Midterm Exam

CHAPTER 7 - ENVIRONMENTAL HAZARDS

Key Words

Risk - the statistical possibility of a given event on the basis of the number of such events that have already occurred in a defined population

Smoke plume - smoke created during the use of an ESU Electrosurgical unit or laser “contains toxic chemicals, vapors, blood fragments, and viruses”

Associations - private professional and government organizations that create standards and recommendations aimed at reducing injury in healthcare settings.

  • ERCI institute - non profit research evidence based practices

  • APIC - Association for professionals in infection control and epidemiology -

  • CDC - Center of disease control and prevention

  • U.S Enviornmental Protection Agency

  • FDA - U.S food and drug administration

  • The joint commission-

  • OSHA - Occupational Safety and health administration

FIRE SAFETY

Fire requires 3 components

Fuel

  • Patient Drapes

  • Hair

  • Nonmetal airway

  • Prep solutions

  • Gastro intestinal Gas - hydrogen, oxygen, nitrogen, Carbon dioxide , and methane

Oxygen

  • OEA - oxygen enriched atmosphere = greater than 21% oxygen concentration

  • Oxygen & Nitrogen

Source of ignition

  • Electrosurgical Unit

  • Laser

  • Faulty electrical equipment.

R - Rescue : patients in the immediate area of the fire

A - Alert : other people to the fire do that they can assist inpatient removal and response activate the alarm system.

C - Contain : the fire shut doors to slow spread of smoke shut off zone valves controlling in-line gases into room

E - Evacuate : personnel in the areas of the fire

PASS - Pull Aim Squeeze Sweep

Compressed gas cylinder - made of heavy steel strong enough to avoid puncture, contains oxygen, compressed nitrogen, argon, Nitrous oxide , carbon dioxide.

Two valves

  • one opens cylinder to allow gas to flow into regulator.

  • Second controls flow from regulator to the tubing.

PPE- Personal protective equipment - protects personnel from high concentrations of chemicals.

Musculoskeletal Risks

When lifting an object keep it close to your body

When pushing a cart back foot should be braced comfortably behind the other foot

Use Abdominal Muscles when lifting

Chapter 8

Bacterial structure

Bacilli - Rod shaped

Spirochete - curved or spiral shaped

Cocci - spherical

  • micro- singly

  • strep- chains

  • pairs - diplo

  • staph - groups of four or clusters

Vibrio - comma shaped

Important Bacterial Infections

GRAM POSITIVE COCCI

staphylococci

  • S. Epidermis

  • S. saprophyticus

  • S. aureus

Streptococci

BETA

  • S. Pyogenes

ALPHA

  • S.pneumoniae (V)

  • S. viridans

GROUP D

  • S. faecalis

GRAM NEGATIVE COCCI & BACILLI

Neisseria

  • N. Meningitids (V)

  • N. Gonorrhoeae

AEROBIC GRAM POSITIVE BACILLI

Spore Forming

  • Bacillus B. Anthracis (V)

Non Spore Forming

  • listeria L. Monocyteogenes

Corynebacterium

  • C. diptheriae (V)

  • C. urealyticum

  • C. jeikekium

Clostridium Difficile - spore forming severe diarrhea can be rapidly fatal

Myobacterium tuberculosis - causes TB disease causes dense nodules to form in lungs liver spleen and bone marrow.

Methicillin-Resistant Staphylococcus Aureus and Epidermis (MRSA) - transmitted through hands equipment and supplies

Vancomycin - Resistant entercocci - direct contact inhabits intestines and female genital tract

VIRUSES

  • Rubella

  • Varicella zoster - chicken pox

  • Variola - German measles

  • Morbillivirus - measles

  • Enterovirus - polio

  • Lyssavirus - rabies

Prion - proteinaceous infectious bacterial

No nucleic acid can not be cultured in a lab no sterilization can take from

Chapter 9

Recommendation = should, backed by evidence

Regulatory Requirement = must

Permissible - May, no evidence against

Sterility - is absolute free of all living microorganisms including bacterial spores. Nonsterile or contaminated

STERILE FIELD- draped patient draped instrument tables and equipment

contamination

  • physical contact

  • Droplet - coughing sneezing

  • Airborne - dust lint

  • Vectors - bugs

STRIKETHROUGH - contamination of sterile surface by penetration of non sterile fluid through covering

Disinfection - destruction of microorganisms on inanimate non living object

Anti sepsis- destruction of microorganisms on living tissue

antiseptics used for hand hygiene

HVAC - Heating, Ventilation, and Air Conditioning

Operating room : 20 air changes/hour +

SPCROOM : 4 +

Neutral Zone - designated space for ST and surgeon to place and pick up sharps without being hurt. Hands free tecnigu

Three areas of the operating room, unrestricted, semi-restricted and restricted (know an examples of each)

Average air exchange rate per hour in the operating room - 20

What bacteria are the on scalp and hair - Staphylococcus aureus

Squames - Dead skin cells

Two method of hand antisepsis - Surgical hand scrub and surgical hand rub

What is double gloving- two gloves of different colors to avoid puncture. close is for all surgical cases where gowning is required

SSI - Surgical Site Infection

Sharp - any object that can penetrate the skin what is a sharp

Common source of injury - Hypodermal needles, Sutures

Neutral Zone - an area designated for the safe handling and transfer of sharps, minimizing the risk of accidental injuries and promoting safer practices in surgical settings.

Hands Free and No touch Technique

Droplet, Airborne, Contact, and Transmission precautions are essential to prevent the spread of infections during medical procedures.

Standard Precautions

Chapter 10

AORN - association of perioperative nurses

SPD - Sterile processing department

Antiseptic

Disinfection - reduce microbe not eradicate

Bacteriostatic - chemical or process that inhibits bacterial growth

Spaulding system - provides health care professionals a way to determine if a patient car requires sterilization

  • CRITICAL ITEMS (HIGH RISK) - come in contact with sterile body tissues internal organ systems and vascular systems surgical instruments vascular cannulas hypodermic needles

  • SEMI CRITICAL (INTERMEDIATE RISK) - used on non intact skin or mucous membranes requires HLD - high level disinfection (reduces bioburben to an absolute minimum) endotracheal tubes and airways rectal/vaginal instruments

  • NON CRITICAL (LOW RISK) - intact skin blood pressure cuff stetescope

Reposable instrument - can only be sterilized a certain amount of times then disposed of

Cavitation -high frequency sound waves are generated through a water bath causing Tony air bubbles trapped within debris to implode and release debris from the instrument.

Chemical used inside water - Enzymatic Cleaner

Chemical indication - paper strips chemically treated to change color when a certain criteria is met

Biological indicator - used bacteria growth to test if sterilization was successful

IUSS - immediate use steam sterilization (flash sterilization)

Highly flammable Liquid - EO Ethelyne Oxide

MSDS - Material Safety Data Sheet

icidal - to kill

Chapter 36

MCE - Mass casualty Emergency

Emergency - Geographically Emergency

Natural Disaster - arises from a force of nature

Levels

1 local - local teams are able to manage

2 regional - regional assistance from communities required

3 state - statewide and federal assistance required

1042 & 1043 pages

Pandemic widespread rapidly contagious

FEMA -

EMA - State Version

Know Disaster Cycle - preparedness response…(fill in circle)

Surge capacity -

Triage -