Sterile Technique
True or False?
Foot traffic coming in/out of a room does not matter if everyone wears scrubs, a hat, a mask, and shoe covers.
False.
Foot traffic increases the air flow and wind within the room, potentially causing the spread of infection-causing agents through the air.
When should you bring the bed/cart into the room when the case is finished?
When the anesthesia provider in the room says it is an acceptable time to do so.
What needs to be done to the Neptune machine after each surgical case?
Any used manifold must be removed and thrown away, and the Neptune machine must be wiped down like the rest of the room.
Which part of the Universal Protocol may the senior resident or fellow complete in the absence of the attending surgeon?
Time-Out
Who must open implants to the sterile field?
The circulator, not the rep.
True or False?
Sterile items/trays are okay to be spread all around the OR room as long as everyone is cognizant and careful not to contaminate them.
False.
Sterile items/trays should be placed all together in a specific area of the room to prevent contamination.
Name at least 3 times music should be turned down or off in an occupied OR room?
When the patient is being induced, during counts, while the patient is being extubated, during any critical point in the case.
What colour bin is designated for anything that has come in contact with chemotherapy agents?
Yellow
What is the age limit for pregnancy screening in a patient who has an intact uterus.
55 years of age.
How many people are required as a minimum to transfer a patient from the table to the cart?
Four- One for the head, one for the feet, one for pushing, and one for pulling at the very least.
Should you treat an OR differently when a sterile Z-drape is covering the back table?
No. You should still wear a mask and limit foot traffic throughout that room.
What should the RN circulator do and where should they be after Huddle is completed?
Help anesthesia with induction and be at the patient's side in case of any issues during that time.
Where should continuous irrigation bags be placed when connected to a patient's Foley catheter?
On a pole and above the level of the bladder at all times. They should never be below bladder level.
When they are below the bladder level, irrigation isn't occurring, which increases the risk of occlusive blood clots inside the Foley.
True or False?
In the event of a count discrepancy, the surgeon is allowed to close the surgical incision completely IF they obtain an X-ray immediately after closure and while the patient is still in the OR room.
False. The count discrepancy must be resolved or an X-ray must be taken and read before the last skin stitch or staple is inserted.
What are the three things that must be done before a standard patient moves from the cart to the OR table?
Make sure the cart and OR table are both locked, the patient's gown is unfastened in the back, and a team member is on the receiving side of the OR table.
How many times should the scrub person touch or move a sterile item when setting up and getting ready for a case?
As seldom as possible to prevent contamination.
Why should the elbow of a Yellofin or Blue Allen stirrup not hang off the end of the bed?
The weight of the stirrup and the patient's leg is not supported when the elbow of the stirrup hangs off. When the elbow is against the silver beam on the side of the bed, the weight is supported and prevents the stirrup from breaking or falling off.
What is the maximum temperature level for the fluid warmers?
No more than 122 degrees Fahrenheit.
When should you use the suture packs (full or empty) as a reference to how many needles you should have on the field?
Never. Counting suture packs is not reliable.
Why should OR scrubs be laundered by the hospital and not at our own homes?
Scrubs carried outside of the OR can increase spread of infection inducing agents that are commonly found in living spaces. Example: staph can harbour in your dryer.
What are all of the things you should check to ensure an instrument tray in a hard container is sterile?
There are two pull tab indicators that changed colour, the inside indicators have changed colour, all instruments are open and unclamped, the inner filter sheets are whole without rips or tears, all areas and instruments are dry and free of moisture, and there is no bioburden or foreign contaminant in the entire case.
What are the temperature and humidity parameters for the ORs?
Temperature must be 68-75 degrees Fahrenheit, humidity must be 30-60%.
Where should you place your radiation dosimetry badge when working in a room with X-ray?
At the neckline outside of the lead apron.
According to the Wound Classification Policy, what should the wound class be for a laparoscopic cholecystectomy with bile spillage?
Class III- Contaminated.
DOUBLE JEOPARDY!
Why do we use normal saline to irrigate an open wound instead of sterile water?
Sterile water can cause cellular rupture due to hypotonic osmolarity. Saline is isotonic and does not cause cellular edema.