Intro to Radiography: Aseptic Techniques

aseptic (sterile)

describes a product or method that is free of microbiological organisms

why is asepectic technique important

prevents infections

reduces risk of infection to those who are at risk

protects ourselves

situations that call for aseptic technique

surgery

insertion of IV lines

catheters and drains

radiologic procedures that call for aseptic technique

biopsies

angiography

arthrography

hysterosalpingography

surgical asepsis

protection against infection before, during, and after surgery

sterile technique

medical aspesis

removal or destruction of infected material

goal is to remove all microorganisms

five methods of sterilization

chemical

autoclaving

gas

gas plasma

dry heat

chemical sterilization

immersion and soaking of clean objects in bath of germicidal solution followed by sterile water rinse

what does the effectiveness of chemical sterilization depend on

strength of solution, temperature, immersion time-difficult to control

what is the least satisfactory method for providing surgical asepsis

least recommended

chemical sterilization

autoclaving sterilization

device that provides steam sterilization under pressure and high temperature (250-275 degrees)

items must be able to withstand high heat and pressure

quickest and most convenient way of sterilization

autoclaving

gas (conventional gas) sterilization

sterilization with mixture of gasses heated

time consuming

used on electrical plastic, rubber, and optical wear

two gasses used for gas sterilization

freon and ethylene oxide heated to 135 degrees

poisonous to humans

gas plasma sterilization

items cleaned, wrapped, and placed in compact mobile unit where low temp hydrogen peroxide gas plasma diffuses through wrapped instruments and kills both microorganisms and spores

safe for central sterile supply department workers

used on endoscopes, fiberoptic devices, microsurgical instruments

dry heat sterilization

similar to an oven

temp ranges from 329-338 degrees-tools must be able to withstand even higher heat than autoclaving

articles in sealed tubes or containers

depends on heat penetration

most popular and effective method of dry heat sterilization

vacuum chamber that employs infrared heating element

what is a sterile field

specified area that is considered free of viable microorganisms

sterile tray or towels

what should sterile packaged be checked for

expiration date

clean and dry

their sterility indicators have changed to predetermined color, confirming sterility

having been previously opened

sterility indicators

used to identify that a pack has been sterilized

placed inside and outside the package

change color when required conditions have been met

package is no longer sterile when

soiled or wet

passed expiration

previously opened

steps on opening a sterile package

1. place package at center of surface with top flap set to be opened away

2. pinch first flap between thumb and index finger by reaching around not over

3. right hand to open right flap and left hand to open left flap

4. grasping turned down corner pull final flap

steps for dropping a sterile package

1. hold package in one hand with top flap opening away from you

2. pull top flap back and hold it away from contents of package and sterile field and with free hand to hold flap against the wrist of hand holding the package

3. drop contents on to sterile field from approx. 6 in. above the field at a straight angle

steps on pouring sterile solution into sterile bowl or on sterile field

1. remove lid or cap and place on unsterile surface with topside down

2. hold bottle with label uppermost so that the poured solution cannot affect label

3. with little of bottle over field as possible, gently pour 1-2 inches over bowl

where does the sterile field end

at the level of the tabletop or at the waist of the sterile gowned person

where is the sterile corridor

located between draped patient and the instrument table

purpose of surgical hand scrubbing

remove debris and transient microorganisms from the hands, nails, and forearms

reduce the resident microbial count to a minimum

inhibit rapid rebound growth of microorganisms

two basic methods of surgical hand scrubbing

numbered stroke method-certain number of brush strokes for each finger, palm, back of hands, and arms

the times scrub method

how far up the arm do you surgical hand scrub

3 inches above the elbow

steps on self gowning

grasp gown and bring away from the table

hold gown as shoulders and let it unfold

place hands inside arm holes to guide through sleeves-do not let hands outside the cuffs

circulator assets by tying around shoulders

steps on gowning others

grasp gown at the shoulders and so outside faces towards you and cuff hands under the shoulders

person will place arms in gown up to mid upper arms

circulator will assist in pulling gown up and tying

gently pull cuffs back over persons hands but be careful not to touch their bare hands

steps on self gloving

pick up gloves by inside cuff with one hand and do not touch glove wrapper with bare hands

slide glove onto opposite hand and leave cuff down

using partially gloved hand slide fingers into outer side of opposite glove cuff

slide hand into the glove and unroll the cuff

with gloved hand slide fingers under the outer edge of opposite cuff and unroll

steps on gloving another person

pick up right glove and place palm away from you and spread cuff so there is an opening, keep thumbs under cuff

person puts hand in glove-do not release

gently release cuff while unrolling over their wrist, then proceed with left glove

purpose of skin preperation

to minimize the introduction of pathogens to the body via puncture or incision, thus reducing chance of infection

skin preparation includes:

through cleaning

hair removal if necessary

application of antiseptic solution

surrounding of prepared area with sterile drapes

mechanical part of skin preparation

sterile gloves

scrub using sponge with antimicrobial solution and sterile water

cleaning from the inside out in circular motion

repeat

rinse and wipe away excess

chemical part of skin preparation

the use of antiseptic solution

applied moving from the inner portion of the area outward

may be repeated with another sponge or swab

dressing changes

best changed in team setting

treated as though the patient is infected

physicians order is needed for change and re application

re application of dressing you should:

remove gloves, wash hands, and re glove

sterile towel to create sterile field for dressing

secure with tape

dispose properly

what is a tracheostomy

operation performed under sterile technique that involves incising the skin over the trachea and then making surgical incision in trachea

what does a tracheostomy do for patient

provides an airway during an upper airway obstruction

used in emergency situations

what is a tracheostomy used to replace

endotracheal tubes that have been in place for several weeks

how to establish communication with someone with a tracheostomy

written

hand signals

simple language

first chamber of thoracotomy tube

collection chamber

second chamber of thoracotomy tube

water seal chamber

third chamber of thoracotomy tube

suction chamber

what are urinary catheters used for

emptying the bladder

releving retention of urine or bypass obstruction

irrigate the bladder or introduce drugs

accurate measuring of urine output

relieve incontinence

where should urunary catheter be kept

below the level of the bladder

what may techs be reposnible for, for urinary catheters

catheretizing patient for voiding cystogram as an outpatient

two main types of urinary catheters

foley-has balloon

straight

two other types of urinary catheters

suprapubic-placed directly into bladder from 1 in above symphysis pubis

condom-condom with catheter at the end attched to collecting bag

two types of radiography used to verify placment of intravenous and intra arterial lines

flouroscopy or portable radiography

not placed by diagnostic tech

what is a pacemaker used to treat

bradycardia

what is a pacemaker

electromechanical device inserted under the skin to regulate the heart rate

can be placed on left or right side

depending on cause and severity of arrythmia, treatments may include:

cardiac pacemakers or ICD devices

ablation therapy

cardioversion external shock

c-arm in surgery

requires increased attention to sterile field

snap cover draping of c-arm and intensifier

shower curtain approach of draping

drape site with additional sterile cloth

portable x-ray

clean hands

clean machine

have lead available

rad bags

communication with patient and staff

neonatal portable radiography

sepsis and nosocomial infections are major threats that result in significant morbidity and mortality each year in neonatal unit