; fungi; open wounds
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What is an example of quaternary ammonium?
Benzalkonium chloride
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This chemical disinfectant has broad bactericidal and virucidal activity but can be cytotoxic.
Chloride
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Glutaraldehyde is commonly used in _____________ and ____________ equipment
Cold trays; endoscopic equipment
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What is commonly used for preservation of tissue specimens?
Formaldehyde
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How do you sterilize arthroscopic equipment?
- Gas
- Cold sterilization: Cidexplus for 20 min & rinse w/ sterile H2O
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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
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Where should the hands be when performing a surgical scrub?
Above the elbows
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What should you always do before performing a surgical scrub?
- Don cap and mask
- Open the gown pack
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How long must you perform a hand scrub to perform adequate sterilization?
5 min
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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
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What does draping maintain?
A sterile field
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What is the draping method using 4 drapes called?
Quarter drapes
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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
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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
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What is strike through?
When a surgical gown is wet with blood or saline, which is permeable to bacteria
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Where is sterile saline poured?
Stainless steel bowl that has not been touched by the container
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