Good theatre practice

Question 1

define sepsis

Answer 1

the presence of pathogens

Question 2

define asepsis

Answer 2

free from infection

Question 3

define antisepsis

Answer 3

prevention of sepsis

Question 4

what is strerilisation

Answer 4

elimination of all mircoorganisms including spores

Question 5

define disinfection

Answer 5

removal of microorganisms (does not always include spores)

Question 6

what is a disenfectant?

Answer 6

agent that will distroy mircoorganisms

Question 7

what needs to be done regarding the instuments used for surgery?

Answer 7

• cleaned,
• checked for damamge and that they are working effectivly,
• sterilised to maintian asepsis

Question 8

Give an example of a weekly theatre cleaning routine:

Answer 8

• Morning Damp dusting – First thing.
• Between cases – Immediate action required
• At the end of day – disinfectant solutions
• Once a week – Deep cleaning, All areas remember the hard to reach places

Question 9

how do you check a theatre has been cleaned corrrectly?

Answer 9

take regular swabs for culture growth (remember had to reach areas), skins, taps, operating table

Question 10

Preoperative preparation of the patient

what needs to happen to the patient the 12ish hours before surgery?

Answer 10

starvation

Question 11

Preoperative preparation of the patient

is bathing needed before a surgery?

Answer 11

depends of the breed and the type of surgery occuring, might be needed a few days before

Question 12

when can clipping of the area be done?

Answer 12

• before surgical day (can irritate the skin and cause microorganism overgrowth)
• prior to induction (if patient is cooperative)
• once induction has been done

Question 13

Preoperative preparation of the patient

what special preperation is sometimes needed for lower GI surgery?

Answer 13

enema

Question 14

Preoperative preparation of the patient

what special preperation is sometimes needed for urinary tract and abdominal surgery?

Answer 14

urinaty catherterisation (reduces size of the bladder provides more room in abdomen)

Question 15

Preoperative preparation of the patient

what special preperation is sometimes needed for oral surgery?

Answer 15

flushign of the mouth with dilute hibiscrub

Question 16

Preoperative preparation of the patient

what special preperation is sometimes needed for foot surgery?

Answer 16

apply bags with hibiscrub, allowing feet to soak , to remove all dirt

Question 17

what are the key questions to ask before surgery?

Answer 17

• patient history has been confirmed
• not sensitive to chosen dienfectants

Question 18

what are the 3 main steps of preoperative pateint preperation?

Answer 18

• cannula
• catheter
• cleaning

Question 19

what is used for/needed for the preoperative scrub/clean of animal?

Answer 19

• sterile bowl
• sterile lint-free material (10x10 gause swab)
• sterile/non-sterile gloves can be worn but hands must bee clean

Question 20

what solution is used for the surgical scrub solution

Question 21

what two preoperative procedures require a sterile scrub to be performed before they are carried out?

Answer 21

IV cannulas and urinary catheters

Question 22

what areas of the body require preoperative sterile flushign prior to exploratory or repair surgery?

Answer 22

wounds, eyes, ears, mouth and feet

Question 23

why is surgical scrubbing of the patient vital?

Answer 23

animal carries commensal bacteria of skin that can be opportunistic and pathogenic if allowed to enter the body

Question 24

what technique is used for the surgical scrub of the animal skin?

Answer 24

circular motion moving outwards way from the incision site

Question 25

what is the nomal solution used for cleaning preperation of the patients skin? how long does this need to be in contact?

Answer 25

chlorohexidine 2%, minimum of 5 minutes

Question 26

what skin cleaning solution is used for patients that have chrohexidine sensitivites? how long does this need to be in contact?

Answer 26

povidone iodine 7.5%, for 3 minutes

Question 27

what are the issues with using povodine iodine fro a surgical skin scrub?

Answer 27

does not achive good bacteriocidal effects inthe presence of gross contamination (mud, blood)

Question 28

what solution is usded to clean ocular areas?

Answer 28

Povidone Iodine 0.2%-2% or 1:50 dilution. (chlorohexidine is an irritant to the mucus membrane)

Question 29

what cleaning solution is used for the ear?

Answer 29

- flushed frist with saline - then dilute 0.2% chlorohexidine

Question 30

what cleaning solution can be used for feet?

Answer 30

wrapped in a bag containing 2% chlorohexidine left for 5 mins to remove gross contamination, then clipped and scrubbed for another 5 mins

Question 31

what can be used to clean open wounds prior to surgey?

Answer 31

0.9% saline

Question 32

what should not be used in open wounds prior to surgery and why?

Answer 32

chlorohexidine as it has been found to be toxic to cells and could cause delayed wound healing and problems post op

Question 33

what is used to clean the mouth prior to surgery?

Answer 33

0.1% chlorohexidine (dogs) (premade rinse)

Question 34

what are the isses of using chlorohexide for oral cleaning in cats?

Answer 34

research has shown that can lead to oral ulceration of mucus membrane - need to use proper oral scrub for cats

Question 35

what are the issues with other wetting during the srugical scrub of the patient?

Answer 35

can lead to strike through of the surgical drapes, and cooling of the patient leading to hypothermia

Question 36

why do we drape the patient?

Answer 36

- to maintian asepsis - prevent contamination of surgical site

Question 37

what should drapes cover?

Answer 37

where practical - the entire patient only leaving the surgical site visible | (not needed for cat castrate or large animal)

Question 38

what are the advantages of disposable drapes?

Answer 38

- more cost effective - better at repetting liquids (prevent strike through)

Question 39

what is strike through in a surgical sense?

Answer 39

then the blood and fluid or liquid from above the drape soak into the drape and can hurbour bacterial growth

Question 40

what are the uses for a fenestrated drape?

Answer 40

for small procedures with small animals

Question 41

what draping technique is used for a large surgery

Answer 41

4 corner draping

Question 42

what is an adhesive barrier drape? when are they used?

Answer 42

sticky on one side and can be fixed to patient, act like a second skin, helpful for limb surgery where surgeon wants to move the limb

Question 43

what can adhesive barrier drapes be inpregnated with and what does this do?

Answer 43

inpregnated with iodine to provide an extra barrier for asepsis