Wound Classification
An old wound with retained devitalized tissue (eg, gangrene, necrosis) or an existing clinical infection (eg, purulence
Class IV – Dirty and Infected Wound
Intermittent pneumatic compression devices (eg, sequential compression devices [SCDs]) should be applied and functioning before the administration of regional or general anesthesia.
When should I turn on the intermittent pneumatic compression device?
The medication name, strength, dilution and diluent if used, date, and time accepted on to the sterile field
How should medications on the sterile field be labeled?
Ignition source, fuel and oxygen
What is considered the fire triad?
The recommended time the antiseptic solution should be allowed to dry prior to draping.
What is a three minute dry time or refer to manufacturer's IFU
A fresh, open, or accidental wound in which there is gross spillage from the gastrointestinal tract; or there is acute non-purulent inflammation present.
What is a class III or Contaminated wound
The patient‘s knees should be flexed approximately 5-10 degrees. Positioning the knees in slight flexion prevents popliteal vein compression and reduces the patient‘s risk for deep vein thrombosis (DVT).
Why the AORN recommend flexing the patient‘s knees in the supine position?
The process of combining two or more different medications. This is not mixing or reconstituting
What is Compounding
Procedure Type - IF above the xiphoid process add 1 point
Oxygen Source- IF open oxygen Source add 1 point
Ignition Source -IF using cautery or light source add 1 point
What is included in a fire score risk assessment?
What is the amount of skin a 26ml chlora prep stick will cover
An assessment of the patient's risk for infection.
Wound Classifications
Place the arms in a neutral position with the palms facing the body. Do not hyperextend the elbows. Pull the draw sheet up between the patient's body and arm, place it over the arm, and tuck it between the patient and the OR bed mattress. Ensure the draw sheet extends from above the patient's elbow to the fingertips. Ensure the draw sheet is tight enough to secure the arm but not so tight that it creates a pressure source
What is how to tuck the arms in the supine position?
This solution is used when irrigating or injecting in the vascular system.
What is .9% NACL in an IV bag ( no preservatives)
Allow flammable prep solution to dry according to Manufacturers instructions
Protect ignition sources
Standard draping procedures
What are routine fire safety protocols for a fire score of 0-2?
Starting from clean to dirty. Working from proximal to distal. Begin with incision site for a minimum of 30 seconds.
What are principles of surgical prepping
A wound in which the respiratory, alimentary, or genitourinary tract is entered under controlled conditions without evidence of infection or contamination or a major break in technique
Class II – Clean Contaminated Wound
Preoperative skin assessment. Identification and titles of people participating in positioning the patient. Patient's position, including the position of the arms and legs and any repositioning activities. Type and location of positioning equipment or devices in relation to how it touches the patient. Type and location of safety restraints. Type and location of any additional padding. Specific actions taken to prevent patient injury. The chain of custody for any jewelry or other items that are removed from the patient. The type and location of implants, jewelry, or other items that cannot be removed. Actions taken to prevent injury from items that cannot be removed. Postoperative skin assessment
What are key elements in Documenting the patients position in the EMR?
Pour sterile irrigant into a graduate while held by CST away from the back table. (NS with preservative)
What is the best practice if you have to pour a sterile irrigant on to the sterile field?
Allow prep solution to dry according to IFU. Protect ignitions sources. Use occlusive drapes to prevent oxygen from flowing towards ignition sources. Use lowest concentration of O2 to maintain O2 saturations. Stop O2 one minute prior and during the use of an ignition source. Have wet sponge or towel with water or NS on sterile field for fire suppression. Have a syringe of NS available for oral cavity procedures. Use the minimum amount of ESU power to achieve hemostasis. Use H2O soluble gel for facial hair and H2O based eye lubricants when necessary
What is a high risk fire safety protocol that is to be used when the fire score is a 3 ?
Apply surgical scrub antisepsis on the peri wound working toward the peripheral margins of the field. Then clean the open portion of the wound and discard sponge. Repeat. Blot dry. Either paint wound in same fashion or ( if betadine ) or Repeat process if scrubbing only
What are principle's of surgically scrubbing an open wound or compound fracture?
A clean wound, not infected or inflamed, and the respiratory, alimentary, or genitourinary tracts are not entered. The wound is primarily closed or drained with closed drainage (eg, bulb drain).
Class I – Clean Wound
A patient in this position is at risk for injury from pressure on vulnerable points on the dependent side (ie, ear, acromion process, olecranon, iliac crest, greater trochanter, lateral knee, malleolus).
What is the lateral position?
A device that allows a sterile solution to be delivered to the back table.
What is an IV bag decanter
Disconnect the breathing circuit from the Endo tracheal tube and Remove tube immediately.
What should be done at the first sign of an airway fire.
5% Betadine Solution
What is an approved antiseptic solution that can be used in the eye.