Ch. 13 Operating Room

Question 1

What values must an operating team have for high function?

Answer 1

• sharing goals
• having clear roles
• mutual trust
• establishing effective communication
• agreeing with measurable processes and outcomes

Question 2

how big should an operating room be for human surgery

Answer 2

at least 400 square feet

Question 3

what is ultraclean airflow and what does it alloq

Answer 3

It is also known as laminar airflow
Allows filtration, dilution, and land distribution of air
Creates a unidirectional, positive pressure flow of air
Horizontal laminar flow is preferable to vertical

Question 4

what are the recommended HVAC guidelines for an operating room

Answer 4

minimum 15 air exchanges per hour
30-60% humidity
20-23 C (or 68-73 F)

Question 5

what is the difference between an antiseptic and a disinfectant

Answer 5

antiseptic will prevent or reduce the growth or action of pathogenic organisms on living tissue whereas disinfectant will destroy most pathogenic organisms (but not spores) on inanimate objects

Question 6

what is the mechanism of action for quaternarium ammonium disinfectant compounds

Answer 6

causes leakage of the protoplasm in microbes
works very well again gram negative bacteria, has some effect on fungi and viruses
low cost
decreased efficacy when in contact with organic debris

Question 7

what is the MOA of phenols for disinfectants

Answer 7

denatures enzymes and causes cell lyses
intermediate level disinfectant
good for large area disinfection
very irritating especially for the airways

Question 8

what is the MOA of chlorine disinfectants

Answer 8

disrupt cellular metabolism
rapid and high level disinfectant but not effective against fungi
strong odor
corrosive to some metals

Question 9

what is the MOA for alcohols as a disinfectant/antiseptic

Answer 9

causes protein denaturation, lysis, and metabolic interruption of cells
good against bacteria and fungi and okay against viruses
approved as an antiseptic, not for cleaning large surfaces
does not penetrate organic material

Question 10

what is the MOA of iodine for patient prep

Answer 10

causes oxidation/substitution by free iodine and denatures protein
good against bacteria, viruses, and fungi but not spores
decreases oral inflammation
may cause irritation and in dogs causes a lot of skin reactions
has moderate residual activity

Question 11

what concentration of iodine should be used for skin prep for personnel and patient

Answer 11

5-10% for personnel

10% for patient

Question 12

what concentration of iodine should be used for surgical scrub and solution

Answer 12

2% for scrub and 10% or 2% for solution

Question 13

what is the MOA for chlorhexidine as an antiseptic and disinfectant

Answer 13

disrupts cell membrane
great against bacteria (bactericidal at high concentrations and static at low concentrations), viruses and okay against fungi
Has excellent residual activity
no inhibition by blood debris
low skin irritation
ototoxic
lethal to fibroblasts at concentrations higher than 0.05%

Question 14

what concentration of chlorhexidine should be used for wound treatment solutions?

Answer 14

less than 0.05%

Question 15

what concentration of chlorhexidine should be used for oral rinses?

Answer 15

0.12%

Question 16

what concentration of chlorhexidine should be used for disinfectant solutions?

Answer 16

0.5-2.0%

Question 17

what concentration of chlorhexidine should be used with surgical scrub solutions?

Answer 17

2.0-4.0%

Question 18

what is the MOA of triclosan?

Answer 18

affects the cytoplasmic membrane and syntheses of RNA, fatty acids, and protein
slow acting
bacteriostatic, not cidal

Question 19

what are the most common materials for gloves

Answer 19

latex
vinyl
nitrile rubber
neoprene

Question 20

what factors make glove perforation more common?

Answer 20

non dominant hand
non soft tissue surgeries
longer procedures (more than 60 min)