RAD-102 Ch 18 Aseptic Techniques

where can aseptic techniques be applied

any clinical setting

aseptic techniques are particularly important in situations involving

surgery

intravenous lines

urinary catheters

drains

what is the goal of aseptic techinques

protect the patient from infect and to prevent spread of pathogens and or harmful microorganism

methods of aseptic techniques

clean

sanitize

disinfect

classes of asepsis

surgical

medical

when is the use of aseptic important

performing sterile procedures

factors that make medical imaging particular challenging for asepsis

equipment designs

variety/nature of exams

mix of staff expertise

what procedures require aseptic techniques

biopsies

angiographic procedures (venous)

line placements

hysterosalpingography (examine uterus and fallopian tubes)

arthrography (joint spaces)

sources of infection

skin

hair

nasopharynx

fomites

air

human error

cross-contamination

surgical asepsis definition

protection against infection before, during, and after surgical procedure by using sterile techniques

medical asepsis definition

the removal of or destruction of infected materials

surgical medical imaging team

chief surgeon

assisting surgeon

anesthesiologist or CRNA

operating room (OR) nurse - circulating

surgical technicians

surgery technologists RT (R)

support/staff

what is a sterile field

microorganisms-free area that can receive sterile supplies

how is sterile field established

using a sterile drape

what is sterile corridor

area between patient drape and instrument table

what is first step in using sterile drape

confirm package is sterile

when is an packaged item considered unsterile

expired

already opened

how to drop contents into sterile field

6 inches above field at slight angle

why are contents dropped onto sterile field

to ensure wrapping doesn’t touch sterile field

pouring sterile fluids into sterile basin

verify contents and expiration date

pour exact amount

avoid splashing

pour at edge of sterile field 1-2” above container

purpose of surgical scrubbing

remove and reduce concentration of micro-organisms

basic methods of surgical scrubbing

numbered strokes

timed methods

when are dressings best changed

in a team setting with another health care professionals

what is physician responsible for in regards of dressing

ordering dress changes

reapplication

steps of dressings changes

wash hands

explain procedure to patient

secure consent before beginning procedure

treat all dressings as infect

don’t touch with bare hands

remove adhesive tape surrounding dressings

remove dressings with forceps or gloved hands, wrapped, placed in a plastic bag

what is a sterile towel used for

place sterile dressing

what is a tracheostomy

an operation performed under sterile technique involving incision of skin over trachea and surgical incision of trachea

what does a tracheostomy provide

airway during upper-airway obstruction

why is communication with tracheostomy patients critical

anxiety level is high

what must technologist caring for tracheostomy patient be sensitive to

unmet and inexpressible needs

keeping anxiety level low

what should technologists do to minimize possibility of tracheostomy infections

do not touch tracheostomy area unless under sterile conditions

who should suction tracheostomy patients

only trained personnel

common insertion sites for thoracostomy vary with

interpleural substance to be removed

common thoracostomy insertion site

fifth to sixth intercostal space

• as high as fourth

• as low as eighth

lateral and midaxillary

technologists responsibility for chest tubes

perform imaging to confirm chest tube position and chest status

don’t catch tubing on x-ray

keep exterior assembly of chest tubes lower than patients chest

use caution when moving and positioning patient

when should technologists report chest tubes drainage

excess of 100m/L per hour

change from serous fluid to darker red color

types of urinary catheters

retention balloon (foley) (B)

straight type (A)

what sizing system is used for urinary catheters

french system

• 2.6-5.9mm

  • 8-20 Fr

what is in retention balloon

saline

purposes of foley catheter

bladder emptying

relieve bladder retention

irrigate bladder

introduce drugs into bladder

permit accurate measurement of urine output

relieve incontinence

where is the tip of indwelling catheter

urinary bladder cavity

where is an indwelling catheter taped

inside of leg

where should indwelling catheter drainage bag be

lower than bladder to prevent retrograde flow into bladder

why is urinary catheter removed

voiding cystourethrograms

steps to remove urinary catheter

wash hands

provide privacy

explain procedure

wear gloves

uncover patient and place basin under catheter valve → cut balloon valve to allow saline to drain

place towel under catheter and pull gently once flow has stopped → inform nurse/physician if felt resistance

wrap removed catheter in towel, cover patient discard catheter

what are permanent pacemakers

electromechanical devices inserted under patients skin to regulate heart rate

pacemaker size/weigh

1in width, diameter, thickness

little over 1 oz

newer pacemaker designs are compatible with

MRI

C-arm surgical covers

snap cover bag over IR

shower curtain drape

barrier over surgery site during imaging (less common)

what should radiographer in operating do

dress appropriately

be aware of sterile areas

identify surgical team and float nurse

take charge of your area of responsibility

position IR and x-ray unit appropriately

communicate clearly with operating room staff

what portable requires extra care with aseptic techniques

neonatal

what is neonatal portable radiography performed for

transient tachypnea of newborn (TTN)

respiratory distress syndrome (RDS)

types of gonadal shield

shadow shield

contact shield

what is important regarding imaging of infants

maintain stable environment without cross-infection

what should be followed regarding portable radiography

recommended good practice for removal of hazardous waste