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Define asepsis.
prevention of contact with microorganisms
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Define aseptic technique
all of the steps taken to prevent contact with microorganisms
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What are the different sources of contamination to the surgical wound?
- environment
- surgical instruments & materials
- personnel
- patient
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Describe an aseptic surgical room?
- smooth, cleanable surfaces
- proper ventilation and air flow
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How do we ensure that surgical instruments and other materials are properly sterilized?
run them through the autoclave
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What should sterile personnel wear while in surgery?
- cap
- mask
- scrub suit
- scrub hands and arms
- sterile gowns and gloves
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What are some ways to prepare a patient for surgery?
- fast
- bath
- walk
- enema
- clip
- scrub
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What do we need to do to the patient before surgery?
- clean dirt from hair and skin
- get rid o fany discharges (GI tract contents)
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Define pack preparation
surgical materials made up into sterile packs
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What are things that can be wrapped in a pack?
- gowns
- scrub suits
- drapes
- towels
- sponges
- laparotomy pads
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What is a standard pack and what is an individual pack?
- standard pack: general, all instruments
- individual pack: individual instruments so if an instrument gets dropped on the floor you don't have to open up a whole new pack
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How should materials be wrapped for packs?
should be strong without tearing and with no holes
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What kind of material can be used for wrapping packs?
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Describe the envelope wrap.
- the pack is wrapped in such a way that it can be opened aseptically without touching the inside of the pack
- may double wrap for added security
- held together with indicator tape on outside
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What happens if you pack a pack too tightly?
steam won't penetrate all the way to the middle
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Why do we use trays in surgical packs?
to prevent instruments from poking holes in wrapping
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Does autoclaving remove dirt?
no
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What do we have to do to the instruments before we autoclave them?
clean them
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What should be on the pack label?
- contents
- size and type (for gowns, scrub suits, drapes)
- date of sterilization
- initials
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How long does a pack stay sterilized?
3 - 4 weeks
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What do you do if sterile packs are out of date?
rewrap them and resterilize them
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Steam needs to reach at least ___ degrees fharenheit for at least ___ minutes or ___ psi for at least ___.
- 250 degrees fharenheit
- 30 minutes
- 15 psi
- 15 minutes
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Other than a steam autoclave, what are other ways to sterilize?
- gas (ethylene oxide)
- dry heat oven (not practical)
- boiling (not practical)
- chemical sterilization (cold pack) (not a good way)
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When do we use for items that can't go through steam (example: plastic)?
use ethylene oxide
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What are indicators?
tape or paper strips placed outside and inside packs to show that the pack has been properly sterilized
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What do we use autoclave tape for?
- outside pack to show that it has been exposed to steam - does not prove all microbes in pack are killed
- a piece of tape can be placed inside pack to ensure all microbes have been killed
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What are indicator strips?
placed inside pack and do not change color unless pack has been hot enough for long enough
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What are gas indicator strips?
change color when adequately exposed to EO (ethylene oxide)
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What are surgical gowns made of?
cloth or disposable paper
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What is the purpose of a surgical gown?
sterile covering for operating room personnel to contain microbes on our clothes and bodies and to prevent contamination
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How do we wrap gowns?
- accordion fold before wrapping
- front of gown and arms to the inside
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How do we open and put on a sterile gown?
- hold gown by neck and let it fall open
- put arms into sleeves but not all the way through for closed gloving
- assistant ties in the back
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What is purpose of scrubs?
- clean, loose fitting clothing to be worn only in the surgery suite
- prevent carrying contamination in
- prevent carrying contamination home
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What is the purpose of drapes?
sterile covering for patient used to keep surgical field as aseptic as possible
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What are the different types of drapes?
- window drapes
- four-corner drapes
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How are the drapes secured to the patient?
towel clamps or sutured
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What is a window drape?
a hole cut in the middle of the drape
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What is a four-corner drape?
Four drapes used to create a window
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What are the advantages and disadvantages to using the four-corner drape method?
- advantages: can control hole size, can be used to drape a more awkward location
- disadvantages: more complicated, more stuff to slide around
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What is the purpose of surgical gloves?
- sterile covering for surgeon's hands
- stronger and stretchier than exam gloves
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How do we reuse surgical gloves?
- wash, dry gloved hands
- lightly powder gloved hands (talc) so they don't get sticky
- remove gloves from hands
- turn inside out and glow up like a balloon to check for tears and holes
- pack left and right globes, same size, on correct sides of pack
- palm up, cuff folded so thumb is just sticking out
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What is open gloving?
done with out gown
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What is closed gloving?
- done after gown is put on
- hands stay inside the sleeves initially
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