Term
| What are some of the common zoonotic disease risks with surgery? |
|
Definition
-rabies
-Brucellosis
-Dermatophytosis
-Fleas, ticks, lice |
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Term
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Definition
| -the use of manipulatory interference for the diagnosis and tretment of disease, or for modifying normal physiologic function or an anatomic structure for a specific purpose |
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Term
| Definition: Surgical failure |
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Definition
| -loss of function or death of the patient |
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Term
| What is the hardest thing to know as a surgeon? |
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Definition
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Term
| Give a few examples of when not to cut. |
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Definition
-when surgical risks outweigh the potential good
-what's best for the patient and its owner
-when less aggressive methods will accomplish an acceptable goal |
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Term
| What are Halstead's principals? |
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Definition
-gentle tissue handling: time, trash, trauma
-hemostasis
maintain blood supply
-maintain asepsis: boobs to belly button
-no tissue tension
-accurate apposition
-obliterate dead space |
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Term
| Definition: Sterilization |
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Definition
| -destruction of all microorganisms on inanimate objects |
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Term
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Definition
| -destruction of most pathogenic microbes on inanimate objects, some may try to "claim" kills all microbes |
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Term
|
Definition
| -used to kill microbes during surgical scrubs on skin ("live" skin cannot be sterilized) |
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Term
|
Definition
| -reduce microbes to "safe" level |
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Term
|
Definition
| -removing physical removal of surface contaminants usually with a soap or detergent |
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Term
|
Definition
| -preventing the access of microorganisms, absence of pathogenic microbes in living tissue |
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Term
| True or FAlse: The inner tissues of the body are considered sterile. |
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Definition
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Term
| Urine from which parts of the urinary tract is sterile? |
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Definition
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Term
| What are the four overall methods of sterilization? |
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Definition
-chemicals: iquids (cold chemical sterilization) or gas
-thermal: wet heat or dry heat
-plasma
-ionizing radiation |
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Term
| PUt the following in the order of easiest to sterilize to most difficult: prion, virus, spore, bacteria |
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Definition
| -bacteria < virus < spore < prion |
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Term
| What magic combination of factors requires attention for the decontamination of prions? |
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Definition
| -heat, chemical, pressure, and time |
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Term
| What liquid do we use to sterilize lenses? |
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Definition
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Term
| What is the MOA of glutaraldehyde? |
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Definition
| -protein and NA alkylation |
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Term
| What are the appropriate immersion times for cold chemical sterilization? Then what? |
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Definition
-10 h at 68-77F OR 10min same temp for disinfection
-after immersion, then rinsed with sterile water and dried with a sterile towel to avoid damaging patient tissues |
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Term
| What are the two major agents used for gas sterilization? |
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Definition
-formaldehyde
-ethylene oxide |
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Term
| What is the MOA of Ethylene oxide? |
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Definition
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Term
| What are the major concerns we have with the use of ethylene oxide for gas sterilization? How is it prepared for efficacy> |
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Definition
-flammable, explosive, and carcinogenic
-becomes effective hen mixed with CO2 or Freon |
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Term
| What agent is used for wet heat thermal sterilization? |
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Definition
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Term
| What are the advantages of wet heat thermal sterilization? Disadvantages? |
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Definition
-Advantages: simple to use & inexensive
-Disadvantages: unreliable & some spores/bacteria-algea can resist boiling for up to 48 hrs |
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Term
| What are the four primary methods of steam thermal sterilization? |
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Definition
-pressure cookers
-washer sterilizers
- pre-vacuum sterilizers
-gravity displacement sterilizers |
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Term
| What is the most common method of thermal sterilizaiton used? |
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Definition
| -saturated steam under pressure (autoclave) |
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Term
| What is the MOA of steam sterilization? |
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Definition
| -coagulation & cellular = bonds protein denaturation/ disrupts H |
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Term
| What is the standard used to test the efficacy of steam thermal sterilization? |
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Definition
| -reduce population of BAcillus stearothermophilus spores to sterility assurance level of 10^-6 |
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Term
| What are the three primary methods of dry heat thermal sterilization? |
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Definition
-hot air oven
-incineration
-infrared radiation |
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Term
| What are the advantages of dry heat thermal sterilization? Disadvantages? |
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Definition
-Advantages: use for oils, poweders, petrolatum, sharps
-Disadvantages: destroys rubber, plastic, and ruins the temper of steel & sterilization time is longer |
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Term
| What are the temps/time requirements of effective dry heat thermal sterilization? |
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Definition
-170C for 60 mins
-160C for 120 mins
-121C for 12 h |
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Term
| What is Plasma Sterilization (Sterrad)? |
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Definition
| -a low temp sterilization technique which is not the method of choice for sterilizing heat sensitive items |
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Term
| How does plasma sterilization work in general? |
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Definition
| -process uses reactive ions, electrons, and neutral atomic particles to sterilize items |
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Term
| True or False: Vapor phase of H2O2 is a form of plasma sterilization. |
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Definition
|
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Term
| What special step must be taken for plasma sterilization? |
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Definition
| -items must be wrapped in nonwoven polypropylene fabric or plastic pouches |
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Term
| What are some things that cannot be sterilized safely? |
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Definition
-linen
-gauze sponges
-wood or paper
-endoscopes
-some plastics
-liquids
-items that cannot be disassembled
-items that cannot be completey dried
-items with silver or copper or Bisphenol A epoxy
-tube and catheters longer than 12 in or less than 3mm in diameter |
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Term
| What method of sterilization do we use for materials that cannot be sterilized by heat or chemicals? |
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Definition
-radiation
-aka cold sterilization |
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Term
| HOw does radiation sterilization work? |
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Definition
| =electromagnetic or particle radiation )Co 60) |
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Term
| What are the causes of sterilization failure? |
|
Definition
-improper cleaning
-mechanical failure of the system
-improper use of equipment
-improper wrapping
-poor loading technique
-failure to understand the concepts of sterilization |
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Term
| What are some causes of steam sterilization failure? |
|
Definition
-packs wrapped too tightly
-improperly loaded in the chaber |
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Term
| How do we properly load the chamber for steam sterilization? |
|
Definition
-packs placed vertically and longitudinally
-heavy packs to the periphery
-1-2 inches of air b/n packs
-do not stack linen packs |
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Term
| True or FAlse: Chemical indicators indicate sterility. |
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Definition
| -FALSE, do not indicate sterility, only that certain conditions for sterility have been met |
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Term
| What is the surest way to determine sterility? |
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Definition
| -strain of highly resistant, nonpathogenic, spore-forming bacteria |
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Term
| Should indicators be the only method of monitoring used to verify sterility? Why or why not? |
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Definition
-NO
-also have proper supervision of personnel, a good understanding of sterilization process, and high standards |
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Term
| Which bacteria is not killed by disinfection? |
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Definition
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Term
| What are the liquid chemicals that we use for disinfection? |
|
Definition
-Chloride (hypochlorite compounds)
-phenols
-Quaternary Ammonium compounds )Benzalkonium chloride)
-Iodine
-Iodophors
-Alcohols |
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Term
| What specifically do we use chloride to disinfect? MOA? concerns? |
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Definition
-floors and countertops
-MOA: release of free chloride and oxygen
-concerns: tissue irritant, inactivated by organic debris, corrosive to metal |
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Term
| What is the Lister disinfectant? |
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Definition
|
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Term
| Are phenols bactericidal or static? |
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Definition
| -bactericidal but not for spores or viruses |
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Term
| Are phenols inactivated by organic material? |
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Definition
|
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Term
| What phenolic derivatives ave mostly replaced phenols? Used for? Concerns? |
|
Definition
-Cresols: used on envronmental surfaces
-Bisphenols as antiseptics but may be irritating and do not use in cats |
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Term
| How do quaternary ammonium compounds disinfect? |
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Definition
| -surface active agents act as cationic detergents that dissolve lipids in bacterial cell walls and membranes (low level = no spores/viruses) |
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Term
| What are some concerns when using Quaternary Ammonium compounds? |
|
Definition
-caution for using them for surgical prep b/c selectively absorbed by fabrics
-irritating to tissues |
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Term
| What level of disinfectent are iodines? |
|
Definition
| -intermediate: bactericidalviricidal but NOT sporicidal |
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Term
| For what do we specificaly use iodine? Concerns? MOA? |
|
Definition
-cleaning dark colored counters and floors
-corrodes instruments, stains fabric and tissue, tissue irritant, can be inactivated by organic material
-MOA: iodination |
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Term
| What are the advantages of iodophors as compared to iodines? |
|
Definition
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|
Term
| What are the two main alcohols that we use as disinfectants/antiseptics? |
|
Definition
-70% Ethanol
-70-99% Isopropyl |
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|
Term
| What are the major uses of alcohol? Major concerns? |
|
Definition
-spot cleaning and infection sites
-long exposure time!!! 10 mins, poor for spores/viruses, corrosive to stainless steel |
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Term
| What is the MOA of alcohol? |
|
Definition
| -protein denaturation and cell lysis |
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