GOWNING
Hold the gown away from your body, high so as that it does not touch the floor.
- Allow it to open up and put your arms into the arm holes while keeping your arms extended.The inside of the gown is facing you
- Then flex your elbows and abduct your arms. fig 2.6
- Wait for the nurse to help you.
-She will hold the inner sides of the gown at each shoulder and pull them over your shoulders fig 2.7 and will tie the tapes of the gown at the back. fig 2.8
GLOVING
Dust your hands with powder and rub them together to spread it.
- Be careful to touch only the inner surface of the gloves.
- Grasp the inner aspect of the turned down cuff of a glove, and pull it on to your opposite hand. fig 2.9
- Leave its cuff for the moment.
- Put the fingers of your already gloved hand under the inverted cuff of the other glove, and pull it on to your bare hand. (fig 2.10, fig 2.11a, & b)
- It is a good practice to wash your gloved hands in sterile water to remove the powder.
EYE PROTECTION
Masks and protective eyewear or face shields should be worn during procedures that are likely to generate droplets of blood or other body fluids, the face should prevent exposure of mucous membranes of the mouth, nose and eyes of the surgeon.
They are lightweight, adjustable and do not obstruct vision. An educational programme is necessary to introduce surgeons to these new barriers.
You are now ready to prepare the op-site for cleaning.
Any questions be sent to drmmkapur@gmail.com
All earlier post are stored in archives for you’re access and review
Wednesday, June 23, 2010
Monday, June 14, 2010
START THE DAYS WORK
SCRUBBING UP
ALL taking part in the surgical procedure and the OT .team must scrub.
The scrub rooms are situated before the entrance to the O.T.
Adjust the elbow tap levers to deliver water without splashing fig 1.1.In most tropical countries only a cold water tap is necessary.
- Wet your hands, apply a little soap or detergent, and work up a good FOAM.
- Scrub your hands and forearms to 5 cm above your elbows for one complete MINUTE.
- Wash your forearms.
- Then take a sterile brush and put soap on it. fig 2.1
- Scrub the lateral side of your left thumb, then its medial side, then the lateral and medial aspects of each successive finger. fig 2.3
- Scrub your nails, and then the back and front of your left hand.
- Follow same routine with your right hand. Scrub for 5 minutes in all.
Some surgeons only scrub their nails, and then thoroughly wash and rinse their hands and arms upto their elbows a number of times for 5 minutes.
Rinse the suds from your hands while holding them higher than your elbows. fig 2.4
- Turn off the taps with your elbows. fig 2.5
Dry your hands with a sterile towel before you put on a sterile gown.
- Dry your hands first, then your forearms.
- Grasp the folded towel with the fingers of both hands, then let it drop open, so that you don't touch anything with the open towel.
- Dry your hands on one corner, then dry your forearms.
- Try not to bring a wet (unsterile) part of the towel back to a dry area of your arms and hands
Any questions be sent to drmmkapur@gail.com
All previous posts are stored in archives for you’re access and reveiw
ALL taking part in the surgical procedure and the OT .team must scrub.
The scrub rooms are situated before the entrance to the O.T.
Adjust the elbow tap levers to deliver water without splashing fig 1.1.In most tropical countries only a cold water tap is necessary.
- Wet your hands, apply a little soap or detergent, and work up a good FOAM.
- Scrub your hands and forearms to 5 cm above your elbows for one complete MINUTE.
- Wash your forearms.
- Then take a sterile brush and put soap on it. fig 2.1
- Scrub the lateral side of your left thumb, then its medial side, then the lateral and medial aspects of each successive finger. fig 2.3
- Scrub your nails, and then the back and front of your left hand.
- Follow same routine with your right hand. Scrub for 5 minutes in all.
Some surgeons only scrub their nails, and then thoroughly wash and rinse their hands and arms upto their elbows a number of times for 5 minutes.
Rinse the suds from your hands while holding them higher than your elbows. fig 2.4
- Turn off the taps with your elbows. fig 2.5
Dry your hands with a sterile towel before you put on a sterile gown.
- Dry your hands first, then your forearms.
- Grasp the folded towel with the fingers of both hands, then let it drop open, so that you don't touch anything with the open towel.
- Dry your hands on one corner, then dry your forearms.
- Try not to bring a wet (unsterile) part of the towel back to a dry area of your arms and hands
Any questions be sent to drmmkapur@gail.com
All previous posts are stored in archives for you’re access and reveiw
Saturday, June 5, 2010
OTMANAGE CRITICAL CONTROL
INFECTION CONTROL, STERILIZATION & OT CLEANING
How does Air Entry Air Conditioning Effect Infection in OT?
There must be a positive pressure in the OT compared to wash rooms, utility rooms and corridors to prevent entry of contaminated air.
The temperature be kept at 68 to 700F (20-23 C) with a humidity of 30-60 percent.
-This reduces bacterial growth and static electricity.
-Each O.T. should have independent temperature controls.
Air in flow should be filtered through high efficiency particulate system (HEPA) with 15 air exchange per hour at least three of these must be fresh air.
-Air must enter the OT through vents in the ceiling and leaves through vents near the floor.
-The air ventilation system must have a regular routine for inspection and maintenance including change of filters.
-All these steps will control bacterial growth and thus wound infections.
What are Infection Control Mechanisms?
Infection will occur if high standards of preoperative,
intra-operative,
and postoperative rules are not observed in relation to the care of instruments and patients.
If there is any break of these rules by the surgical team;
-The occurrence of infection and cross-infection will rise.
-Resulting in anything from minor wound infections to a major disaster(tetanus)
-Standing rules and procedures need to be DEFINED by hospital Infection Control Committees (ICC) and OBSERVED by the surgical teams.
The infection control committee, usually headed by a physician, infection control nurse, or nurse epidemiologist.
Following the standards set by the ICC, provides the hospital with an effective program with the following goals:
-Investigate and identify source of the infection in each case.
-The source may be a person, a patient or an employee or may be the practice of one or more employees of poor aseptic technique. or
-A team member may be harboring a specific disease organism that is transmitted to the patients in his or her care.
-Provide effective isolation of infected patients.
-The ICC also identifies need for change in rule book to prevent a future outbreak
What are Common Bacteria on Skin and Surface?
Bacteria include staphylococci and streptococci these are responsible for the majority of cases of cellulites and abscesses seen on the skin.
-Most respond to an appropriate broad spectrum antibiotics.
-Abscesses in the perineal area are frequently infected with anaerobic bacteria or are mixed infections.
-In these situations metronidazole or some similar antibiotic needs to be given
• WHERE INFECTION is suspected in patent or staff, a bacterial SWAB should be taken, this will guide the treating physician to select the correct antibiotic.
• Fungal infection on toe-nails and finger-nails may be easily recognized by sending nail clippings or even the complete nail for mycology. Such action may avoid the need for surgery and establish a definitive diagnosis.
• Candida (fungus infection in mouth) infections are easily recognised and treated with any of the antimycotic agents.
Most cases of infection in surgery can be avoided by:
• Careful aseptic technique in the OT (given below).
• Attention to rules and procedures for sterilization of instruments and dressings (to be defined by the hospital administrators).
• However, in addition to problems of common bacterial pathogens, surgeons are now having to address themselves to the problems of viral agents such as HEPATITIS B, C, and HIV infection, which may have very many more serious long term consequences (guidelines at the end of this chapter).
• Infection is not always a one-way problem of patients infecting doctors and other patients: in a few instances an infected surgeon or his team can infect the patient, or other colleagues.
• It is therefore important for all members of the surgical team to be aware of the potential DANGER of their personal infections, and to know how to avoid them by strict personal hygiene and to treat these infections if they occur.
They must be freed from OT duties for the duration of their infection
Any questions be sent to drmmkapur@gmail.com
How does Air Entry Air Conditioning Effect Infection in OT?
There must be a positive pressure in the OT compared to wash rooms, utility rooms and corridors to prevent entry of contaminated air.
The temperature be kept at 68 to 700F (20-23 C) with a humidity of 30-60 percent.
-This reduces bacterial growth and static electricity.
-Each O.T. should have independent temperature controls.
Air in flow should be filtered through high efficiency particulate system (HEPA) with 15 air exchange per hour at least three of these must be fresh air.
-Air must enter the OT through vents in the ceiling and leaves through vents near the floor.
-The air ventilation system must have a regular routine for inspection and maintenance including change of filters.
-All these steps will control bacterial growth and thus wound infections.
What are Infection Control Mechanisms?
Infection will occur if high standards of preoperative,
intra-operative,
and postoperative rules are not observed in relation to the care of instruments and patients.
If there is any break of these rules by the surgical team;
-The occurrence of infection and cross-infection will rise.
-Resulting in anything from minor wound infections to a major disaster(tetanus)
-Standing rules and procedures need to be DEFINED by hospital Infection Control Committees (ICC) and OBSERVED by the surgical teams.
The infection control committee, usually headed by a physician, infection control nurse, or nurse epidemiologist.
Following the standards set by the ICC, provides the hospital with an effective program with the following goals:
-Investigate and identify source of the infection in each case.
-The source may be a person, a patient or an employee or may be the practice of one or more employees of poor aseptic technique. or
-A team member may be harboring a specific disease organism that is transmitted to the patients in his or her care.
-Provide effective isolation of infected patients.
-The ICC also identifies need for change in rule book to prevent a future outbreak
What are Common Bacteria on Skin and Surface?
Bacteria include staphylococci and streptococci these are responsible for the majority of cases of cellulites and abscesses seen on the skin.
-Most respond to an appropriate broad spectrum antibiotics.
-Abscesses in the perineal area are frequently infected with anaerobic bacteria or are mixed infections.
-In these situations metronidazole or some similar antibiotic needs to be given
• WHERE INFECTION is suspected in patent or staff, a bacterial SWAB should be taken, this will guide the treating physician to select the correct antibiotic.
• Fungal infection on toe-nails and finger-nails may be easily recognized by sending nail clippings or even the complete nail for mycology. Such action may avoid the need for surgery and establish a definitive diagnosis.
• Candida (fungus infection in mouth) infections are easily recognised and treated with any of the antimycotic agents.
Most cases of infection in surgery can be avoided by:
• Careful aseptic technique in the OT (given below).
• Attention to rules and procedures for sterilization of instruments and dressings (to be defined by the hospital administrators).
• However, in addition to problems of common bacterial pathogens, surgeons are now having to address themselves to the problems of viral agents such as HEPATITIS B, C, and HIV infection, which may have very many more serious long term consequences (guidelines at the end of this chapter).
• Infection is not always a one-way problem of patients infecting doctors and other patients: in a few instances an infected surgeon or his team can infect the patient, or other colleagues.
• It is therefore important for all members of the surgical team to be aware of the potential DANGER of their personal infections, and to know how to avoid them by strict personal hygiene and to treat these infections if they occur.
They must be freed from OT duties for the duration of their infection
Any questions be sent to drmmkapur@gmail.com
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