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91 Cards in this Set
- Front
- Back
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List the potential dangers of long-term exposure to waste anesthetic gases.
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Congenital abnormalities in children, spontaneous abortions, and even liver and kidney damage.
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Describe the procedure to follow if anesthetic is spilled.
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Remove all nonessential personnel from the area, open windows if available and turn on all exhaust fans, control liquid with generous portion of kitty litter and place a plastic bag over the spill to reduce evaporation. Pick up absorbed liquid and kitty litter with a dust pan and place it inside a plastic garbage bag, seal tightly and dispose of in outside trash can. Leave windows open and fans on until gas levels have been reduced to a safe level.
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List precautions that must be taken to reduce waste anesthetic gas when using a mask or tank for induction.
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Be sure to use the appropriate flow rate and proper reservoir bag for the size of patient – DO NOT turn up the oxygen flowmeter to maximum when masking a patient. Induction chambers should always be connected to the scavenging system of absorption canisters to reduce levels of escaping gasses. Ventilation in the room should be good and use local exhaust fans when available.
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Describe storage conditions for compressed gases.
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Store in a cool dry place away from potential heat sources such as furnaces, water heaters, and direct sunlight. Secure tanks, even small ones, in an upright position by means of a chain or strap. Cylinders stored inside a closet should also be secured as they can fall against the door and cause injury when the door is opened.
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Scalpel handles
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primarily used for incisions or dissections, Handles come in many sizes, but 3, 4 are most common. Bard-Parker no. 3 uses detachable blade nos. 10,11,12,15 and most useful for small animal surgery. Bard-Parker no. 4 most commonly used for large animal surgery and uses blade nos. 20,21,22
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Scalpel blades
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Blade nos. 10 – used for most general surgeries, 11 – used for small procedures such as severing ligaments. 12 – used for such things as lancing an abscess. 15 used on small precise or curved incisions – i.e. declawing cats Bard-Parker scalpel no. 3 for small animals. Blade nos. 20, and 23 commonly used on large animals used on Bard-Parker scalpel no. 4 for large animal surgery.
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Lister bandage scissors
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Used to cut bandages. On blade is blunt to slip under bandages.
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Littauer suture scissors
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used to cut all sutures but wire sutures.
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Wire cutting scissors
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used to cut wire suture.
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Mayo-Hegar needle holder
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needle holder with no build in suture cutter.
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Olsen – Hegar needle holder
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needle holder with built in suture cutter.
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Adson thumb forceps
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have delicate intermeshing teeth (“rat toothed”), provides a good atraumatic grip of delicate tissues, commonly used for dissection.
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Adson – Brown thumb forceps
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have multiple intermeshing teeth with a broad tip for good tissue and needle handling. Commonly used during suturing and wound closing.
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Rat tooth thumb forceps
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have long interdigitating teeth, primarily used for the skin or fascia.
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Allis tissue forceps
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securely grasps, but also crushes tissue. Considered traumatic and only used on tissue being removed.
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Babcock forceps
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shaped similar to Allis, but less traumatic (smoother grasping surface and less tip compression).
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Backhaus towel clamps
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available in different sizes, common clamp
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Halstead mosquito forceps
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small hemostatic forceps designed to occlude small vessels.
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Kelly forceps
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forceps used larger hemostatic on larger vessels
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Rochester camalt forceps
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large crushing forceps with longitudinal grooves and cross-grooves at the tip to provide more traction. Used for clamping across tissue containing vessels. Commonly used in spays to crush the vessels of the ovarian pedicle or the body of the uterus.
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Rochester-Pean forceps
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Large transversely grooved forceps used to clamp tissue bundles and large forceps.
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Snook’s ovariectomy hook
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specialized type of hand held retractor used to expose the horns of the uterus during a spay.
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Senn retractor
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double ended hand held retractors commonly used to retract skin, fat, muscle.
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Gelpi retractor
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self retaining retractors commonly used for muscle retraction during orthopedic and neurologic surgeries.
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Define Asepsis
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a condition of sterility where no living organisms are present.
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Define Endogenous contamination
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arises from within the patient and reached the wound through the blood stream.
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Define Exogenous contamination
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sources of contamination originating outside of the patient including air, surgical instruments an supplies; patient’s skin and the surgical team.
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Define Sterilization
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destruction of all organisms and spores on an object.
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Define Disinfection
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destruction of the vegetative forms of bacteria, but not the spores.
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Define Antisepsis
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preventing infection by preventing the growth of infectious agents.
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Define Disinfection time
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amount of time it takes for disinfection to occur.
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Define Disinfectant
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agent that destroys or inhibits microorganisms.
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Define Autoclave sterilization
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sterilizers that employ steam under pressure.
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Define Flash sterilization
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emergency sterilization where instruments or object is placed unwrapped in an autoclave, sterilized and then carried to the operating room
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Define Chemical sterilization
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performed with certain liquids or gasses. Used for items that cannot tolerate high temperatures or steam associated with autoclaving.
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How might microorganisms that cause infection be introduced into a surgical site?
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Improper instrument sterilization, lack of operating sanitation, from the skin of the patient and from vet staff.
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Why might some surgical procedures require less sterile preparation and aseptic technique than other procedures?
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Some procedures are a contaminated or dirty surgery such as debridement of a cutaneous abscess.
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Lancing and debridement of an abscess is a minor surgical procedure, however, is can be very unsterile. What precautions should be taken?
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The wound is scrubbed, but instruments may be disinfected rather than sterilized. Sterile gloves may be worn, but not complete surgical attire. Preferable for patients to remain outside of the operating room to prevent contaminating it.
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List and describe the 3 general types of physical methods used for sterilization.
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Filtration – separates particulate material from liquids or gasses by use of a filter.
Radiation – used for materials that would be damaged by other methods of sterilization – usually part of the manufacturing process. Thermal energy – most common type of sterilization. There are 2 types of thermal energy sterilization – dry heat and moist heat. |
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When will a pack processed in the autoclave become sterile?
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When the steam has penetrated the pack completely and all materials have been exposed to steam at the proper temperature for the proper duration.
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When preparing an instrument pack for autoclaving, how should the instruments be prepared?
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Check that all materials are free from grease, oil or protein residues. Complex instruments should be disassembled and any box locks open.
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How should the instruments and materials be packed within the autoclave to assure steam penetration of the pack?
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Materials need to be packed as loosely as is practical to assure good steam penetration in the pack. Packs should have 2.5 – 7.5cm of space around each pack.
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What is considered the “minimum” standard for routine autoclave sterilization? (i.e. temp, time, and pressure)
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) Minimum time temperature standards – exposure to saturated steam at 121 C (250 F) for 13 minutes considered to be safe standard.
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What is flash sterilization?
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Emergency sterilization where instruments or object is placed unwrapped in an autoclave, sterilized and then carried to the operating room.
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Why should the autoclave door be “cracked” open after sterilization? What effect could skipping this step have on the autoclaved packs and their contents?
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If the door is opened wide cool air will condense the steam in the materials making them soggy and promoting the corrosion of metal instruments.
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List and describe the 4 types of sterilization indicators discussed in your text.
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Autoclave tape –identifies packs and articles exposed to steam, but does not indicate whether the proper requirements of time, temperature, and steam have been met.
Fusible melting pellet glass - indicates that a temperature of app. 118 C (244 F) was reached, but does not indicate whether the proper time or steam saturation was achieved. Culture test indicators – test strips that contain a controlled spore population of some particular strain of bacterium. Challenge test is useful as it is only test that proves microorganisms were killed. Results are not immediately available and does not access steam penetration. Chemical sterilization indicators – undergo color changes when subjected to saturated steam for adequate amounts of time. |
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Where and how should sterile packs be stored?
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Stored in a dust-free, dry and well ventilated area away from contaminated equipment.
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When might autoclaved packs be considered contaminated and need to be autoclaved again to assure sterility?
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If a pack is dropped, the tape sealing it is broken, or the pack wrap becomes wet, punctured or torn.
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When might gas sterilization be used over autoclave sterilization?
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Used for items that cannot tolerate the high temperatures or steam associated with autoclaving i.e. power equipment or some plastic products).
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What are the most common agents used for gas sterilization?
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Ethylene oxide, and hydrogen peroxide gas plasma.
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List and briefly discuss the common antiseptic and disinfecting agents. When would one agent be used over another?
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Iodine – good antimicrobial agents, but have limited activity against bacterial spores. Used for surgical preparation, topical wound therapy and body cavity lavage.
Chlorhexidine – antiseptic agent that is an effective antimicrobial agent with activity against bacteria, molds, yeasts, and viruses, Has a rapid onset and residual activity that is not effected by alcohol, lavage solutions, or organic debris. Popular surgical scrub due to effectiveness and nonirritating to skin. Alcohol – used as antiseptic and disinfectant agent. Are bactericidal , but ineffective against spore and fungi. No residual effects and re inhibited by organic debris. Never used on open wounds as is both painful and cytotoxic. Phenois – AKA carbolic acid historically used as antiseptics and disinfectants but replaced by newer safer and more effective agents. Quaternary Ammonium – synthetic cationic detergents that act on cell membranes and are effective against bacteria but not spores or viruses. Popular bland nontoxic agent disinfectant. Chloride – among first agents to be used as medical disinfectants (WWI as Dakin’s solution). Antimicrobial, but cytotoxic when used on living tissue. Aldehyde – both toxic and irritating which restricts use from living tissue. |
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According to your text, what are the two most commonly used antiseptic agents?
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Povidone – iodine and chlorhexidine.
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Briefly describe the process of cold sterilization.
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Refers to soaking instruments in disinfecting solutions such as chlorhexidine or glutaraldehyde. Sterility is not guaranteed and so used for minor procedures or equipment that cannot tolerate other forms of sterilization i.e. endoscopic. Exposure time >3 hours and equipment must be thoroughly rinsed before use.
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Army-Navy retractor
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US army pattern retractor – double ended hand held retractor commonly used to retract fat, skin or muscle to view underlying tissues. Has smooth blades that are less traumatic to tissues.
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Weitlaner Retractor
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self retaining retractor commonly used for muscle retraction, especially in orthopedic and neurological surgery. pronged at ends used for orthopedic surgeries
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Castroviejo Needle holder
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very delicate instrument, spring loaded attachment to needle, tips are tiny, fine suture needles, for eyes and neurosurgery
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Lid Speculum
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for ophthamalic surgery or exam, slides under each eyelid
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Iris Scissors
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used for ophthamalic surgeries
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Ruskin Rongeur
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have small cupped tips used to cut small pieces of dense tissue such as bone, cartilage, or fibrous tissue.
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Bone curet
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used to scrap hard tissue such as bone or cartilage. Small cuplike structure at one or both ends of handle. Cup has sharp edges.
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Intramedullary Pin
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also called Steinmann Pins. They are placed in the intramedullary cavity of long bones for fracture fixation.
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Intramedullary Pin Cutter
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used to cut pins to the proper lengths.
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Jacobs Hand Chuck and Key
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Jacobs Hand Chuck and Key
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Gigli Wire and Handles
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used to cut bone by placing the wire on the bone and drawing it back and forth in a sawing motion.. T-shaped handles give surgeon a firm grasp of the wire.
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Mayo Scissors
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heavy scissors used for cutting tough tissue such as heavy connective tissue.
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Metzenbaum Scissors
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preferred for most soft tissue dissection. They are fine, curved scissors used for cutting delicate tissue for most soft tissue such as fat or thin muscle.
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Absorbable suture
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broken down and resorbed by the body resulting in a loss of tensile strength within 60 days. Used in tissues that heal rapidly to adequate strength.
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Non-absorbable suture
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does not significantly weaken with time. It is used in areas that heal slowly and are subjected to disruptive stress.
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Multifilament suture
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Or braided suture material is made up of very small elements that are braided or twisted together to form the desired diameter. It tends to be relatively strong, handles well, and has good knot-holding abilities. But many braided sutres induce significant reaction and can harbor bacteria. They have “wicking” characteristics and should not be used in hollow organs or the skin where part of the suture is exposed to a contaminated environment and the wicking fluid can carry bacteria into the body.
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Monofilament suture
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avoids the capillary problem and thus has a lower incidence of infection. Has low coefficient of surface friction making it easy to pull through tissues. But low surface friction results in poor know security nessitating many throws on each knot. Some has returns to its original shape (memory) and results in poor handling characteristics.
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Surgical gut
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collagenous protein obtainedfrom the submucosal layer of sheep small intestines.
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Synthetic absorbable suture
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– are broken down by hydrolysis.
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Synthetic non-absorbable suture
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retains its tensile strength for more than 60 days. Monofilament nylon typically used for skin sutures.
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Suture reaction
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– induced more from some suture materials than others. Reaction impedes healing of normal tissue.
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Taper needles
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– do not cut tissue, but spread it around the needle and following suture. This avoids hemorrhage and results in a sealed suture line. Used in suturing most hollow organs.
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Cutting needles
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have 2 or 3 opposing cutting surfaces. Used for skin, eye tissues, and some tough facial tissue.
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Eyeless (swaged needles)
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Attached directly to the suture at the factory. A single suture strand is drawn through the tissue and automatically uses a new sharp needle with every strand.
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What are the basic uses of suture material?
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- Apposing the edges of an incision or wound.
- Obliterating open space in which serum would tend to accumulate. - Tightening and stabilizing joint that have sustained ligament injury or have luxated. - Strengthening or replacing weakened tissues, as in hernias. - Ligating blood vessels or tissues that will be removed. |
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What are the qualities of the ideal suture material?
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- Able to be used for any procedure with the same characteristics in all tissues
- Is easily handled and tied by the surgeon. - Causes minimal tissue reaction and does not support, spread, or sequester bacterial growth. - Has high tensile strength in a small diameter, yet not cut through tissues. - Knots securely with minimum number of throws with small knot size. - Is easy and economical to produce and sterilize. - Does not induce allergic, electrolytic, or neoplastic changes. - Holds tissues until healing occurs, then resorbs with minimum tissue reaction. |
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List the synthetic absorbable suture materials that are discussed in your text. Place them in order of the materials that are absorbed the fastest to those that have the slowest absorption time.
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Monocryl, Dexon, Biosyn, Maxon, PDS
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Why would Vicryl or Dexon not be appropriate suture materials to suture the bladder? What products are recommended?
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They are more rapidly degraded in alkaline environment and dissolve faster in infected urine. PDS and Maxon are recommended for closure fo the bladder.
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List the synthetic non-absorbable suture materials that are discussed in your text. When might one suture material be used over the other?
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Polyamide - monofilament used for skin sutures that are to be removed. Polypropylene – useful when permanent support is needed. Polybutester – useful for repairing ligaments and other structures that must stretch under weighted motion. Polyester fibers –strong noncapillary suture. Polymerized caprolactum – should not be used below skin level
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7) Why are there a variety of suture sizes? Which are larger? Which are smaller?
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The appropriate size suture for each procedure needs to be no stronger tha the tissue on which it is used. Knot is the strength-limiting area of most suture and the relative knot security decreases as the suture size increases, smaller suture offers a mechanical advantage. Larger suture is the 1-7 range while smaller is 1-0 down to 11-0.
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When should a cutting-edge needle not be used?
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Should not be used when an air-tight or watertight suture line is required.
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What is the purpose of having a variety of instrument packs in the veterinary hospital?
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A pack helps to organize instruments that are commonly used are readily available and infrequently used instruments are not contaminated and resterilized unnenecessarily.
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According to your textbook, list the instruments that should be included in a Standard or General instrument pack.
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General Pack – No. 3 scalpel, Brown Adson Thumb Forceps, Adson Thumb Forceps, needle holder – Mayo Hegar, Mayo scissors, Metzenbaum scissors, wire-suture scissors, Mosquito hemostats (3 straight, 3 curved), Crile forceps (1 straight, 1 curved), Carmal forceps (2 curved), Allis forceps (2), Snook Hook, Towel clamps (8), towels (6), stainless steel bowl, sponges (standard count), lap songes (2), sterilization indicator.
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According to your textbook, list the instruments that should be included in an Emergency instrument pack.
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No. 3 scalpel, Brown-Adson Thumb forceps, Needle holder – Olsen-Hegar, Mayo Scissors curved, Mosquito hemostats (3 straight, 3 curved), Crile or Kelly forceps (1 straight, 1 curved), Allis forceps, towel clamps(4), Towels (4), sponges (standard count), sterilization indicator.
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According to your textbook, list the instruments that should be included in an Orthopedic instrument pack.
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Army-Navy Retractors, Senn retractors, Rongeurs, Large Kern bone holding forceps, Small Kern bone holding forceps, bone curette, Periosteal elevator, Steinmann pins (5/64, 3/32, 7/64, 1/8, 9/64, 5/32, 3/16, ¼), Kirschner wire (0.035, 0.045, 0.062), Jacobs chuck and key, Roll 18-gauge stainless steel wire, Roll 20-gauge stainless steel wire, Roll 22-gauge stainless steel wire, Metal ruler, Michel clips and applicator, Sterilization indicator.
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Why should gauze sponges in an instrument pack be counted before and after surgery?
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To ensure none has been left in the patient
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Surgical instruments are expensive and should be handled gently. Describe the steps taken, immediately following use, to properly clean the instruments and prepare them for repacking and sterilization.
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Instruments should be rinsed with cold water to prevent blood and organic debris from drying in the serrations, hinges, box locks, or ratchets (preferably distilled or deionized water). If there is going to be a delay before final cleaning, immerse them in water containing instrument detergent. Scrub each instruments with a soft brush and instrument detergent. Ultrasonic cleaner is used next and then instruments are thoroughly rinsed and air-dried. Instruments are lubricated then autoclaved.
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If an ultrasonic unit is used to clean instruments, how should those instruments be placed in the unit?
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Instruments are placed with box locks open. Those with dissimilar metals are not placed together in the unit. Afterwards they are thoroughly rinsed and air-dried.
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