14 Flashcards Preview

Ch 1-21 > 14 > Flashcards

Flashcards in 14 Deck (35):
1

difference btwn antiseptic and disinfectant

antiseptic chemicals applied to living tissuedisinfectant chemicals applied to inanimate objects

2

types of antiseptics

Alcohol 60-70%IodophorsChlorohexidineTriclosan

3

Characteristics of alcohol antiseptics

rapid bacterialcidal (not spores, variable viruses)60-70%denatures bacT proteins, interfere with metabolism and lysis of cellsefficacy decreased in presence of organic material

4

T/FIsopropyl alcohol has better bactericidal activity but less virucidal activity than ethyl alcohol

TRUEIsopropyl alcohol has better bactericidal activity but less virucidal activity than ethyl alcohol

5

Characteristics of iodophors antiseptics

iodine containingI2 bacteriacidal (NOT I-)disorders protein structure, blocks protein synthesis, alters cell membranesalso kills spores, viruses, fungi(ex. povidone-iodine)

6

concentration of povidone iodine lethal to canine fibroblasts

lethal to canine fibroblasts at 0.5-1.0%

7

adverse skin reaction to povidone iodine

50% (HIGHER THAN CHLOROHEXIDINE GLUCONATE)

8

Difference btwn chlorohexidine gluconate and chlorohexidine acetate

chl gluconate: SCRUB 2-4%chl acetate: SOLUTION < 0.05% (wound treatments)

9

characteristics of chlorohexidine antiseptics

does NOT kill sporesbacterialcidalvariable at viruses and fungireduced activity in presence of organic debris residual activity/cumulative effect

10

activity of chlorohexidine varies with concentration:

low bacteriostatic (interfere with cell membrane;leakage)higher bactericidal (coagulation of cell contents)

11

what systems can chlorohexidine be toxic too

neurotoxicototoxic (middle ear)ocular damage

12

characteristics of triclosan antiseptics

phenol familycauses cell wall disruptionbacteriostatic (less effective than povidone and chlorohex)

13

use of a razor for clipping as opposed to clippers

associated with higher incidences of SSI

14

what % of skin flora remains protected in deeper skin layers/ follicles even after clip and sterile prep

20%

15

contact times for surgical preps

30 s chlorohexidine2 minutes povidone iodine

16

Rochat et al compared one step vs two step povidone iodone/alcohol

= effective

17

scrub suit material and thread count

cotton muslin 140-270 threads per inchor even betterlaundered tightly woven 280 thread count/inch; water resistant (Quarpel) or paper non absorbable gowns

18

when does Quarpel lose its barrier properties

laundered tightly woven 280 thread count/inch; water resistant (Quarpel)75 laundered cycles

19

what area of the hands has the highest bacterial count

FINGERNAILS

20

T/Fseveral studies show that chlorohexidine is more effective than povidone iodine in reducing bacterial counts and maintaining reduction

TRUE

21

incidence of glove perforation 1. single layer2. double layer

1. single layer gloves 12.7-31%2. double gloving 11.5-44% (outter glove) and 3.8-13% (inner glove)

22

T/F Vinyl is more resistant to perforation vs latex

FALSElatex more resistant to perforation than vinyl

23

where are glover perforations most likely to occur

nondominant handorthopedic procedureslonger procedures

24

when gloves are routinely changed, study found that most glove perforations occurred when....

during draping

25

disposable gown contamination based on Moylan et al.

46.6% contamination by 3-3.5 hours of sx76.5% contamination if sx > 4 hr

26

what % of foot bacteria become airborne

15%but little evidence exists to support footwear products

27

what is the #1 method of increasing bacterial load in the environment

TRAFFICminimize traffic

28

laminar flow vs conventional air flow in the OR

prefer laminar flow in HORIZONTAL direction61% decrease in room bacT92% decrease in wound bacT with laminar flow

29

how many air exchanges/ hour is recommended, temperature, and humidity

15 air exchanges/hr30-60% humiditytemp 68-73 Fdoors closed, pressure positive

30

based on compendium July 2011 Zeltzmancompare dry nonwoven vs woven gauze sponges 4 x 4 in terms of material, lint and absorptive capacity

12-ply woven absorbs 5-12.5 ml COTTON 31.2ug lint4-ply nonwoven absorbs 10-18.3 ml 70%rayon/30%polyester; prone to less lint 1.4 ug lint

31

absorptive capacity of moistened 12 x 12 lap sponge

50 ml

32

general estimate of weighing dry 4 x 4 for estimation of blood loss

general1 ml = 1 gm weight

33

ways to prevent retained sponges

1. use defined packs by manufacturers2. count before and after procedure3. throw away once immediately used4. do NOT keep sponges near surgical field5. throw away all sponges and use only laps for cavity procedures6. tag small sponges with hemostats if used7. use sponges with radio opaque markers8. avoid placing free sponges in cavities9.routinely surgery and throw away sponges10, USE CARE

34

term for retained surgical sponge

gossypibomacotton matrix within body1. wall off FB granuloma2. abscess formation

35

Hayes 2014 Vet surgeryrisk factors for glove perforation

1. sx time > 1 hr2. primary surgeon role3. ortho procedures (power instruments, wire)4. polyisoprene material