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Introduction to Surgical Technology - Final


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State primary goal of surgical intervention
To return pt. to the best physical and psychological state possible
To prevent the occurrence of a disease of illness is called what?
To relieve or alleviate symptons without curing the underlying cause or disease is?
To regain the pt's health and strength to resume normal activities
To determine the nature and cuase of an illness
List the 3 types of hospitals
Nonprofit - revenue not taxed
For Profit - Owned by group of individuals revenues taxable
Surgical Facilities - Undertakes minor surgeries with no postoperative care necessary
List 4 facilities where surgery can be performed
ambulatory care
satellite surgery center
physician's office
Describe typical hospital organizational chart
BOD = hires CEO
Medical Staff - delivers services
Admin - designs and implements procedures and policies
Describe typical organizational structure for surgical services
Surgical Board Charge Nurse
Staff Nurses, ST, and nurse's assistant
Departments that deliver direct patient care
surgical techs
Department that deliver indirect patient care
blood bank
central supply
foo services
List 4 broad categories of surgery today
List 3 phases of surgical case management
List members of the surgical team
anesthesia care provider
OR Director
Nurse Manager
OR Educator
Unit secretary, orderly
List 5 areas of employment for sugical tech
vet clinic
private physician (surgeon
sales rep
List 2 ways of receiving training as a ST
military - 9 and 18 month programs
2 year college
Define and give brief description of AORN
Association of PeriOperative Registered Nurses
Define and give brief descrip of AST
Association of Surgical Technologists
Define and give brief descrip of CAAHEP
Commission on Accreditation of Allied Health Education Programs
Define and give brief description of LCC-ST
Liason Council on Certification for Surgical Technologists -- Body responsible for developing and adm the national certification
Free from living microorganisms
Transfer of responsibility from licensed person to nonlicensed person (licensed person assumes responsibility
Dependent Task
Task delegated to another person and require direct supervision by the person delegating task
Independent Task
Tasks that are transferred to another person and do not require supervision
Proprietary School
Private -- for nonprofit
What event is associated with development of role of sT
What were first STs called
ORTs Operating Room Technicians
What year did formal schooling of ORTs begin
When was AST formed
What year did the title of ORTs change to STs
What is the mission statement of a hospital
A statement that reflects the overall goal and ethics of that institution
What is the chain of command
the heirarcy of administrative positiions
What is accreditation
Process by which a team visits hospital and inspects practices, policies and outcomes of patient care
What organization accredits hospitals in the US
JCAHO Joint commission on accreditation of healthcare organizations
Occupational Safety and Health Administration govers infection control and safety
Centers for Disease Control - governs infection control and safety
What are the rules regarding blood being transported and used at the hospital
Blood may be transfused only after two licensed personnel have together verified the id number of the patient and confirmed the corresponding information on the blood unit bag, including contents, type and cross-matching identification. ID process is performed at least twice before blood is administered.
patient-centered care means
surgical team bases assessment, planning, and intervention on the unique needs of the individual patient
Critical thinking means what
Application of knowledge and experienced gained in the past to solve a current problem
What are Maslow's hierachy of human needs?
Security and Safety
Self Esteem
Self Actualization
What is considered a high risk patient
one who requires surgery but has one or more comorbid diseases
What are the basic physiological needs of a patient
nutrition, water; shelter, air and oxygen, rest and sleep, elimination, movement and freedom from pain
List some instances where a patient would be considered high risk
respiratory disease
alcoholic or drug addicted
immunosuppressed patient
trauma patient
patient with aids
What are some of the different behaviors seen in OR regarding children of different development ages
infants -- need to by physically close to caretakers
toddlers -- suffer frustration and loss of autonomy and anxiety when separated from parents
preschoolers -- suffer extreme fear in OR (will view as deliberate abandonment)
school aged children are more compliant and cooperative. The fear mutiliation but are curious about their care.
adolescents are very sensitive about their bodies...fear loss of control and body exposure.
What are some problems in OR with geriatric patients
Increased injury due to loss of adipose tissue and loss of skin elasticity, Loss of body heat from lack of body fat.
What are the characteristics of therapeutic communication
goal directed
unique to each patient
it requires active engagement
it requires excellent observation and listening skills
What are some qualities of good communication skills
(express your needs but respect the right and needs of others)
What is groupthink
a collective behavior and thinking. It is based on peer pressure and occurs when members of a group are polarized in their opinions
How is tone defined
Tone is the environment of the message. It reflects the sender's emotions
What is cultural differences
reflects the values, social practices and communication methods of a group of people
in conflict resolution, a situation in which one party is satisfied and the other is not
In conflict resolution, both parties in a conflict gain by the solution
Physical response to a message, a component of effective communication
Agreement among members of a group
Ethical dilemma
A situation is which ethical choices involve conflicting values
legally responsible and accountable
ommission to do something that a reasonable person and prudent person would not do.
Sentinel event
An unexpected occurrence involving death or serious physical inury. Sentinent signals the need for immediate investigative response
Morals are described as
personal standards
laws are described as
social standards
ethics are described as
a group of standards
A ST is allowed to pass drugs to surgeon what should a ST do during passing the drugs
always acknowledge the name and amount of medication
Advance directive
instructions about your medical care in event you can't speak
Living Will
Specifically states what types of interventions or treatments a patient wants
The failure to stay with a patient who is under one's care is called
Money awarded in a civil lawsuit to compensate the injured party is
Defamation in writing is called
Testimony of a witness under oath and transcribed by a court reporter
Crime of intentionally lying or falsifying information
Spoken defamation
Medical Power of Attorney
Legal document signed by a person giving another the power to make health care decisions
Doctrine of respondent superior liability
Dictates that the employer can be sued if an employee commits negligence during his scope of employment
Doctrine of forseeability
Dictates the extent to which an event or action could have been anticipated and prevented by reasonable and prudent action.
Doctrine of res ipsa loquitor
Indicates the thing speaks for itself (someone leaving in a sponge)
doctrine of detrimental reliance
a surgeon may in certain cases rely on the professionalism of the scrub and circulator and therefore may deflect responsibility for an injury
Primum Non Nocere
First, do no harm
Aeger Primo
the patient first
What are some of the most common areas of negligence
retained objects
improper positioning
patient identity and operative site
specimen handling
failure to communicate
loss of patient property
What is HIPPA
The Health Insurance and Portability and Accountability Act of 1996
What does HIPPA do
Protects a patient's privacy
Who created HIPPA
HHS Department of Health and Human Services
Civil Assault
the threat or attempt to strike or harm, whether or not it is carried out or not
Civil Battery
the actual unlawful touching or striking another person
False Imprisonment
Depriving a person of his/her freedom
A written order to appear in court
A summons is different from a subpoena because it actually makes you a party to the lawsuit
a claim for tortuous injury and the judgment is the amount of money awarded to plaintiff for damages
Who can sign a consent form?
Legal guardian, spouse or other authorized person. The attenting PHYSICIAN MAY NOT WITNESS THE CONSENT
What does DNR mean
Do Not Resuscitate
What are the Code of Ethics of the Association of Surgical Technologists
Codes that reflect the expectations of those professionals as they make decisions involving ethical issues
The person that initiates a lawsuit
The person whom a lawsuit is filed against
Intentional Torts
Intentional acts are willful and violate the civil rights of a patient...assault, battery, defamation, false imprisonment
Unintentional Torts
they include negligence and malpractice...patient identification, incorrect procedure, sponges left in patient, burns, falls.....
Informed consent is the responsibility of....
The physician
Informed consent must include
Patient's legal name,
surgeon's name
procedure to be performed
patient's legal signature
signature of witness
date and time of signature
List five causes of stress in the operating room
lack of sleep
drug and/or alcohol abuse
burned out
poor communication
Communication using words
Communication in which words are written; depends on the ability to write, read and see
Communication sent in ways other than by words; depends on the five basic senses
Non verbal
Communication in which words are spoken aloud; depends on the abilities to speak and hear
What are the essential elements of effective communication
the sender, the receiver, the content and the feedback
List effective listening skills
Focus on sender,
do not judge sender,
watch for nonverbal clues
rephrase content
ask for clarification
The violation of the obligation to keep a patient's records and confidences private
breach of confidentiality
An injury induced by a doctor or caregiver
Iatrogenic injury
The expectation that an individual may be called to account for actions taken that were consistent with responsibilities
Law established on the basis of previous court decisions
Common Law
The degree of negligence in which each of the parties involved may be shown to have been responsible for the injury involved
Comparative negligence
A serious crime punishable b law with penalties ranging from imprisonment to death
A private or civil wrong or injury for which the court provides a remedy through an action for damages
Being unqualified or inadequate to perfom duty or duties
An act or omission that is the result of actual conscious indifference to rights, safety or welfare of persons
gross/criminal negligence
A lawsuit
Legal liability of a manufacturer
Product liability
Definition of a surgical conscience
a developed skill of constant committment to aseptic technique. It also involved a personal moral of accepting responsibility for ones actions
List three resources that help a surgical tech interpret and follow professional standards of conduct
medical journals,
continuing ed
Risk is defined as
the statistical probability of a harmful event. defined as the number of harmful events that occur in a given population
taking risks means
trying to beat the odds
Risk management means
taking specific precautions to reduce the risk
What are the risk factors for surgical personnel
blood and body fluids
harmful chemicals
heat and powerful electrical devices
lift heavy objects
and frequent handling of sharp objects and stress
EPA means
Environmental Protection Agency
What are the 3 components that a fire requires
fuel, a source of ignition, and oxygen
What are some Fuel sources
preparation solutions, particularly those containing alcohol,
medical devices (rubber, plastic)
surgical drapes
patient hair
intestinal gases
laser energy
ligh sources
harmonic scalpel
What is OEA
Oxygen -rich environment
What is lanugo
fine patient body hair
What are some prep solutions and other chemicals used in surgery that are flammable
betadine (Povidone iodine solution)
fibrin glue
bone cement
What is the first thing to remember in a patient fire
What three steps do you take to protect the patient and stop the fire
shut off flow of all gases to patient's airway
remove any burning objects from surgical site
assess the patient for injury and repond apropriately
What is the plan to follow if a structural fire occurs
What is a Class A Fire
involves wood, paper and cloth
What is a Class B Fire
Carbon Dioxide
involves flammable liquid
What is a Class C Fire
involves electrical and laser fires
Three steps to use a fire extinguisher PASS mean what
pull, aim, squeeze, and sweep
On the diamond NFPA hazard triangle what do the different colors and symbols stand for
yellow-instability- #1
red - flammability - #2
Blue - Health - #3
White - Special #4 W or Ox
In the mavcc worksheets on page 31 of Module 1B know the symbols and what they mean
Harmful to Food stuff
Breathing in gases, vapors, fumes and other forms of material
By mouth
Through the skin
What is the correct standing posture
Align ears, shoulders, hips knees and ankles
Keep shoulders relaxed and knee slightly bent
Good body mechanics prevent what
Injury and fatigue
Using the body correctly results in what
Coordination and Endurance
List four types of emergencies
Mechanical Failures
Bomb Threats and
Severe weather
What are the fire extinguisher symbol shapes for classification
Triangle --- Class A
Square -- Class B
Circle Class C
Star -- Class D
What are 3 osha regulations required of employers
Provide written training and policies
follow CDC guidelines
keep MSDS sheets
What does OSHA operate under
US Department of Labor
The bloodborne pathogens that concern operating room professionals are
hepatitis B, hepatitis C and HIV
Bloodborne pathogens are found in
Contaminated Blood
Infections can occur if infected blood enters a person's bloodstream through any of the following routes
unprotected opening in the skin such as cuts, scrapes and dermatitis
unprotected mucous membrane openings such as eyes, nose and mouth
penetration into the skin by a sharp object such as a broken glass, a needle or knife blade
List examples of devices that can cause sharps injuries
Wire sutures
hollow injection needles
guide wires
drain trocars
laparascopic trocars
orthopedic drill bits
Mount the needle where in the needle holder
Midcurve rather than 3/4 of the way back, to prevent slippage or bending of the needle
Universal Precautions
Basic guidelines for infection control published in 1988 by the CDC
Identify 8 substances that require hand protection
Blood, sputum, urine, feces, nasal secretions, vomitus, spinal fluid, and semen
The most penetrating of the three types of radiation is
Cannot be stopped by a sheet of paper, and though some can be stopped by human skin, others need a thicker shield to stop them
Can be prevented from penetrating the body by a sheet of paper by human skin
Cylinder Color Gray
Carbon Dioxide
Cylinder Color Black
Cylinder Color Blue
Nitrogen Oxide
Cylinder Color Brown
Cylinder Color Yellow (black and white international)
Cylinder color Green (white international)
Cylinder Color Orange
Flammable Anesthetic Gases
ethyl ether
ethy chloride
Contact with corrosive or irritating chemicals such as acids or alkalines
Overexposure to radiant energy
Resulting from overexposure to electricity
Contact with fire, hot objects, or hot fluids
Genetic mutation
having the ability to cause permanent change in genetic structure
a naturally occurring sap obtained from rubber trees used in manufacture of medical devices
A method of transferring sharp instruments on the surgical field without hand to hand contact
neutral zone
Post exposure prophylaxis
recommended procdures to help prevent the development of blood-borne diseases after an exposrue
Define Standard Precautions
Guidelines recommended by CDC to reduce risk of transmission of blood-borne and other pathogens
What is smoke plume
95% water and 5% other chemicals, blood cells, infected or fragmented bacteria and viruses Toxic smoke from lasers
What is used to measure the cumulative radiation dose for those who are frequently exposed
What color are waste bags for infectious material
Some chemicals found in the smoke plume are
toluene - liver and kidney damage
acrolein - causes eye, nose and throat irritation
formaldehide - used to preserve tissue, causes irritation to mucous membranes, causes kidney damage
hydrogen cyanide - used commercially for pest control, causes nausea, dissiness and headache
What can happen with severe allergic reaction to latex
antiphilactic shock
Before any surgical procedure a patient must sign what
Informed Consent
NPO means what
Nothing by Mouth
Patient should be transported head first or feet first
Feet First
Patient should enter an elevator head first or feet first
When the patient is lying flat on back with arms next to body it is what position
When the patient is lying on back and head is lowered and feet are raised it is what position
When patient is in supine position with feet lower than head it is what position
Reverse Trendelburg position
A modified sitting position is called what
Fowler's position
When lying flat on back with feet in stirrups
Lithotomy position
What position when you are face down on belly with arms at side
Prone position
What position if head down and butt up in the air
Kraske Jackknife
What position if you are lying on side
Right or left lateral position
What position if on right side and the kidney roll is placed under body
Right or left kidney position
What position if on left side and right leg is flexed
Sims position
Control of body temp is important, what if too much body temp is lost
What is normal temp for adults -- oral, rectal and axillary
98.6 oral
99.6 rectal
97.6 axillary
What are normal pulse values for birth through adults
Birth 130-160
infants 110-130
children 1-7 80-120
over 7 80-90
adults 60-80
What are some of the pulse points in the body
radial artery, (wrist)
femoral artery
brachial artery (middle of arm)
popliteal artery (knee)
temporal artery
carotid artery
apical (apex of heart)
what is slow heart rate
what is fast heart rate
what are normal respiration rates
infants 30 to 60
children 1-7 18-30
adults 12-20
No breathing
normal breathing
rapid breathing
What are normal bp readings for newborn through adult
newborn 50-52 systolic and 25-30 diastolic
child under 6 95/62
child to 10 100/65
adolescent 118/75
adult 120/80
what is homologous
blood donated by another person

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