SUR-100 Final
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281 terms
Terms | Definitions |
|---|---|
 threatening life or limb | emergent (ex: aneurysm) |
| doesn't have to be done immediately | elective (ex: torn meniscus) |
| JCAHO | an allied health professional who works closely with surgeons, RN, anesthesiologist, and other surgical personnel delivering patient care & assuming appropriate responsibilities before, during, and after surgery |
| hold certification and CST level 1 | rules and competencies |
| prior initiation of surgical procedure | pre-op |
| while procedure is being performed | intra-op |
| when surgery is terminated | post-op |
| job duties | be aware of employment, nature of job, & required task and limitations |
| CAAHEP, SRC/STSA | surg tech education |
| NBSTSA | surg tech certification |
| investor owned health care facilities | proprietary |
| AST | association of surgical technologist |
| CAAHEP | commission on accreditation of allied health education programs |
| hospital organization is established by | Board of Directors/Trustees |
| verifies the credentials of the physicians and specified health care personnel | Medical Staff Committee |
| CEO | is hired by BOD to implement board policy and philosophy |
| medical staffing is headed by | Chief and Staff |
| CRNA | certified RN anesthesiests |
| accrediting agency | JCAHO |
| let the master answer | respondent superior |
| required for testimony but not named in the suit | subpoena |
| chief of medicine/chief of surgery | oversee everyone in their particular specialty |
| most common charge brought against a health care professional | negligence |
| RFO | retained foreign object |
| most common RFO | sponges |
| AST | provide educational opportunities |
| AST | responsible for core curriculum |
| responsible for all aspects of individual certification including re-certification | NBSTSA |
| directly oversees academic accreditation for the field of surg tech and surg assisting | ARC/STSA |
| most common types of patient indiscretions committed by operating room personnel; include negligence and malpractice | unintentional torts |
| assault and battery | intentional tort |
| invasion of privacy | intentional tort |
| defendant named in suit | summons |
| sworn testimony on paper and signed | affidavit |
| method of questioning and answering under oath | deposition |
| person accused of the crime | defendant |
| misconduct or incorrect action you shouldn't do | malpractice |
| the responsibility for securing written, informed surgical consent belong to | surgeon |
| info must be given in understandable | language |
| negligence | omission or commission of an act that a reasonable/prudent person would not do under the same conditions, a departure from the standard of care |
| person who starts lawsuit | plaintiff |
| decision whether something to be presented to a judge | precedent |
| what's normally done in health care situation | standard of care |
| slander, said or written that hurts character | defemation |
| individual mistakes | unintentional torts |
| civil wrong intentional or unintentional | tort |
| abandonment | a patient still in the need of care |
| Patient Bill of Rights | expect that all communications and records pertaining to his/her care will be treated as confidential |
| manifested by action/inaction of silence that assumes consent has been authorized | implied |
| permission given for an action | consent |
| patient must be legal age, mentally alert, legally competent, and not under the influence of drugs | consent before surgery |
| prior to surgery every patient must have | H&P (history and physical record) and informed consent |
| formal process which you are listed in a registry | registration |
| legal right by government that authorizes and oversees professional activities | licensure |
| recognition of a body that you have met standards | certification |
| identification or interaction with another person | social |
| branch of philosophy that deals with systematic approaches to moral issues | ethics |
| food, water, oxygen, temp regulation | physiological needs |
| identifies the knowledge and skills required for the professional in order to provide effective and reliable services | scope of practice |
| what is a key factor in peds prior to surgery | separation anxiety |
| room temp for peds | 75 degrees |
| bleeding, infection, sepsis, injury | shock |
| used for sharps to reduce accidents between ST and surgeon | neutral zone |
| not profit organization that accredits health care organization | joint commission (JC) |
| operating room team member who is responsible for opening sterile supplies onto the sterile filed during a surgical procedure | circulator |
| department that identifies patient hazards and develops solutions | risk management |
| ST removes hot instruments from the autoclave, what actions should be taken prior to using them on the patient | rinse with sterile water |
| in an infant hypovalemic shock is due to | dehydration |
| blunt trauma | MVA |
| patients with delayed healing, infection, and bad circulation | obese |
| skin, muscle, and bones are fragile | geriatric patients |
| first 28 days of life outside the uterus | neonate |
| usually caused by gram-neg. bacteria | septic shock |
| results in decreased venous return that lowers cardiac output and leads to poor tissue perfusion with eventual lactic acidosis | hypovolemic shock |
| very critical, needs treatment within in one hour of injury | golden hour |
| surgery during pregnancy is avoided during which trimester | first |
| hallways in surgical area, sterile storage areas separated by red line | semi-restricted |
| contains sink and other equipment for instruments | decontamination room and utility |
| should be closed to avoid dust accumulation | cabinets |
| 20 | minimum air exchanges per hour |
| pressure of air flow that captures microbes to be filtered | laminar air flow |
| room temp needs to be between | 65-75 degrees |
| relative humidity should be between | 50-55 % |
| sub-sterile area | has blanket warmer, flash sterilizer, sinks, and supplies |
| recovery room, standard is one hour | PACU |
| provides intraoperative fluoroscopy | radiology |
| ideal trimester to perform abdominal surgery | second |
| obese patients are at higher risk for | infection |
| adolescent patient is very conscious about | privacy |
| number one cause of death in children ages 1-15 | accidents |
| skin conditions are more relevant to | elderly patients |
| OR rooms or anywhere open sterile supplies | restricted |
| up to how many exchanges of air per hour | 600 |
| trauma the room temp | 75-78 degrees |
| OSHA | occupational safety and health administration |
| ANSI | american national standards institute |
| AAMI | association for the advancement of medical instrumentation |
| spark, or heat | source of ignition |
| doesn't burn but necessary for fire and accelerates it | oxygen |
| contains halon for electrical or laser fires | Class C |
| best fire extinguisher for sire | halon |
| cover the patients thyroid and reproductive organs for | ionizing radiation |
| 3 main roles to protecting the ST | time, distance, and shielding |
| treat all blood, body fluids, excretions, and secretions as if infectious. Updated isolation rules | standard precautions |
| number of microbes or amount of organic debris on object at any given time | bioburden |
| chemical agent that kills most microbes, but usually not spores | disinfectant |
| initial set of isolation rules established in 1985 and 1987 | universal precautions |
| invasion of human body or tissue by pathogenic microorganisms that reproduce and multiply, causing disease | infection |
| nosocomial | infection acquired within a health care facility |
| item that has been rendered free of all living microorganisms including spores | sterile |
| destruction of all microorganisms, including spores, on inanimate surfaces, the destruction of all microorganisms in or about an object, as by steam, chemical agents, high velocity electron bombardment, or ultraviolet light radiation | sterilization |
| these pathogens are predominately spread by the surgical team | airborne |
| sterile packages opened using aseptic technique. | principle 1 |
| principle 1 | sterile items stored in nonsterile areas shouldn't be used |
| punctures, tears, or strike-through renders nonsterile | principle 1 |
| can't write on sterile package | principle 1 |
| surgical team member should only sit when entire procedure will be sitting | principle 2 |
| only sterile members may touch sterile surfaces | principle 3 |
| pass front to front or back to back | principle 3 |
| talking kept to minimum | principle 3 |
| non sterile items should be at least how many inches away from field (principle 3) | 12 |
| contact with intact skin and environmental surfaces | non-critical |
| physical factors | disinfectant efficiency |
| items sterilized in this must be completely rinsed before use | glutaraldehyde |
| what items can't be submerged and must be rinsed and dried. main one is pre-vac | power drills and saws |
| what items are to be cleared with air, channels washed under pressure, and must have the channels and holes throughly cleaned | rigid endoscopes |
| rigid endoscopes require | use of manufacture policies |
| 3 main factors to check when dealing with instruments | inspection, reassembly, and preparation |
| time, temp, moisture, and pressure are all principles of | steam sterilization |
| type of steam sterilization used for drills and saws | pre-vac |
| type of sterilization immediate use after 10 min., 270 degrees, and at 27 psi | flash sterilizer |
| lumens | ex: suction tips for 10 min. |
| these should never be sterilized | implants |
| bowie dick test | DART |
| 1024KB | 1MG |
| 1GB | 1024MG |
| 1024GB | 1TB |
| 1000TB | 1 googlebyte |
| high availability of charge carriers | conductors (ex:metal) |
| conductors | offer little resistance to the flow of an electrical charge through them |
| electrons that are tightly bound and highly resistant to the flow of an electrical current | insulators |
| electricity is measured in | amperes |
| resistance is measured in | ohms |
| voltage=current x resistance | ohms law |
| active electrodes which delivers the electric current to the surgical site through tissue | ESU |
| WT Bovie | developed first spark-gap tube generator |
| also called the law of conservation of momentum | newton's law of motion |
| whenever force is exerted, equal and opposite force occurs in reaction | newton's law of motion |
| solids, liquids, gases, and even plasma | matter |
| waves are shorter than ultraviolet | xrays |
| gas laser used for skin (ex: warts) | CO2 |
| gas laser used on retina | argon |
| laser that is solid crystal used on gyn or gastric scope | nd:yag |
| manipulation of an instrument | robotic arm |
| up and down movement of robot | pitch |
| right and left movement of robot | yaw |
| rotating movement of robot | roll |
| used to compress the walls of vessels (most common is the hemostat) | clamps |
| difficulty breathing, chest pain, changes in skin color or temp, changes in vital signs, open bleeding wounds | emergency situations |
| STSR's main role | protect the sterile field |
| main priority in an emergency situation is | maintain airway |
| anaphylactic shock include | swelling, itching, difficulty breathing, hypotension, tachycardia, diminished urine output or death |
| #4 knife handle holds a | 20 blade |
| most common knife handle | #3 |
| allows for ventilation but doesn't work in esophagus because tissue will collapse around it | bronchoscope |
| inserted through the body orifices for viewing, repairing, biopsy of tissue, hemorrhage control, or retrieval of a foreign body | colonoscope |
| can be interchanged with one another | choledochoscope and layrngoscopes |
| tank is located on wall and contains a pressure of 500 psi, but typically the operating pressure is 80-100 psi. These pressure gauges are set by OR staff according to recommendations | nitrogen |
| has powerful and precise coagulating properties, and is commonly used for GI endoscopy | nd:yag |
| insufflators | used during laparoscopic procedures to infuse CO2 into the abdominal cavity. (typical intraoperative pressure for laparoscopy is 12-15 mm HG |
| grounding pad placement is very important for | ESU |
| routine part of orthopedic surgeon's armamentarium | tourniquet |
| can use tubing as a tourniquet for an extremity | penrose drain |
| is a plastic adhesive drape with an opening for surgical site | aperture |
| these are disposable drapes | fenestrated |
| non suture needle that is trucut | percutaneous biopsy needle |
| cherries or peanut sponges are also known as | kitners |
| an example of a one layered dressing | colloid |
| a non-occlusive dressing | permeable dressing |
| eliminates dead space, reduces edema, reduces hematoma formation | pressure dressing |
| transportation of patient includes they need to never be alone, transported slowly, and | feet first |
| patient should shower or bathe and shave | preoperatively |
| what part of the gown is considered to be nonsterile | cuffs |
| position back table, mayo stand, an ring stand furthest from | door |
| you open this onto the back table | basic pack |
| OR doors must remain | closed |
| this is opened before the basin and instruments | back table |
| ST's gown and gloves should be opened on a | separate surface |
| order to open sterile supplies | back table cover, basin, wrapped items, peel packs, and instruments |
| count order | field, mayo, back table, off site |
| #1 item to lose | lap sponge |
| order to count | sponges, sharps, instruments |
| only count instruments when | going into body cavity |
| normal surgery count | 3 |
| c-section count | 4 |
| if patient is to be moved there should be a minimum of how many people | 4 |
| safety straps should be how many inches above the knee | 2 |
| armboards are to be no more than how many degrees | 90 |
| position for surgery on lower abdomen and pelvis | trendelenburg |
| decreases respiratory rate | trendelenburg |
| position used for shoulder surgery and breast reconstruction | fowler's |
| position used for peritoneal, rectal, and vaginal surgery | lithotomy |
| position used for rectal surgery | kraske or jackknife |
| position used for thoracic, hip, and kidney surgery (kidney rest under iliac crest) | lateral and kidney |
| order for when patient is in OR room and ready to go under | sleep, prep, drape |
| non-woven fabric drapes | disposable |
| skin incision is made through the drape known as "incise drape" | plastic |
| drape inhibits growth of microbes on patients skin | iodophor |
| skin remains intact, most common MVA injuries, hematoma may develop | closed wound |
| integrity of skin is destroyed | open wound |
| integrity of the skin is cut injured, no loss or destruction of tissue, and no foreign body in wound | simple wound |
| tissue is lost or destroyed, foreign body remains in wound | complicated wound |
| wound edged can be approx. and secured | clean wound |
| expected to heal by first intention | clean wound |
| object penetrates skin, can become infected within 4-6 hours, debridement is necessary | contaminated wound |
| would classification that represents dirty or infected | Class IV |
| when do you record wound classification | end of procedure |
| open traumatic wound greater than 4 hours | Class IV |
| inflammatory response phase | phase one |
| begins within minutes of injury | lag phase |
| produces an enzyme to dissolve and remove tissue debris | WBC's |
| proliferation phase | phase two |
| is secreted by fibroblasts and formed into fibers resulting in a gain in tensile strength of wound | collagen |
| risk of infection is great | 2nd intention |
| decubitis ulcer is packed open | granulation |
| suturing delayed 4-6 days | 3rd intention |
| cicatrix | normal surgical scar |
| extends beyond the border of the cicatrix and continues to grow | keloid scar |
| unites two structures that normally are separate | adhesion |
| partial or total separation of sound layers | dehiscence |
| viscera are exposed through incision | evisceration |
| an emergency situation requiring immediate surgery to replace viscera and close the wound | evisceration |
| packing dressing is wet to dry | iodoform |
| suture sizes range from | #5 to #11-0 |
| monofilament, absorbable, natural, and quick absorption | plain gut |
| gyn procedures, with chromium salts added | chromic gut |
| monofilament, synthetic, absorption, soft tissue approximation | monocryl |
| monofilament, absorbable, synthetic, difficult to tie | PDS/Maxon |
| polydioxanone, loop suture, for continuous suture of the abdomen | PDS |
| suture used for laparotomy | PDS |
| polypropolene, synthetic, monofilament, non-absorbable, easily crushed by instruments, wet surgeons hands when tying | prolene/surgipro |
| monofilament, nonabsorbable, #1 good closure of fascia, has good memory | nylon |
| synthetic, absorbable, braided, violet and undyed, most commonly used more than anything else | vicryl/polysorb |
| natural, absorbable, braided, used on GI closure, little memory and is used for drains | silk |
| on drain use a 2-0 stitch on FS | silk |
| braided nylon, more durable, holds knots better because its softer to the tissue | nurolon/bralon |
| on neuro use for closing the dura on craniotomy, 4-0 on an RB1 needle | nurolon/bralon |
| white, braided, polyester, for facelifts | mersilene |
| green, braided, polyester, good for suturing tendon | ethibond |
| doesn't cut through skin, button, wire teeth, tendon repair | stainless steel |
| needle used for skin and joint capsule | cutting |
| needle used on liver or kidney (very large and skinny) | blunt |
| pop-off, used to tie off large vessel | stick tie |
| place just the tie on an instrument usually a tonsil or right angle | tie on a pass |
| to tie | ligate |
| thin translucent layer of the abdomen | peritoneum |
| layer right below the skin of the abdomen | subcuticular |
| suture technique used for retraction | traction sutures |
| suturing technique #2 and #5 (ex: belly, expected to dihiscence) | retention |
| accessory devise used on closing the abdomen, plastic catheter tubing | bridges and bolsters |
| lines abdominal cavity lying beneath the posterior fascia | peritoneum |
| tough connective tissue just below the skin and above subcutaneous | subcuticular |
| prolene or nylon preferred | skin |
| another name for linear stapler | TA |
| gastrointestinal anastomoser | GIA |
| allows for end to end anastamosis of the bowel or end to side on a gastroduodenal | EEA stapler |
| KUB | kidney's, ureter, bladder |
| standard lower abdominal xray | KUB |
| myelography | evaluate nerve |
| palpation | feeling |
| auscultation | listening |
| EEG | brain |
| ECG | heart |
| EMG | combo of muscular contraction |
| this is very critical to confirm during lumbar lamenectomy | level |
| spirometry | how forcibly you can exhale |
| PCTA | percutaneous transluminal cardiac angioplasty |
| cardiac catheterization | femoral and radial |
| cholangiography | gallbladder |
| seldinger's technique | cut down of femoral |
| spinal tap diagnoses | MS |
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