Skin Antisepsis
These are examples of areas where using a chlorhexidine skin prep are contra-indicated.
This procedure should be completed prior to the first case of the day (and before supplies are placed around the room)
What is Damp Dusting of all horizontal surfaces.
This fluid should never be used for soaking instruments during or after surgery.
What is Normal Saline
A medication or solution on the back table that is not labeled should be this:
What is: discarded
What are: Short Superior and Long Lateral
This is the best way to prevent vermin (ie mice and flies) from entering the perioperative environment
What is removing all food sources, enforcing bans on food and liquids in the semi-restricted areas, and keeping doors and windows closed.
This can occur if the patient is overly stimulated during emergence and may require administration of succinylcholine and reintubation as treatment.
What is Laryngospasm
These are examples of things that need to be considered when determining the skin prep parameters.
What are: location and size of incision (including moist or dry site), type/placement of drapes, type of solution, potential for extension of incision or placement of drains
What are: Right - Patient, Medication, Dose, Time, Route, Indication (Reason), Documentation
These are the risks of errors in specimen management
What are: Inaccurate diagnosis, improper therapy, delayed treatment, need for a second procedure
This type of cleaning is recommended for patients on MRSA precautions
Terminal Cleaning
Of the following end of case duties; Calling PACU, Completing Documentation, Assisting Anesthesiologist with extubation; this should be your priority.
Assisting Anesthesiologist with extubation
This is a consideration for prepping the skin of a patient who is not under General Anesthestic
What is: communicating your actions - warning of cold solution; and giving guidance to avoid contamination of newly prepped area
The information on this document should not be substituted for a verbal order from the surgeon - all medications and solutions must be verified for every patient.
What is the DPC or picklist.
These are examples of specimens that are not routinely sent for pathology:
What are: Tonsils or Foreskin from patients under the age of 16, Bone from total joint replacements, Digits removed for non-viability,
In order to protect yourself from blood/body fluid or infectious material exposure - these are the recommendations for using PPE while assisting with Anesthesia (non-Covid times!)
What is : wear non-sterile gloves for direct patient care; Change gloves after contact with blood/body fluids (ie after intubation); eye protection for procedures where there is risk of splash (ie intubation, extubation, insertion of foley catheter); hand hygiene as needed.
Non-sterile gloves should not be worn when opening sterile supplies, in the sterile core, while charting or while interacting with other "clean" parts of the environment.
This is the timeframe when the Surgical Safety Checklist Debriefing should take place.
What is after completion of final count, prior to any team members leaving the OR.
This is the appropriate action if the skin prep pools around an ecg electrode during application.
Hypervolemia or hyponatremia
These specimens should NOT be placed in a fixative (ie formalin) after removal
What are: Specimens requiring intraoperative consult (frozen section); Lymphoma protocol or Embryopathology; Gall or Urinary Tract Stones (if no tissue is present)
This pathogen is resistant to standard sterilization and disinfection processes and so requires one hour contact with a solution of Sodium Hypochlorite or Sodium Hydroxide prior to standard cleaning.
These are some examples of charting/documentation that need to be completed at the end of the case.
Results of counts (and signed for), Times (Surgery end, patient out of room), Skin integrity after removal of devices (Cautery Pad, Tourniquet etc.), Operation Performed, Wound Classification, Insufflation Volume Delivered, Medications Administered