Asepsis, Antibiotics and infection Flashcards Preview

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Flashcards in Asepsis, Antibiotics and infection Deck (37)
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1

Asepsis

the maintenance of pathogen free environmenta on or within living tissue

2

Aseptic technique

methods used to prevent contamination of living tissue with pathogens

3

sterilization

the process of killing all microorganisms with the use of either physical or chemical agents

4

antiseptic

chemical agent

kills pathogenic microorganisms or inhibits the growth as long as the agent and microbe remain in contact

agents applied to the body

5

Disinfectant

a germicidal chemical substance that kill microorganisms on inanimate objects that cannot be exposed to heat

 

6

why worry about aseptic technique?

increased risk of a surgical site infection

increased risk of inections secondary to a diagnostic or supportive procedures (IV fluids, ETT, urinary catheter)

increased risk of nosocomial infections

 

7

Why worry about surgical site infection?

increased morbidity

increased mortality

increased cost

client dissatisfaction

8

What determines if a wound will become infected?

 

host factors: age, systemic disease, poor nutrition, shock, immune suppression

environmental factors: excessive trauma during sx-->necrotic tissue-->increased risk of infection, trauma after sx (licking chewing, mutilation, excessive activity)

pathogen factors: numbers and level of pathogenicity

9

What can we do to decrease infection?

maintain cleanliness of the OR

sterilization of surgical equipment and materials

prep of surgical personnel

prep of patient

proper operative technique

post op care

10

operating room

enclosed room, enclosed cabinets, dedicated to surgery, not used for storage, laminar air flow

number of people in OR, excessive conversation, excessive number of entrances/exits increases infection rates

clean with disinfectants-quat

11

packs

double wrapped in cotton muslin or paper

indicators are enclosed wtihin and/or on the exterior

smaller items can be sealed in pouches

always check indicator to confirm adeqyate penetration

12

sterilization steam

most common method

kills m/o by coagulation and denaturing proteins

temp, pressure, steam and time are factors in the process

30 min cycles with 15-30 drying

13

ethylene oxide sterilization

alkylation of proteins and nucleis acids

not as readily available

venting of toxic gas required

can sterilize plastic and other materials that cannot be steam sterilized

14

Cold sterilization

Glutaraldehyde, ortho phthalaldehyde, peracetic or peroxyacetic acid

must be rinsed prior to use

for endoscopes

not appropriate for sx

15

Scrub clothing

shirt tucked in, elastic leg opening

bacteria shed most by high movement areas-perineum, thighs

lab coat should be worn when outside OR

personnel should change into scrubs once in hospital

16

cap/hood

organisms exfoliated from head

haired skin has more bacteria than non-haired skin

17

shoe covers

no benefit

placement/removal contaminates hands

increased falling accidents

have dedicated foot wear

18

surgical masks

protective

19

surgical gowns

disposable=consistently impervious, wastefu,l, expensive

fabric gowns-comfortable, less impervious

20

objectives of hand scrubbign

mechanical removal of gross dirt and oil from the hands

reduction of the transient m/o count as close to zero as possible

prolonged depressant effect on the resident microflora of the hands and forearms

21

hand scrub

soft scrub

hands free sink

antiseptic

CONTACT TIME!

clean underneath nails

22

gloves

closed glove technique

must cover entire cuff of gown

must fit snug on hand

23

patient prep

clip hair-right before surgery

skin prep-chlorhexidine gluconate, povidone-iodine + isopropyl alcohol, start in center, small to larger ovals, be gentle, 4 mins

antiseptic spray

drape surgical field

 

24

chlorhexidine

good residual actvity

variable effectiveness with viruses and fungi

25

povidone-iodine

effective against fungi and viruses

stains coat, less residual activity

causes skin rxns in 50% of dogs

26

alcohols

rapidly bactericidial

effectiveness decreases in presence of organic debris

27

perioperative administration of abx

administration of abx immediately before sx, re-administered q 60-90 m during sx and d/c immediately after sx or up until 24 hr after end of sx

28

postoperative administration of abx

administration of abx after 24 hours after teh end of the sx if considered

29

when are prophylatic abx indicated

if procedure is expected to last >90 min

if procedure is orthopedic

if surgeon is inexperienced

use for dirt and contaminated wounds

if infection will result in a catastrophic outcome

compromised patient

30

clean wound

created using aseptic technique