1 / 34

Chapter 31

Chapter 31. Assisting with Office/Ambulatory Surgery . Surgical Asepsis and Sterilization. Surgical asepsis: all microbial life destroyed before invasive procedure performed All equipment to be used is sterile Procedures to promote sterile technique Surgical hand washing Sterile gloving

nimrod
Download Presentation

Chapter 31

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Chapter 31 Assisting with Office/Ambulatory Surgery

  2. Surgical Asepsis and Sterilization • Surgical asepsis: all microbial life destroyed before invasive procedure performed • All equipment to be used is sterile • Procedures to promote sterile technique • Surgical hand washing • Sterile gloving • Preparing patient’s skin for surgery • Sterile draping

  3. Surgical Asepsis and Sterilization • Hand cleansing (hand hygiene) for medical and surgical asepsis • Removing pathogenic microorganisms from hands after they become contaminated • Crucial step in preventing health care associated Infections (HAI)

  4. Surgical Asepsis and Sterilization • Hand cleansing (hand hygiene) for medical and surgical asepsis • Antimicrobial soap, warm water, vigorous scrubbing of hands, wrists, forearms • At least 3 minutes • Rinse hands and arms; maintain hands above elbows and avoid contact with surfaces of sink • Thoroughly dry hands and arms; don sterile gloves

  5. Sterile Principles • Sterile object may not touch nonsterile object • Sterile objects must not be wet • 1-inch border between sterile area and nonsterile area • Do not turn your back on sterile field

  6. Sterile Principles • Anything below waist considered contaminated • Surgery trays positioned above waist • Sterile objects held in front and away from body and above waist • Do not cough, sneeze, talk over sterile field

  7. Sterile Principles • Do not reach over sterile field • Do not pass contaminated dressings or instruments over sterile field • Place contaminated instruments in separate container or area • Be aware of actions to determine whether sterile field has been contaminated

  8. Sterile Principles • Opening sterile packages • Outer wrapper considered contaminated • Open and drop onto sterile field without touching inner contents

  9. Sterile Principles • Pouring sterile solutions • Pour into sterile basin or cup without touching bottle’s rim or splashing solutions on sterile field

  10. Methods of Sterilization • Gas sterilization • Dry heat sterilization • Chemical (“cold”) sterilization Steam sterilization (autoclave) >>

  11. Common Surgical Procedures • Assisting with office/ambulatory surgery • Dressing change • Wound irrigation • Preparation of patient’s skin before surgery • Suturing of laceration or incision repair • Sebaceous cyst excision

  12. Common Surgical Procedures • Incision and drainage of localized infection • Aspiration of joint fluid • Hemorrhoid thrombectomy • Suture/staple removal • Application of sterile adhesive skin closure strips (Steri-Strips)

  13. Additional Surgical Procedures • Method used determined by provider’s preference • Electrosurgery • Electric current in concentrated areas to cut or destroy tissue when pathological examination not required • Useful in removing benign skin tags and warts

  14. Additional Surgical Procedures • Cautery • Application of caustic chemical or destructive heat • Chemical tissue destruction • Silver nitrate or sodium hydroxide • Cryosurgery • Destruction of tissue by freezing • Liquid nitrogen or nitrous oxide

  15. Additional Surgical Procedures • Laser surgery • Light amplification by stimulated emission of radiation • Converts light into intense beam • Specialty surgery • Precautions

  16. Suture Material and Supplies • Suture/ligature • Bring together edges of a wound • Hastens healing and lessens scarring • Most material comes fused or swaged to needle and packaged in various lengths

  17. Suture Material and Supplies • Suture needles >> • Size • Shape • Radius of curve • Type of point • Staples >> • Removal

  18. Instruments • Structural features • Form determines function • Handles • Ratchets • Serrations • Forceps • Teeth

  19. Instruments • Structural features • Guide-pin • Box-lock hinge • Prongs • Hooks • Loops

  20. Instruments • Categories and uses • Cutting • Scissors and scalpels • Grasping/clamping • Hemostats, forceps, clamps, needle holders • Dilating/probing • Specula, scopes, probes, retractors, dilators

  21. Instruments • Care of instruments • Special care to prevent excessive wear and tear • Careful and frequent inspections • Basic rules and rationales • Ultrasound cleaning • Chemical “cold” sterilization

  22. Supplies and Equipment • Drapes • Sponges and wicks • Solutions/creams/ ointments Top: 4x4s >> Bottom: Iodoform gauze >>

  23. Supplies and Equipment • Dressings and bandages • Dressings: sterile material applied directly onto surface of wound or surgical site • Bandages: supportive material applied over top of dressings and are not sterile

  24. Supplies and Equipment • Anesthetics • Injectable anesthetics • Drawing techniques • Prior to applying sterile gloves • After applying sterile gloves • Topical spray anesthetics • Applied to surface

  25. Patient Care and Preparation • Patient preparation and education • Diet modification • Medication adjustment • Acquire special supplies • Insurance approval obtained • Postoperative period prepared for • Allergies checked for

  26. Patient Care and Preparation • Informed consent • Informs of medical or surgical procedure to be performed • Describes actual procedure in lay terms • Cites alternative treatments • Lists possible undesirable outcome and risks • Advanced Beneficiary Notice (ABN)

  27. Patient Care and Preparation • Medical assisting considerations • Home health care • Ability to follow standard instructions • Financial ability to afford supplies needed • Prior medical history • Be a patient advocate

  28. Patient Care and Preparation • Postoperative instructions • Should be written • Clearly understood by patient • Include important telephone numbers • Follow-up call

  29. Patient Care and Preparation • Wounds, wound care, healing process • Open wounds • Closed wounds • Accidental wounds • Intentional (surgical) wounds • Superficial wounds • Deep wounds

  30. Patient Care and Preparation • Wounds, wound care, healing process • Inflammation normal process of wound healing • Best treatment for infection is prevention • Wound care is extremely important

  31. Basic Surgery Setup • Assembling supplies and equipment • Setting up surgery tray • Getting patient and room ready • Preparing to assist during surgery

  32. Surgical Process • Set up surgical tray • Prepare room • Prepare patient • Assist with surgery • Terminal care process of room and equipment

  33. Preparation for Surgery • Applying sterile gloves • Setting up and covering a sterile field • Opening sterile packages of instruments and supplies and applying them to a sterile field

  34. Preparation for Surgery • Pouring a sterile solution into a cup on a sterile field • Preparation of patient’s skin for office surgery • Using dry sterile transfer forceps

More Related