SLE REVIEWER 1.

Applies surgical shoe covers, cap,

and face mask before the scrub.
MEDICAL HANDWASHING 2. Assemble equipment
1. Determine the location of the running • Ensures that sterile gloves, gown,
water and soap or soap and towel are set up for use after
substitutes the scrub.
2. Assemble all the equipment needed • Warm running water.
• Soap 3. Follows agency policy for length of
• Running water scrub and type of cleansing agent
• Disposable or sanitized towels used (scrub typically takes 2 to 6
3. Assess the hands minutes).
• Nails should be kept short 4. Assess the hands.
• Remove all jewelry • Nails should be kept short.
• Check for breaks in the skin • Remove all jewelry.
4. Turn on the water and adjust the flow • Checks hands for breaks in the
5. Wet the hands thoroughly by holding skin (hangnails or cuts)
them under the running Procedure:
water Pre-wash
• Hold the hands lower than the 5. Turns on water using knee or foot
elbows so that the water flows controls.
from the arms to the fingertips 6. Adjusts water temperature to warm.
6. Apply soap and do the following 7. Wets hands and forearms from
strokes: fingertips to elbows.
• Palm to palm 8. Keeps hands above elbows and
• Palm over dorsum away from body.
9. Applies liberal amount of soap.
• Palm to palm with fingers
10. Lathers well to 2 inches above the
interlaced
elbow.
• Back of fingers to opposing
11. Does not touch inside of sink.
palms
12. Removes debris from under nails,
• Rotate thumbs in palm
using nail file under running water.
• Rotate fingers in palm 13. Rinses hands and arms, keeping
• Rub the fingertips against the hands above elbows. Surgical Scrub
palm of the opposite hand Using Antimicrobial Soap (Hands
7. Rinse the hands above elbows)
8. Thoroughly dry the hands and arms 14. Wets scrub brush and applies a
• Discard disposable towels in the generous amount of antimicrobial
appropriate container soap if not already in brush.
9. Turn off the water 15. Using a circular motion, scrubs all
• In the hand operated control the surfaces of one hand and arm.
faucet, use the paper towel to 16. Scrubs at least 10 strokes on each
turn off the faucet nail, all sides of fingers, and each
side of the hand. Uses at least 10
SURGICAL HANDWASHING strokes each for the lower, middle,
Preparation: and upper areas of the forearm.
17. Rinses brush and reapplies 8. Has a coworker pull up gown
antimicrobial soap. Repeats scrub on shoulders and tie neck tie (coworker
the other hand and arm. touches only inside of gown).
18. Rinses hands and arms, keeping
fingertips higher than elbows. Donning Sterile Gloves (Closed
19. Leans forward slightly and allows Method)
towel to fall open, being careful not to let 9. Opens the sterile glove wrapper,
it touch the uniform. keeping fingers inside the sleeve of
20. After washing and rinsing, use a the gown.
towel to dry one hand thoroughly in a 10. Put the glove on the non-dominant
rotating motion, from the fingers to hand
the elbow. Use a new towel to dry the • With the dominant hand, pick up
other hand and arm/Uses one end of the opposite glove with the thumb
towel to dry one hand and arm; uses and index finger, handling it
opposite end to dry other hand and arm. through the sleeve.
21. Makes certain skin is thoroughly dry • Lays glove on opposite gown
before donning sterile gloves. cuff, thumb-side down, with the
palm of the glove facing down,
DONNING A STERILE GOWN AND glove fingers pointed toward
GLOVES (CLOSED METHOD) elbow.
Preparation: • Position the dominant hand palm
1. Assemble equipment and supplies. upward inside the sleeve.
• Sterile pack containing sterile • Use the non-dominant hand to
gown grasp the cuff of the glove
• Sterile gloves through the gown cuff, and firmly
Procedure: Donning a Sterile Gown anchor it.
2. Grasps gown at the neckline/crease • With the dominant hand working
near the neck, hold it away from you, through its sleeve, grasp the
and permit it to unfold freely without upper side of the glove’s cuff, and
touching anything. stretch it over the cuff of the
3. Allow it to fall open while stepping gown.
back from the table. • Pull the sleeve up to draw the
4. Does not allow gown to touch any cuff over the wrist as you extend
nonsterile surface. the fingers of the non-dominant
5. Put the hands inside the shoulders of hand into the glove’s fingers.
the gown, and work the arms partway 11. Put the glove on the dominant hand.
into the sleeves without touching the • Place the fingers of the gloved
outside of the gown. hand under the cuff of the
6. If donning sterile gloves by using the remaining glove.
open method, work the hands down the • Place the glove over the cuff of
sleeves and through the cuffs/if donning the second sleeve.
sterile gloves by closed method, work • Extend the fingers into the glove
the hands down the sleeves only to the as you pull the glove up over the
proximal edge of the cuffs. cuff.
7. Keeps the sleeves of the gown above 12. Adjusts the fingers in both gloves.
waist level. Completion of Gowning
13. Complete gowning as follows: - Cut deep delicate tissues
• Have a co-worker hold the waist • Inside knife
tie of your gown, using sterile - No. 3 handle and no. 10 blade
gloves or a sterile forcep or - Superficial tissues
drape. • Skin knife
• Make a three-quarter turn, then - No. 4 handle and no. 20
take the tie and secure it in front blade
of the gown/or tie them at the - Cut the skin
back.
• When worn, sterile gowns should ➢ Scissors
be considered sterile in front - Composed of two
from the waist to the shoulder. opposing blades that have
The sleeves should be a handle
considered sterile from 2 inches - The length of the scissors
above the elbow to the cuff, is determined by the depth
since the arms of the scrubbed of the surgical site
person must move across a • Straight Mayo Scissors
sterile field. - Cut sutures
13. Remove and dispose of used gown • Curved Mayo Scissors
and gloves. - Cut heavy tissues like
• There is no special technique, but fascia, uterus or
if they are soiled, remove them muscles
by turning them inside out. • Metzenbaum Scissors
- Used to cut delicate
OR INSTRUMENT tissues

Classification of Instruments: 2. Clamping/ Occluding

1. Cutting/dissecting- cut away - Used to seal off hollow
2. Clamping/occluding- to occlude vessels or to occlude them
hollow (blood vessels)
3. Grasping/holding- to hold in ➢ Hemostat
place - Close blood vessels with a
4. Retracting/ exposing- to view minimum of tissue
damage
1. Cutting/ Dissecting ➢ Mixter
- Broadest instrument category - Hard to reach blood
- Used to cut away tissue or vessels
open cavities ➢ Mosquitoes
- Used to clamp down small
➢ Scalpel blood vessels
- knife like ➢ Kelly
- oldest surgical instrument - Larger vessels and tissues
- handle and a detachable
blade 3. Grasping/ Holding
• Deep knife - Grasp things or hold them
- no. 7 handle and no. 15 blade in place
 ➢ Richardsons
➢ Allis Forceps - Chest incisions and
- Has a small interdigiting deep abdominal
teeth on its tip. To exposure
prevent slipping when
holding tissues while ➢ Army navy
minimizing tissue damage - Shallow incisions
➢ Bobcock
- Teethless atraumatic
forceps to grasp delicate IV THERAPY COMPLICATIONS
tissues like intestines
and in the ovaries 1. Air Embolism- airs enters the
➢ Kocher vein through the IV tubing
- Transverse serrations with 2. Infiltration- iv fluid leaks into
large teeth specially surrounding tissue
designed to handle slipper 3. Infection- entry of
tissue like fascia microorganisms into the body via
➢ Foesters IV
- Grasp sponges 4. Circulatory overload-
- Aka sponge forceps administration of fluids too rapidly
➢ Towel clips 5. Phlebitis- inflammation of the
- Holds drapes in place vein can lead to blood clots
- Once in place, should not (thrombophlebitis)
be moved since it 6. Hematoma- collection of blood in
punctures the drape and the tissues
touches the unsterile
side. IV THERAP: TYPES
➢ Tissue forceps w teeth
- Used for skin to prevent 1. Hypertonic
slippage - D5LR
➢ Needle holders - D5 .03 NaCL
- Used to hold the needle - - - D5NS
properly - - D5IMB
- Needs to be replaced - - D5NM
regularly 2. Hypotonic
-
4. Retracting/ Exposing 3. Isotonic
- Hold back wounded edges - PLRS ( trauma, surgery
to provide exposure to the and burn)
operate organs - 0.9% saline/ PNSS
Classification: - D5 Water (
• Self- retaining- stay open by Hypernatremia and
themselves dehydrated states)
• Manuals- require support by
hands