Surgical Hand Antisepsis
This is the purpose of the surgical hand scrub
Remove debris and transient organisms
Reduce resident microbes to minimum
Inhibit rapid regrowth of organisms
This is the posture you should adopt when approaching the gowning table
Bending slightly forward, keeping your hands and arms raised and in front of you
These PPE are required for everyone in the OR during laser use
Laser-specific protective goggles
The dispersive pad should not be placed over these areas
Bony prominence
Scar tissue
Metal implant
Hairy areas
Distal to the tourniquet
These are the most common early signs/symptoms of local anesthetic toxicity
Metallic taste
Tinnitus (ringing in the ears)
Tingling around lips
Dizziness
This is when a pre-wash is required
Prior to every scrub unless you are rescrubbing immediately
Your first pair of gloves should be put on using this technique
Closed gloving
This is the required PPE for radiation safety
Thyroid collar, lead apron (one or two piece), dosimeters for staff regularly exposed for prolonged periods (e.g., x-ray techs, nurses regularly assigned in IR/angio/ortho rooms)
For the patient with an IED, the dispersive pad should be placed as ______ as possible to the surgical site and as _______ as possible from the device generator and leads.
close, far
This would be a reason to hold pre-op heparin
Planned spinal or epidural
Pending INR
Patient has not stopped blood thinners
This is when shoe covers should be added to your surgical attire
When you anticipate splashes or potential for spills (e.g., orthopedics, trauma, c-section)
Double gloving reduces the risk of injury/exposure; wearing two different colours of glove assists with this
Recognizing perforations in the outer glove
What are the three tenets of radiation safety?
Time
Distance
Shielding
Surgical energy devices can act as an ignition source for surgical fires; these precautions should be used to minimize the fire risk
Keeping laser or fibreoptic light sources in standby when not in use
Keep ESU pencil in the holster when not in use
Ensure activation and error alarms are audible
Have sterile water or saline immediately available on the setup
Your patient reports having allergies to kiwi, bananas and avocado—this concerns you as you know these allergies have a cross sensitivity to this product
Latex
This is the correct action if you touch the tap while rinsing at the end of a traditional scrub
Start over :(
Once your gloves are on, you need to do this prior to approaching the back table
Turn yourself
List at least 4 laser safety precautions
Place laser warning signs outside of OR doors
Place protective eyewear for the type of laser being used outside of each entrance
Keep doors closed
Cover windows
Keep the laser in standby when not in use
Remove the laser key and store in a safe location
Have a basin of sterile water available on the sterile field
A fire extinguisher should be available in the OR theatre
According to the NIOSH Hierarchy of Controls, smoke evacuation is this type of control:
a) Elimination
b) Substitution
c) Engineering
d) Administrative
c) Engineering
According to the VCH Surgical Site Identification policy, these are the two conditions that must be met to waive site marking
Does not involve laterality
Entered through a mid-line natural orifice
This is how long the surgical scrub should take (by either method)
What is 4-6 minutes (not including pre-wash of 1 minute)
When removing your sterile gown and gloves, this is the order they should be removed
Gown, then gloves; your top layer glove may be removed prior to the gown
These are the two main reasons for using a tourniquet
Creation of a bloodless surgical field
Anesthesia (Bier block)
True or False: According to the VCH Surgical Plume Evacuation policy, the scrub nurse is responsible for ensuring proper set up of the smoke evacuator in the surgical field
True
These are the two categories of muscle relaxants (and examples of each)
Depolarizing (succinylcholine)
Non-depolarizing (rocuronium)