ELECTRIC INSTRUMENTS 1

ELECTRICAL INSTRUMENTS

Much of the equipment in the operating theatre is powered by electricity.

      Most of the main connections are of Alternating Current (AC) and the frequency is 50 Hz.

Hazards

With AC a person who touches a live conductor and the earth will complete the circuit. 

The current will thus flow through this person and any one of the two possibilities can occur:

•     Electrocution

•     Local burns.

Loose electric connections can also start sparking, and this can lead to ignition of inflammable material (gases) in the OT.

Failure

•     The mains voltage in the India is at 220 V, 50 Hz

•     Emergency lighting and power for the operating theatre is provided by an emergency generator at the standard mains voltage

•     Or from batteries at 12-24 V

•     Or a combination of both

•     It is likely that the generator will supply the emergency electrical needs of the operating theatre through the existing wiring and socket outlets

•     Or some of the electric socket outlets may be connected to the generator.

      The planning of the design must take into account that the emergency generator output should be sufficient to supply the demand likely to be required.

•     However, it is wise during failure of mains supply to limit the demand and use lights and equipment that are essential for the operation in progress.

•     With mains failure, there could be a delay before a generator comes into action.

•     Preventive care must be taken with the use of electro-medical equipment in the vicinity of anesthesia apparatus if flame-able anaesthetic agents are likely to be used (cyclo­propane, ether).

•     There is potential risk of sparks originating from switches or motors igniting flammable anesthetic gases which may
leak from anesthesia breathing tubes.

•     This danger exists within a 25 cm area from the points where leakage occurs.

Any questions be sent to drmmkapur@gmail.com  

All older posts are stored in archives for access and review.

Visitors that follow may post contributions to the site.

To create consumer/provider engagement visit www.surgseminar.blogspot.com

www.drmmkapur.blogspot.com   

Infection Control Recall review 3

QUESTIONS FOR SELF EVALUATION (Sterilization)

    1.   What does sterilization mean as it applies to equipment used in Surgery?

    2.   What is the difference between a gravity steam sterilizer and a high vacuum sterilizer?

    3.   Why is it important that all air be evacuated from the steam sterilizer?

    4.   Name the four phases of a steam sterilization cycle.

    5.   Discuss the proper method of preparing stainless steel instruments for sterilization?

    6.   Why must linen be freshly laundered before it is used to wrap goods for steam sterilization?

    7.   What bacterium is used to monitor a steam-sterilized load?

INTERNET website

1.   Association for Practitioners in Infection Control (APIC). http/www. apic.org   .

2.   Association for Advancement of Medical Instrumentation (AAMI). http/www.aami.org   .

3.   Centers for Disease Control and Prevention. http/www. cdc.gov  .

Any questions be sent to drmmkapur@gmail.com

All older posts are stored in archives for access and review.

Visitors that follow may post contributions to the site.

To create consumer/provider engagement visit www.surgseminar.blogspot.com

www.drmmkapur.blogspot.com  

RECALL REVIEW 2 self evaluation

QUESTIONS FOR SELF EVALUATION (Disinfection)

    1.   What is the difference between disinfection and sterili­zation?

    2.   What is the difference between disinfection and antisepsis?

    3.   What is a bactericide?

    4.   What is the difference between a bacteriostatic agent and a bactericide?

    5.   What disinfectant is used in your operating room to clean the floors and walls? What type of disinfectant is it?

    6.   Why must hospital equipment be decontaminated?

    7.   What is meant by cleaning?

    8.   How does one handle an instrument that has fallen from the surgical field during surgery?

    9.   Discuss the duties of the scrub technologist immediately following a surgical case.

  10.   Describe the proper decontamination process for surgical instruments.

  11.   What is cavitation?

Any questions be sent to drmmkapur@gmail.com 

All older posts are stored in archives for access and review.

Visitors that follow may post contributions to the site.

To create consumer/provider engagement visit www.surgseminar.blogspot.com

www.drmmkapur.blogspot.com 

RECALL REVIEW 1

sterilization DEFINITIONS

Cobalt 60 Radiation

A method of sterilizing pre-packaged equipment by ionizing radiation.

Ethylene Oxide Gas

Highly flammable, toxic gas that is capable of sterilizing an object.

Glutaraldehyde

Chemical capable of rendering objects sterile.

Gravity Displacement Sterilizer

Type of sterilizer that removes air by gravity.

High Vacuum Sterilizer

Type of steam sterilizer that removes air in the chamber by suction vacuum.

Shelf Life

The amount of time a wrapped object will remain sterile while stored on a shelf after it has been subjected to a sterilization process.

Steam Sterilizer

Sterilizer that exposes objects to high pressure steam.

Sterilization Control Monitor

Method of determining whether a sterilization process has been completed; does not indicate whether the items subjected to that method are sterile.

Any questions be sent to drmmkapur@gmail.com

All older posts are stored in archives for access and review.

Visitors that follow may post contribtions to the site.

To create consumer/provider engagement visit www.surgseminar.blogspot.com

www.drmmkapur.blogspot.com 

INFECTIO CONTROL 18 Guidlines

PREVENTION GUIDELINES FOR OT TEAM

All members of the team should have vaccination for
Hepatitis B.

      There is as yet no vaccines for HIV and HCV. The sources for transmission from HBV, HCV and HIV can be the patient, his body fluids and sharps or other equipment. Therefore the following steps are suggested:

1.   Hand washing after removal of gloves with detergent even when gloves have been used in a procedure.

2.   Gloves, goggles and aprons worn in all procedures.

      •     Sharps-All suturing use forceps to hold skin edges

      •     Use needle holders

      •     Use instrument to hold needle to adjust needle holder.

3.   Discard all used needles into sharps containers.

4.   Spills of body fluids covered with absorbent material and kept in contact with 1 percent sodium hypochlorite for 30 minutes and then mopped dry.

5.   Specimens from patients infected with HIV or hepatitis should be placed in a sealed plastic bag and marked with warning tape.

6.   Contaminated dressings and waste material should be placed in a yellow plastic bag for incineration.

7.   Any linen contaminated with blood or body fluids should be handled with gloves, and washed in a washing machine separately at the highest temperature setting or act according to hospital policy. 

Any questions be sent to drmmkapur@gmail.com

All older posts are stored in archives for access and review.

Visitors that follow may post contributions to the site.

To create consumer /provider engagement visit www,surgseminar.blogspot.com 

www.drmmkapur.blogspot.com   

INFECTION CONTROL17 Aids

HIV INFECTION

The acquired immune deficiency syndrome (AIDS) was first described in 1981 and the human immunodeficiency virus (HIV) was first identified in 1983.

•     In 1983 the receptor cell for the virus was identified as the CD-4 of T-helper cell

•     Antibody tests were developed which revealed the HIV status of the individual

•     In 1986 a second strain, HIV 2, was isolated

•     Like hepatitis B, the virus is present in blood and body fluids, but unlike hepatitis B is relatively easily destroyed outside the body, and is not as infectious as the hepatitis B virus

•     Infection of the surgeon can occur from contamination from infected blood or body fluids, either through an open wound, or from a puncture wound like a needle-stick injury

•     Following infection there is an asymptomatic period during which antibody to the virus is not yet present in the blood, and thus HIV tests will be negative

•     After approximately 6 months the infected individual may seroconvert, and the HIV antibody be detected

•     A high proportion will then progress to develop AIDS

•     A common presenting feature of AIDS sufferers is the Kaposi sarcoma, with an incidence of between 25 and  50 percent. Biopsy of such lesions may be the first contact the surgeon has with this disease

•     Kaposi sarcomas present as pink to purple blotches like a bruise or blood blister. They may be flat or raised. They are skin cancer arising from the endothelial cells such as those lining blood vessels. Histologically, malignant transformation causes the endothelial cells to become stippled with spindle-shaped tumor cells; lymphatic obstruction may occur, but they do not metastasize, and remain multifocal both on the skin and in the alimentary tract. Despite the worry of surgeons about risks of infection, these risks are small

•           The prevalance rate of HIV 0.3 to 7 percent in our country. Surgeons have been shown to contaminate themselves with blood in 8.7 percent cases, and sustain penetrating injuries in 1.7 percent cases the transmission rate is 0.3 to 0.4 percent, yet statistically the risk of seroconversion for a surgeon is one infection every 8 years in a high-risk area with a case-load of 15000 patients per year, and as small as one infection every 80 years in a low risk area. Thus the risk to surgeon is exceptionally low.

Any questions be sent to drmmkapur@gmail.com
All older posts are stored in archives for access and review.
Visitors that follow may post contributions to the site.
To create consumer/provuder engagement visit www.surgseminar.blogspot.com
www.drmmkapur.blogspot.com

INFECTION CONTROL 16

Disposal by Incineration

This is the preferred method of disposal for all combustible and other material of an infectious nature (e.g., contaminated needles, plastic syringes and clinical waste).

      Disposable linen and infected protective clothing and drapes should be incinerated
.

VIRUS INFECTIONS IN SURGERY 

HEPATITIS B (SERUM HEPATITIS)

This is one of the most infective viruses.

•     It may be transmitted from patient to patient by as little as 0.0001 ml of infected blood.

•     The virus remains active for up to 6 months in dried blood, consequently instruments which have been poorly cleaned or disinfected may be responsible for infecting other patients, whilst poor surgical technique may result in the doctor becoming infected from the patient, or vice versa

•     It has been estimated that there are possibly 200 million carriers of hepatitis in the world, representing up to 20 percent of the population in African, Pacific, and other Tropical countries, and 0.5 percent of the population in Northern Europe. The current prevlance in the population is from
1 to 15.8 percent

•     Thus, statistically the doctor has a 1 in 200 chance of treating a hepatitis B carrier

•           If the doctor becomes accidentally infected with the hepatitis B virus, not only may the disease develop but the doctor may become a hepatitis B carrier and be an unacceptable risk to patients and may have to give up surgery. The transmission role in case of needle stick is 6 to 37 percent.

Any questions be sent to drmmkapur@gmail.com
All older posts are stored in archives for access and review.
Visitors that follow may post contributions to the site.
To create consumer/provider engagrmrnt visit www.surgseminar.blogspot.com
www.drmmkapur.blogspot.com