T3: Setting Up the Theatre and Anaesthetic Machine

Question 1

What is the aim when setting up the theatre?

Answer 1

• For the theatre to be prepared in such a way that it is fully functional when the patient is brought in.
• It is therefore unnecessary for staff to undertake last- minute fetching and carrying once the procedure is underway.

Question 2

When setting up the theatre in the morning, what is the first thing that should be done?

Answer 2

Theatre should be damp-dusted w/ clinics preffered disinfectant at correct dilution.

Start at top (lights) and work to bottom

Question 3

Describe how you would check/set up the anaesthetic machine?

Answer 3

• check the isoflurane level and refill if necessary
• check that the oxygen supply is connected and functional
• check the soda lime and change if necessary
• perform leak test on the anaesthetic machine
• connect the appropriate circuit for the first patient of the day

Question 4

What things other than damp-dusting and checking anaesthetic machine should you do when setting up the theatre?

Answer 4

• check monitoring equipment (leads, calibrated, power supply, pressure cuffs)
• turn on heat pad
• check lights
• clean bin liner
• any positioning aids ready
• fluid pump is working
• PREPARE SCRUB AREA

Question 5

How should you clean the theatre between patients?

Answer 5

• switch off equipment (unless N/A some machines left on to hear up)
• all instruments and equipment used in previous procedure removed
• detach light handle
• wipe surfaces w/ lint free cloth
• clean bed on surgery table
• remove rubbish and replace liner
• clean oesophageal stethoscope etc
• check iso/soda lime
• sweep/mop/tidy

Question 6

What is antisepsis?

Answer 6

refers to the killing of micro-organisms within living tissue, for example treating a contaminated wound.

Question 7

What does aseptic technique mean?

Answer 7

establishing conditions that prevent the contamination of surgical wounds.

Question 8

What are the three main sources of infection?

Answer 8

1. Environment
2. Theatre personnel
3. The animal

Question 9

What are the 3 stages of cleaning?

Answer 9

1. Removing gross contamination
2. Disinfecting
3. Sterilising

Question 10

3 stages of cleaning:

how do we remove gross contamination?

Answer 10

• using detergents (de-fatting agents) which remove grease and oils
• using mechanical aids such as mops
• pest control (e.g. mouse traps and cockroach baits)
• regular removal of rubbish from the site (e.g. emptying bins)
• This discourages the growth and multiplication of disease-carrying vermin and micro-organisms.
• Removal of obvious dirt and organic materials is essential prior to treatment with many antiseptics and detergents, in order to increase their effectiveness.

Question 11

3 stages of cleaning:

What does disinfection involve?

Answer 11

• removes and destroys most micro-organisms, except some viruses and heat resistant bacteria and bacterial spores
• eg chlorhex, iodine, alcohol, chlorine
• [] and time of contact essential to effectiveness
  *

Question 12

What is an antiseptic and give some examples

Answer 12

• mild disinfectants for use on live tissue
• chlorhex, povidone-iodine, cetrimide

Question 13

What equipment and requirements should a prep or induction area have?

Answer 13

• seperate from but in close proximity to theatre
• own anaesthetic machine, IV pump
• other equip needed:
• heat nat
• ET tubes/ties
• IV catheter
• antiseptic skin prep and swabs
• needles/syringes
• anaesthetic spray (cats)
• adhesive tape
• monitoring equip
• pump/fluids
• vaccuum cleaner
• rubbish bin

Question 14

How long after being autoclaved is a surgery pack still sterilised?

Answer 14

up until 3 months past autoclave date

Question 15

What are the functions of anaesthetic machines?

Answer 15

• Supply oxygen
• supply anaesthetic gases and vapours
• remove carbon dioxide
• inflate animals lungs

Question 16

What is soda lime used for?

Answer 16

• absorb CO2 breathed out
• colour change occurs as it becomes exhausted, though this should not be relied upon to indicate freshness
• should be changed when 50% becomes coloured

Question 17

Describe a circle breathing system

Answer 17

components of a circle system include:

• a fresh gas inlet
• an inspiratory one-way valve
• an expiratory one-way valve
• a reservoir bag
• corrugated tubing (both inspiratory and expiratory)
• a Y-piece where the endotracheal tube is attached
• escape valve where scavenger is attached
• soda lime canister
• vaporiser (VIC systems only)

Question 18

Describe a T-piece breathing system

Answer 18

• used for animals that weigh less than 10kg
• To check for leaks:

close the hole in the end of the bag and the patient connection

allow some gas into the system, and then squeeze the bag to locate any leaks

Question 19

A bit about flow meters?

Answer 19

• controls flow of gas to patient
• small cyndrical bobbin is displaced upwards when gas is flowing
• flow rate indicated from top of bobbin
• rotation of bobbin indicates gas flow

Question 20

Descrive a passive scavenger system

Answer 20

• rely on gas moving into a cylinder containing charcoal such as a scavcan that filters the gases, or by a tube going out of the room outside

Question 21

Describe an active scavenger system?

Answer 21

• connected to a suction pump that then filter out the gases.

Question 22

Why do we intubate patients?

Answer 22

• to protect and support the patients airway because anaesthesia removes the muscular supports.
• minimise the gas pollution and provide safer anaesthesia by removing anatomical dead space.

Question 23

Describe how to select the correct ET tube?

Answer 23

• can check distance between nares
• measure from nose to point of shoulder
• make sure not too much over hang from mouth
  *

Question 24

How do you clean an ET tube?

Answer 24

washed in disinfectant/detergent, may use pipe cleaner and hang to dry

once dry, wipe over with alcohol