EXAM 1: Lecture 4 - General surgery etiquette / procedures

Question 1

What are surgical staff barriers of infection

Answer 1

surgeon and ancillary staff

Question 2

What are patient barriers of infection

Answer 2

draping and skin prep

Question 3

What are environmental barriers of infection

Answer 3

surgical suite (OR) and equipment/instruments

Question 4

what type of patient prep is there in small animal

Answer 4

no extra cleaning prior to inducing unless the animal is filthy

Question 5

what are the benefits of bathing prior to surgery

Answer 5

it does reduce bacterial counts on skin

Question 6

what are the disadvantages of bathing prior to surgery

Answer 6

liberates deeper bacteria through open pores, dries out skin, and hair must be dried prior to clipping

Question 7

how can you prepare a horse for surgery

Answer 7

grooming and pick feet prior to induction

cover feet before starting skin prep

may clip/rough prep while standing

Question 8

How do you prepare food animal for surgery

Answer 8

tie the tail, clip/prep, block

Question 9

how do you prepare food animal for surgery in an OR

Answer 9

similar to horse

Question 10

when is the initial prep and final prep for surgery done

Answer 10

clipping and initial prep should be done in prep/any other room than the OR

final prep is in OR

Question 11

what is the purpose of initial prep for sx

Answer 11

remove grossly visible dirt, blood, etc

remove grease

clean skin

Question 11

explain what you need to do when clipping a patient for prep

Answer 11

1. sterilize/clean the clipper blades
2. size 40 clippers gets closest to skin
3. clip only at time of sx
4. at least 20 cm on either side of surgical site
5. vacuum hair

Question 11

Why is the size of the clip for prep important??

Answer 11

because incisions often need to be extended

Question 12

what are some special consideration for initial prep

Answer 12

hang the limb, preprep feet

Question 13

do opthalamic/dentals require initial prep

Answer 13

no!

Question 14

what are the rules of a sterile skin prep

Answer 14

person performing the scrub must have a cap and mask, NO lab coat, and sterile gloves

Question 15

what is the technique of sterile skin prep

Answer 15

start from the site of the incision and move outward (DO NOT GO BACK IN TOWARDS INCISION), one 4x4 per scrub

Question 16

what is the MOST important time of sterile skin prep

Answer 16

CONTACT TIME!!!

Question 17

what is this image showing

Answer 17

sterile prep

Question 18

how do you prep for optho sx

Answer 18

dilute povidone-iodine solution and never use chlorhex or alcohol

Question 19

why should you never use chlorhex or alcohol for optho sx

Answer 19

it melts the cornea

Question 20

what is important to remember for draping

Answer 20

it is an effective bacterial barrier, lint free, tear resistant, sterile, effective fluid barrier, and breathable (if too its not effective, if not it can create bacterial growth)

Question 21

finish this statement in regards to draping material: “Higher thread count = ___1___ weave = __2__ barrier”

Answer 21

1. tighter weave
2. better barrier

Question 22

is cotton muslin a good draping material

Answer 22

it is inadequate microbial barrier when wet or dry

Question 23

when is prima cotton an inadequate barrier

Answer 23

when it is wet

Question 24

when is prima cotton an adequate barrier

Answer 24

it is adequate for skin shedding

Question 25

what is the disadvantages of fabric

Answer 25

there can be damage from punctures that disrupt barriers

Question 26

what are the types of disposable draping materials

Answer 26

cellulose, wood pulp, polyesters, synthetic polymers fibers bonded into sheets

Question 27

what MUST disposable draping materials have

Answer 27

must be reinforced with polyethylene or plastic film to be water resistance

Question 28

why do we cover all visible surfaces of the patient when draping

Answer 28

it prevents aerosolization from unprepared areas

Question 29

what is the drape out technique

Answer 29

when you drape the smallest area possible with enough room for your incision

Question 30

what is important to remember about draping quadrants and towel clamps

Answer 30

once a clamp has penetrated the drape, it is now contaminated

Question 31

T/F: When you are draping, you want all of the layers to be the same shape and same hole

Answer 31

true!

Question 32

What do we use to drape limbs

Answer 32

ioban and vetwrap

Question 33

list the steps in order for patient prep

Answer 33

1. clip 2. initial scrub 3. move to OR 4. sterile scrub 5. drape

Question 34

how do you position the instrument table to reduce contamination

Answer 34

close to the surgeon if there is no assistant or close to the assistant

Question 35

T/F: anyone in the OR can walk between the table and the surgery site

Answer 35

FALSE!! Only sterile/scrubbed in people can

Question 36

can a non-scrubbed person extend their arm over a sterile field even if they do not touch anything?

Answer 36

no they cannot! It breaks the sterile field

Question 37

what is the typical layout of the SA surgical area

Answer 37

surgeon and assistant on opposite sides of the table, anesthesia by the head, and technician towards the back of the room

Question 38

for large animal, what are the limitations when positioning a patient

Answer 38

there are not a lot of options because the patient takes up the entire table, there must be a lot of padding

Question 39

what should you always ask before you start the procedure??

Answer 39

am i ok to cut anesthesia??

Question 40

are surgical assistants just for looks??

Answer 40

no!!! moral support, supervision

Question 41

what are the roles that an assistant has

Answer 41

organize the table, count gauze, count instruments, hand instruments, retract, hold, cut and run suture

Question 42

why do we need to count gauzes?

Answer 42

so you know if there is a missing gauze BEFORE closing

Question 43

T/F: You can use any type of gauze for abdominal procedures

Answer 43

false!! Must be radiopaque

Question 44

what type of scissors do you use to cut suture

Answer 44

suture or general purpose scissors, NOT mayo

Question 45

explain how running suture works

Answer 45

surgeon places the bite, surgeon gathers suture and then hands excess to assistant. Assistant then holds excess suture out of the way

Question 46

what are the general rules of writing a surgery report

Answer 46

accurate report of what occurred during the procedure, details are important (lengths, suture, and instruments), use proper medical terminology

Question 47

what are parts of a medical record

Answer 47

1. how was animal anesthetized/restrained/positioned 2. describe the prep and how it was prepped 3. describe what area was prepared 4. describe the approach 5. describe the major findings

Question 48

T/F: in your medical record/report, you do not need to put all of the events in order as long as they are all in there

Answer 48

FALSE! They should be in the order of which they were completed

Question 49

what should you end your medical record/report with

Answer 49

how the animal recovered from anesthesia