Term
|
Definition
| whole column of air above a sterile area such as the instrument tray or the surgical site |
|
|
Term
|
Definition
| chemical used to kill or control the growth of microbes on living tissue |
|
|
Term
|
Definition
| chemical used to kill or control the growth of microbes on an inanimate object |
|
|
Term
|
Definition
| the state of containing microbes |
|
|
Term
|
Definition
| action taken to stay as sterile as possible |
|
|
Term
|
Definition
| using a liquid under pressure to rinse out a cavity or wound |
|
|
Term
|
Definition
| an infection acquired in a hospital/clinic |
|
|
Term
|
Definition
| redness, heat, pain, swelling, *altered* function (remember: Dr. Keller doesn't like "loss of function") |
|
|
Term
|
Definition
| microbes that normally live on or in an organism without causing that organism harm |
|
|
Term
|
Definition
| material produced from a living creature, including: feces, saliva, urine, blood, tears,and skin |
|
|
Term
| (from the power point) List the types of microbial control from high control to low control. |
|
Definition
-sterilization
-disinfection
-antisepsis
-sanitation
-cleaning |
|
|
Term
| (from the power point) List types of microbes from most resistant to least resistant. |
|
Definition
-protozoan cysts (oocysts)
-bacterial spores
-nonenveloped viruses
-TB organisms
-enveloped viruses
-fungi
-vegetative bacteria |
|
|
Term
| Spore-forming bacteria include: |
|
Definition
|
|
Term
| Name some diseases caused by Clostridium spp: |
|
Definition
-botulism
-gangrene
-tetanus
-blackleg |
|
|
Term
| Dz caused by Bacillus species? |
|
Definition
|
|
Term
| Physical methods of microbial control: |
|
Definition
-dry heat
-moist heat
-radiation
-filtration
-ultrasonic vibration |
|
|
Term
|
Definition
|
|
Term
| What items can be sterilized by hot air ovens? |
|
Definition
| -powders -waxes -glassware -petroleum products |
|
|
Term
| Time and temp for a hot air oven? |
|
Definition
|
|
Term
| How does moist heat kill microorganisms? |
|
Definition
| denatures the microbes' proteins |
|
|
Term
| Does boiling water make it sterile? |
|
Definition
| No- requires 3 hours to approach sterility. 100C max temp. |
|
|
Term
| What is the most efficient, inexpensive method for sterilizing? |
|
Definition
|
|
Term
| How does an autoclave work to sterilize? |
|
Definition
steam under pressure
-as pressure increases, so does the boiling point of water |
|
|
Term
| Temp and pressure in an autoclave? |
|
Definition
| 121 C and +15psi (over atmos. pressure) |
|
|
Term
|
Definition
indicator: shows that one parameter has changed (eg tape contacted by steam)
integrator: shows that two or more parameters have changed (eg tape contacted by steam for 15min) |
|
|
Term
| At what temperature are spores killed? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| How long must water vapor contact items in an autoclave in order to be sterile? |
|
Definition
|
|
Term
| 2 reasons why instruments should be left un-ratcheted during autoclaving? |
|
Definition
-vapor can not get inside the ratchet to sterilize
-metal expands under heat, and may crack |
|
|
Term
| A wet pack is considered contaminated because of "___." |
|
Definition
| wicking - water acts as a portal through which microbes can easily pass |
|
|
Term
| How long do we set the autoclave for? |
|
Definition
|
|
Term
| What is "flash sterilization"? |
|
Definition
| If 1 or 2 instruments need to be sterilized immediately (eg Doc drops one during surgery), can place in autoclave at higher pressure, which results in higher temps, which results in shorter time to sterilize. |
|
|
Term
| What types of radiation can be used to sterilize? |
|
Definition
|
|
Term
| What method of sterilization can be used on whole rooms? |
|
Definition
|
|
Term
| What method of sterilization can penetrate solids and liquids? |
|
Definition
|
|
Term
| What method of sterilization is used in pharmaceuticals, plastics, and commercial products? |
|
Definition
|
|
Term
| What pore size is required to filter out viruses and mycoplasmas? |
|
Definition
|
|
Term
|
Definition
| HEPA air filter, surgical masks |
|
|
Term
| How does ultrasonic cleaning work? |
|
Definition
| Sound waves form bubbles that implode upon contact with instruments. These implosions clean material from instrumentrs. |
|
|
Term
| What level of sterility does ultrasonic cleaning provide? |
|
Definition
| Used for sanitation, not sterilization |
|
|
Term
| What happens if you autoclave an instrument with soap residue on it? |
|
Definition
|
|
Term
| Soaps usually have a ___ pH. |
|
Definition
|
|
Term
| How do soaps/detergents work? |
|
Definition
| Limited sterilizing ability. They emulsify, degrease, and suspend particles in a solution. |
|
|
Term
| Which commonly used type of disinfectant is also a deodorizer? |
|
Definition
| quaternary ammonium compounds |
|
|
Term
| Mixing __ with bleach or other disinfectants can cause lethal vapors. |
|
Definition
|
|
Term
| Which two disinfectants are sporicidal? |
|
Definition
|
|
Term
| Which two disinfectants are not inactivated by organic materials? |
|
Definition
| biguanides (chlor-hex) and phenols |
|
|
Term
| Newer generations of quats are effective against... |
|
Definition
|
|
Term
| What kind of disinfectant is Triple Two? |
|
Definition
|
|
Term
| What kind of disinfectant is Parvo Plus? |
|
Definition
|
|
Term
| What kind of disinfectant is Roccal-D? |
|
Definition
|
|
Term
| Some active ingredients in quats? |
|
Definition
-benzalkonium chloride
-ammonium chloride
-ammonium chlorides |
|
|
Term
| Some active ingredients in phenols? |
|
Definition
-phenol
-carbolic acid
-coal tar
-cresol
-hexachlorophene
-pine oil |
|
|
Term
| Phenols are effective at killing what types of microbes? |
|
Definition
| bacteria; limited against viruses/fungi |
|
|
Term
| Quats are effective at killing what types of microbes? |
|
Definition
| bacteria; newer ones against some viruses |
|
|
Term
| What type of disinfectant is toxic to cats, rabbits, and rodents? |
|
Definition
|
|
Term
| Aldehydes are effective at killing what types of microbes? |
|
Definition
| everything, even spores with enough contact time |
|
|
Term
| What type of disinfectant is carcinogenic? |
|
Definition
|
|
Term
| What type of disinfectant is very irritating to the skin and respiratory tract? |
|
Definition
|
|
Term
| What kind of disinfectant is Cidex? |
|
Definition
| an aldehyde, specifically gluteraldehyde |
|
|
Term
| What type and brand name of disinfectant is used for "cold sterile"? |
|
Definition
|
|
Term
| What disinfectant is labeled as lasting 14 or 28 days after reconstitution? |
|
Definition
|
|
Term
| How long does it take for a "cold sterile" instrument to be sterile? |
|
Definition
| 12 hours, restart the clock every time you add items to the solution |
|
|
Term
| After 20 minutes soaking in ____, there is a high level of disinfection but not sterilization. |
|
Definition
|
|
Term
| What type of disinfectant is chlorhexidine? |
|
Definition
|
|
Term
| What disinfectant comes as a scrub, solution or tincture? |
|
Definition
|
|
Term
| Chlorhex is effective at killing what types of microbes? |
|
Definition
| bacteria, fungi; limited against viruses |
|
|
Term
| Biguanides are effective at killing what types of microbes? |
|
Definition
| bacteria, fungi; limited against viruses |
|
|
Term
| What type of disinfectant can also be used as an antiseptic? |
|
Definition
|
|
Term
| What type of disinfectant has a residual effect? |
|
Definition
|
|
Term
| How do you prepare chlorhex for lavage? |
|
Definition
| 0.05% (1:40 dilution of 2% solution) |
|
|
Term
| Chemical name for bleach? |
|
Definition
|
|
Term
| What is the cheapest, most effective disinfectant? Why isn't it used all the time? |
|
Definition
| bleach, but use selectively because it irritates resp/eyes, corrosive, caustic, fades fabrics |
|
|
Term
| Dogs frequently have contact sensitivity to ___. |
|
Definition
| halogen class disinfectants/antiseptics (iodine) |
|
|
Term
| How do you prepare iodine for lavage? |
|
Definition
| 1:100 dilution of 10% solution ("tea color") |
|
|
Term
| What type of disinfectant dries tissue? |
|
Definition
|
|
Term
| Halogens are effective at killing what types of microbes? |
|
Definition
| bacteria, fungi; limited against viruses |
|
|
Term
| Although it is capable of sterilization, the way ___ is used only allows for disinfection/antisepsis. |
|
Definition
|
|
Term
| What type of disinfectant fogs lenses, hardens plastics, and dissolves some cements? |
|
Definition
|
|
Term
| What type of disinfectant is very irritating and toxic to cells? |
|
Definition
|
|
Term
|
Definition
-aid debridement by blanching tissues with poor perfusion
-get out blood stains
-58% solution vaporized can sterilize |
|
|
Term
| Ethylene oxide is usually reserved for sterilizing ____. |
|
Definition
| delicate, sharp instruments |
|
|
Term
| Is ethylene oxide a disinfectant or sterilant? |
|
Definition
|
|
Term
| How can liquids and labile objects be sterilized? |
|
Definition
|
|
Term
| What must you do with instruments after they are sterilized with ethylene oxide? |
|
Definition
|
|
Term
| Precautions regarding ethylene oxide? |
|
Definition
-ventilate after use for 24-48 hours
-flammable and explosive
-carcinogenic |
|
|
Term
| How do you perform quality control when using ethylene oxide? |
|
Definition
-integrator
-Bacillus put in sterilizer, then incubate and watch for growth (growth = spores not killed, thus not sterile) |
|
|
Term
| The minimum amount of time between putting an instrument in an ethylene oxide sterilizer and using that instrument is... |
|
Definition
| 14 hours (12hrs to sterilize, 2 hours to ventilate) |
|
|
Term
| When setting up or using an ethylene oxide sterilizer, you should wear a ___. |
|
Definition
|
|
Term
| Rank chemical agents by highest -cidal ability to lowest -cidal ability. |
|
Definition
EtO
Aldehydes
Bleach / Vapor H2O2
Phenols
Newer generation Quats
Chlorhex
Alcohol
Older generation Quats
Liquid H2O2 |
|
|
Term
|
Definition
| wrapped items that are sterilized |
|
|
Term
| Ideal wrap material properties |
|
Definition
-selective permeability (vapor in, microbes out)
-resistance (to tears/scorching)
-flexibility (conforms to shape of pack contents)
-decreased memory |
|
|
Term
| Why are wraps and gowns in light blues, and greens? |
|
Definition
|
|
Term
| Fabric wraps are made of ____. |
|
Definition
|
|
Term
|
Definition
| tightly woven cotton which does not get static or lint |
|
|
Term
| Double-wrapped fabric packs have ___ layers of _____. |
|
Definition
|
|
Term
|
Definition
-less memory
-good flexibility
-no static or lint
-resistant to damage |
|
|
Term
|
Definition
-larger pores
-must wash and dry
-pre-determined sizes
-can't repair in-house |
|
|
Term
|
Definition
-smaller pores
-less layers needed
-cheaper, easily disposed of
-cut to size |
|
|
Term
|
Definition
-less resistant to damage
-less flexibility
-more memory
-may scorch in autoclave |
|
|
Term
| Crepe papers contain _____ fibers. |
|
Definition
|
|
Term
| Advantages of crepe paper over non-crepe paper? |
|
Definition
-more flexibility
-less memory |
|
|
Term
| Disadvantages of crepe paper vs non-crepe paper? |
|
Definition
-more expensive
-more easily torn |
|
|
Term
| For paper gowns, should the darker or lighter side face out when wrapped? |
|
Definition
| darker faces out ("show your colors") |
|
|
Term
| Gloves are packaged in what kind of paper? |
|
Definition
|
|
Term
| Huck towels have a ____ weave which makes them very ____. |
|
Definition
| waffle weave, very absorbent |
|
|
Term
| What is the term for a drape with a slit/hole in the middle? |
|
Definition
|
|
Term
| How should you fold towels and drapes? |
|
Definition
|
|
Term
|
Definition
-contents or type (eg "spay pack")
-date autoclaved
-name of wrapper
-if packing gloves, label size and finger direction |
|
|
Term
| How do you autoclave a liquid? |
|
Definition
-heat-resistant container
-loose cap or needle through stopper
-upright |
|
|
Term
| Place first-used instruments where in a pack? |
|
Definition
|
|
Term
| Place absorbent layer where in a pack? |
|
Definition
|
|
Term
| How many drapes should go in 1 pack? |
|
Definition
| 4- incision might be too big for pre-cut fenestration |
|
|
Term
| How many gauze sponges should go in a pack at JJC? |
|
Definition
|
|
Term
| Instruments and drapes should be washed in ____ water. Why? |
|
Definition
| cool water- it gets blood stains out better |
|
|
Term
| What size glove does Dr. Keller wear? |
|
Definition
|
|
Term
| Time til expiration for double-wrapped 2-ply muslin packs? |
|
Definition
|
|
Term
| Time til expiration for double-wrapped paper wraps? |
|
Definition
|
|
Term
| Time til expiration for paper/plastic heat-sealed peel-open pouches? |
|
Definition
|
|
Term
| Reasons why a pack would be considered contaminated: |
|
Definition
-wet pack because of "wicking"
-tape seal broken or loose
-date expired/missing/illegible
-outer wrap ripped/punctured
-dropped on floor
-organic material
-no integrator
-indicator tape didn't change
-instruments ratcheted shut |
|
|
Term
| How should multiple surgeries be scheduled? |
|
Definition
-cleanest to dirtiest
-also consider difficulty/length of procedure |
|
|
Term
|
Definition
-adhere strictly to aseptic technique to avoid harming the patient
-immediately report/address breaches |
|
|
Term
| What parts of a gown are considered sterile during a surgery? |
|
Definition
-above waist
-elbow to top of cuff
-front only |
|
|
Term
| What organization sets the standards for routine OR cleaning? |
|
Definition
| AORN (Assoc. of periOperative Registered Nurses) |
|
|
Term
| On a surgery day, when should the OR be cleaned? |
|
Definition
| -before and after each procedure -day's end |
|
|
Term
| Properties of an ideal disinfectant: |
|
Definition
-broad spectrum
-nonirritating
-nontoxic
-non-corrosive
-inexpensive |
|
|
Term
|
Definition
sanitize: decrease microbes to safe level
sterilize: eliminate all microbes |
|
|
Term
| Effectiveness of a disinfectant depends on: |
|
Definition
-microbe type
-proteins
-other sanitation compounds
-contact time
-degree of contamination
-organics
-concentration/quantity of chemical
-temperature |
|
|
Term
| How does ultrasonic cleaning work? |
|
Definition
| cavitation - tiny bubbles form and collapse rapidly, removing debris |
|
|
Term
| 3 cornerstones to instrument cleaning? |
|
Definition
| clean, decontaminate, sterilize |
|
|
Term
| 4 steps of instrument cleaning: |
|
Definition
| presoak, preclean, decontaminate, sterilize |
|
|
Term
|
Definition
-gravity-air displacement
-high-vacuum sterilizers |
|
|
Term
| Most common type of autoclave in small animal hospitals? |
|
Definition
|
|
Term
| Most common type of autoclave in teaching hospitals? |
|
Definition
|
|
Term
| What is flash sterilization and why might it be used? |
|
Definition
| Rapid sterilization of a few instruments, usually because they are dropped on the floor in surgery and are needed immediately. |
|
|
Term
| How do you flash sterilize an instrument? |
|
Definition
-no wrap
-272F, 32psi, 4min |
|
|
Term
| Why should you avoid scented disinfectants? |
|
Definition
| The scent can mask poor sanitation. |
|
|
Term
| Factors determining if infection will occur: |
|
Definition
-# microbes
-virulence
-susceptibility of animal
-route of exposure |
|
|
Term
| 4 main contamination sources: |
|
Definition
-operative personnel
-surgery environment
-surgical instruments/equipment
-patient |
|
|
Term
| Ethylene oxide works by... |
|
Definition
| destroying metabolic pathways |
|
|
Term
|
Definition
biological - Bacillus stearothermophilus
chemical - tapes, strips |
|
|
Term
| Cold sterile refers to the process of immersing items in ____ to ___ levels of contamination. |
|
Definition
|
|
Term
| Why would you put an item in cold sterile? |
|
Definition
| -can't withstand heat/steam of autoclave |
|
|
Term
| What cold sterile chemical is virucidal after 10 min and sporicidal after hours? |
|
Definition
|
|
Term
|
Definition
-disassemble and remove tissue/debris
-foam cleaner and lint-free towel
-wipe clean with isopropyl alcohol
-wrap and autoclave to manufacturer's instructions |
|
|
Term
| How to clean laparoscopes/fiber optics? |
|
Definition
-gauze with alcohol
-or gas / cold sterile with 2% Cidex |
|
|
Term
| Cidex is a brand name for the chemical __. |
|
Definition
|
|
Term
| Safety precautions when using Cidex? |
|
Definition
| gloves, eye protection, rinse instruments with sterile saline afterward |
|
|
Term
|
Definition
| -lots of clean tap with suction to remove debris |
|
|
Term
|
Definition
|
|
Term
| HLD is recommended for what sorts of instruments? |
|
Definition
-heat/steam sensitive ones like endoscopes
-semicritical items |
|
|
Term
| Iatrogenic infections can arise from what bacteria? |
|
Definition
| Pseudomonas, E. coli, Klebsiella, Serratia, Salmonella |
|
|
Term
| What to do with items after soaking in cold sterile? |
|
Definition
| Rinse with sterile water - tap can have Pseudomonas or Mycobacerium. Dry with sterile towels. |
|
|
Term
| Most common contamination of surgical wounds occurs from which bacteria? Where are these found? |
|
Definition
| Staph and Strep - on patient's skin |
|
|
Term
| Before surgical prep, what 3 things should you check? |
|
Definition
-patient ID
-surgical procedure
-surgical site |
|
|
Term
| How much hair to clip? What blade? |
|
Definition
| 20cm on each side of incision with #40 blade |
|
|
Term
| The higher the number of a clipper blade, the ____ the remaining hair. |
|
Definition
| higher blade # = shorter remaining hair |
|
|
Term
| LASER scalpel - what does it stand for? |
|
Definition
| Light Amplification by Stimulated Emission of Radiation |
|
|
Term
| Name and describe the two types of LASER scalpel? |
|
Definition
CO2: invisible beam vaporizes water in tissue, only affects visible tissue
Diode: quartz fiber, can be inserted in endoscope, penetrates ~10mm deep |
|
|
Term
| AAHA recommends 3 distinct areas in regards to surgery: |
|
Definition
| prep, scrub, and surgery room/suite |
|
|
Term
| In what clinic area should "dirty" procedures be done? |
|
Definition
|
|
Term
| What is a "dirty" procedure? |
|
Definition
| -one which is likely to expose the area to pathogens, such as abscess care, debridement, and impacted anal sacs |
|
|
Term
| In what clinic area does the Sirois text recommend to put the autoclave? |
|
Definition
| scrub area, so it can serve a dual purpose of scrubbing and pack-making (they are not likely to occur at the same time) |
|
|
Term
| Features of a good surgery suite? |
|
Definition
-separate, closed-off room
-cabinets off floor
-easily cleaned
-free of clutter
-air pressure greater than other rooms |
|
|
Term
| How and when to clean non-movable equipment? |
|
Definition
-wet dust daily with isopropyl alcohol
-lights, table, rad view box |
|
|
Term
| How and when to clean movable equipment? |
|
Definition
-clean and disinfect before returning to suite
- |
|
|
Term
| Unscrubbed people should ___ the sterile field. |
|
Definition
| face it, and never walk between 2 sterile fields |
|
|
Term
| Role of the circulating nurse? |
|
Definition
-open packs
-acts as runner |
|
|
Term
| Thread count range for textile wraps? |
|
Definition
|
|
Term
| Can crepe paper wraps be reused? |
|
Definition
| They shouldn't, because autoclaving reduces paper fiber integrity |
|
|
Term
|
Definition
-clean
-good condition
-durable
-standardized contents
-fits autoclave
-integrator inside and indicator outside |
|
|
Term
| Does dry heat dull cutting edges? |
|
Definition
|
|
