Studyguide - Aspetic Technique

What is surgical asepsis?

Prevents contamination by microbes (causing infection) before, during, & after an invasive procedure via sterile technique

What is Medical Asepsis?

Practice that helps to reduce the number & spread of microorganisms (infection)

What is a radiographer's responsibility concerning surgical asepsis?

1. As a radiographer, it is your responsibility to protect yourself and others from radiation

2. You are also responsible for the knowledge and awareness concerning the areas that are sterile and avoiding contamination

3. The radiographer must wear his or her radiation detection monitor outside of the lead apron while working in the OR

4. The RT is also responsible for making certain that any radiographic equipment used during a sterile procedure is clean and free of dust before use

What are ways to tell if an object is sterile?

1. Wrapped in plastic/paper wrapping in a controlled area

2. If the sterility of an item is questionable, it is not to be considered sterile

3. Isolated on blue drapes

How do you drape for a sterile procedure?

1. With sterile gloves, pick up the first drape and place it on the closest side without letting it drop below waist level

2. DO NOT MOVE it again, underneath is now contaminated

3. Add additional drapes as required (total of 4) on each side then finally the side farthest away from you

Which way do you open a sterile tray or drape if you are NOT sterile?

Away from you

Which way do you open a sterile tray or drape if you are sterile?

Towards you

What is the 1st zone of the OR suite?

1. Unrestricted

2. People may enter in street clothes

What is the 2nd zone in the OR suitre?

1. Semi-restricted

2. Persons who are dressed in scrub clothing, mask, and shoe covers

What is the 3rd zone in the OR suite?

1. Restricted zone

2. Persons wearing scrub suits, mask, cap, shoes covers, and sterile applications

3. Those directly involved on the operation are dressed in sterile gowns and sterile gloves and are often referred to as "being scrubbed"

What parts of a gown are considered not sterile?

1. Below the waist

2. Cuffs (collect moisture, cover with sterile gloves)

What are examples of invasive procedures performed in the imaging department?

1. IV administration or injections

2. Foley catheter

3. PICC line placement

4. Pacemaker (Cath Lab)

5. Catheterization of femoral or brachial vessels (Specials)

If you are sterile and need to pass another sterile person, what is the method?

Back to back

What is the chain of infection?

1. Causative agent/disease

2. Reservoir

3. Portal of exit

4. Mode of transmission

5. Portal of entry

6. Susceptible host

What are examples of causative agents/disease?

1. Any microorganism that can cause disease

2. Bacteria

3. Virus

4. Parasites

5. Fungus

What is a reservoir?

Passive host or carrier, immune

What is a Portal of Exit?

1. Place where the organism leaves the reservoir

2. Respiratory Tract, intestinal tract, urinary tract, blood/fluids

What is a Mode of Transmission?

1. Means by which an organism transfers from one carrier to the other (direct or indirect)

2. Fomite (inanimate object)

3. Vector (animal/insect)

What is a Portal of Entry?

1. Opening where an infectious disease enters the host's body

2. Mucous membranes, open wounds, catheters/tubes

What are examples of Hosts?

Person, animal, or plant

What are examples of fomites in radiology?

1. Cassettes

2. Lead aprons

3. Bucky handles

What is Endogenous Flora?

1. Good microbial bacteria community

2. Respiratory, digestive, urinary

What are examples of medical asepsis (clean technique)?

1. Hand hygiene

2. Clean cloves

3. Disinfecting surfaces

4. Isolating infectious patients

What are examples of surgical asepsis (sterile technique)?

1. Inserting a catheter

2. Operating on a patient

3. Changing a surgical wound dressing

4. Placing an implanted device

5. Opening packs

6. Skin prep

7. Draping

What is the #1 HAI?

UTI

What is sterilization?

Complete elimination of all living organisms

What are the methods of sterilization?

1. Moist heat/steam under pressure

2. Dry heat (infrared heat if equipment cannot be moist)

3. Chemical agents

4. Ethylene Oxide/Gas

5. Radiation

6. Filtration (physical method)

What is Steam Under Pressure/moist heat sterilization?

1. Autoclave

2. High temperature & humidity

What is chemical sterilization?

Low temperature

What is Ethylene Oxide chemical sterilization?

Items cannot be wet or heated, must be dried after

What is radiation sterilization?

1. Gamma

2. Low temperature, high sterilization time

3. Usually performed after packaging (plastic or tubing products, gowns)

What is a drape with a hole called?

Fenestrated drape

Where do you wear the dosimeter?

Outside of the lead, under the sterile apron

How do you pour a sterile solution?

1. Check label, packing, and expiration date

2. Remove lid without touching the inside

3. Place lid on an unsterile surface topside down

4. Cleanse the lip of the container by pouring a small amount into a waste container

5. Have a sterile person move the basin to the edge of the sterile field (avoid splashing)

6. Pour required amount 6" above basin to avoid contamination

How do you drop a sterile object into a field?

1. Separate the wrap according to the package instruction

2. Peel back/open enough to allow the object to freely drop (the edges are not considered sterile)

3. Invert the packaging and drop the sterile object onto a sterile field 6" above at a slight angle

What could be a noticeable sign that a tray has become nonsterile?

1. If the sterility of an object is questionable, it is NOT considered to be sterile

2. A contaminated area must be covered by a folded sterile towel or drape of double thickness

3. A sterile field must be created just prior to use

4. Never leave the field unattended, presume not sterile

5. An unsterile person should never reach across a sterile field

6. Anything dropped below the tabletop/waistline is no longer sterile (discard)

7. The edges of a sterile wrapper are not sterile

8. Any sterile material that becomes damp/wet is no longer sterile

9. Any objects wet with disinfectant must be placed on a folded sterile towel to absorb moisture

10. A wet area on a sterile field must be covered with several thick sterile towels/impervious drape

How many microns are a droplet?

>5 microns and travel 3-5 feet

What is a disinfectant?

Remove microorganisms from a surface

What is An antiseptic?

Used to disinfect the skin

You are about to assist with sterile procedure, in scrubbing it is important to... (scrub steps)

1. Put on lead before beginning the scrub

2. Arms should be bare 4 inches above the elbow

3. Wet hands and forearms 2 inches above the elbow, holding the hands up to allow the water to drain down (cleanest to dirtiest)

4. Fingers, hands, and arms should be considered to have 4 sides

5. Obtain an antimicrobial disposable scrub brush and scrub in a firm rotary motion following anatomic pattern

6. Begin with the thumb and go to each finger, then go to the dorsal surface of the hand/palm/wrist, ending 2 inches above the elbow

7. Rinse the soap with water & repeat steps

8. Drop the brush into the sink/receptacle, don't touch anything & hold hands above the waist

9. Pick up the sterile towel folded on top of the sterile gown by one corner and let it drop/unfold in front of you at waist level (don't let it touch anything)

10. Dry one hand/arm, do not go over areas already dried

11. When done, drop the towel to the floor/receptable & do not let hands drop below the waist

Why does the surgical scrub always begin with the hands?

They are in direct contact with the sterile field

What is an iatrogenic infection?

1. Caused by a medical procedure

2. Ex) Chest tube placement causing a pneumothorax

What parameter around the field is considered non-sterile?

1. 1" of the edge of a sterile drape/field is considered non-sterile

2. Sterile Corridor - area between the patient drape an the instrument table

What are Contact Precautions pathogens?

1. MRSA

2. C-Diff

3. VRE

4. Scabies/Lice

What are Droplet Precaution pathogens?

1. Mumps

2. Pertussis

3. RSV

4. Rubella

What are Airborne Precaution pathogens?

1. TB

2. Measles

3. Chickenpox

What are reverse isolation/immunocompromised pathogens?

1. Chemotherapy/Radiation Therapy patients

2. Organs transplant recipients

3. Immunosuppressive drugs

4. Immunodeficiency disorders (advanced HIV/AIDS)

5. Neutropenia (low WBC count)

What is the most effective way to prevent HAIs?

Hand washing