Sterilization Decisions
The surgeon asks whether an alcohol skin prep and a disinfectant wipe can be used interchangeably. Which product belongs on living skin?
An antiseptic
A surgeon wants to dissect delicate soft tissue rather than cut suture. Which scissors would you prepare?
Metzenbaum scissors.
An item slips down the hanging side of a sterile back-table drape. Is the hanging side part of the sterile work surface?
No. The sterile table surface is the top at table height.
A procedure is scheduled with a surgeon whose usual supplies differ from the standard setup. Which document is the starting point for gathering those preferences?
The surgeon’s preference card; then adapt the plan to the patient and procedure.
A patient lies flat on the back for a procedure. Name the basic position.
Supine
A reusable airway device will contact a mucous membrane. What Spaulding category applies, and what is the minimum processing outcome?
Semicritical; at least high-level disinfection according to its validated IFU.
A rough bony surface needs smoothing after a cut. Which type of instrument serves that purpose?
A rasp
Two gowned team members need to pass in a narrow area. Which orientations protect their sterile gown fronts?
Front to front or back to back.
A specimen must be examined while the operation is still in progress. Which pathology process should the team plan for?
A frozen section, with immediate specimen communication and handling.
The table is tilted so the patient’s head is lower than the feet. Name the position.
Trendelenburg
An instrument pack has a changed chemical indicator. What does that color change demonstrate?
Exposure to the conditions monitored by that indicator
The surgeon needs a gentle hold on a delicate tubular structure. Which clamp is a better choice than a heavy toothed clamp?
A Babcock clamp
Fluid wets a sterile drape and reaches the nonsterile surface beneath it. Name the contamination pathway.
Strike-through contamination.
Small vessels continue to ooze during closure. Which Halstead principle calls for controlling this bleeding to support visibility and healing?
Meticulous hemostasis.
The chart names the left side, but the patient indicates the right side. What is the correct response before transport or setup proceeds?
Stop, notify the responsible team, and resolve the discrepancy using the identification and site-verification process.
A specialty tray arrives from a vendor wrapped and labeled sterile. What must happen before your facility releases it for a patient?
Inventory, inspect, clean, and process it according to the manufacturer’s IFU and receiving facility policy.
A large volume of fluid is present in the abdomen. Which guarded suction tip helps spread suction pressure?
A Poole suction tip.
You watch a circulator open an envelope-wrapped item. Which flap must be opened last to avoid reaching across the contents?
The near flap.
A synthetic absorbable suture begins to lose strength as water penetrates its strands. Name the breakdown process.
Hydrolysis
A patient’s legs are being moved into stirrups. How should the team raise and lower them to limit uneven strain?
Move both legs together, slowly, with support and coordinated team direction.
After a steam cycle, the inside of a wrapped tray is damp. What is the safest disposition, and why?
Do not use it. A wet package has a compromised sterile barrier and must be reprocessed.
Two orthopedic cutting instruments are on the field. One blade is beveled on both sides; the other on only one. Name each.
The osteotome is beveled on both sides; the chisel on one side.
A technologist discovers a small tear in a sterile glove just before passing an instrument. What should happen immediately?
Announce the contamination and replace the glove using an appropriate sterile technique before continuing.
The closing count has one sponge unaccounted for. Give the technologist’s two immediate responsibilities.
Tell the surgeon and circulator at once, and participate in the search and count reconciliation according to policy.
An anesthetized patient is turned onto the side. What spinal alignment should the team maintain, and what areas need special protection?
Maintain a neutral spine; support and pad dependent areas, bony prominences, and vulnerable nerves.