PX CARE

• Sepsis


  Infection in the blood
• Asepsis


  Freedom from infection
• Surgical asepsis


  The complete removal of microorganisms and their spores from the surface of an object
• Pathogens


  Disease-causing microorganisms
• Any medical procedure that involves penetration of body tissues (an invasive procedure) requires the use of surgical aseptic technique
• Below the waistline is considered unsterile
• Tracheostomy involves the removal of the trachea
• Linen refers to the patient's soiled clothing
• IVP stands for Intravenous Pyelography
• Medical asepsis


  Any practice that helps reduce the number and spread of microorganisms
• Zones in the surgical environment

  • Zone 1 (unrestricted)
  • Zone 2 (semi-restricted)
  • Zone 3 (restricted)
• Radiographers in the surgical environment

  • Must follow protocols designed by OSHA
  • Shoes must be closed-toe and not cloth covered
  • Personal hygiene must be meticulous
  • Jewelry, long/artificial nails, and nail polish are prohibited
  • Body piercing jewelry must be removed
  • Hair, beards, and mustaches must be covered
  • Shoes must be protected from contact with body fluids
  • Must scrub hands and arms before entering Zone 3
  • Must don a mask before entering a room where a surgical procedure is in progress
• Members of the surgical team

  • Surgeon
  • Surgical Assistant
  • Anesthesiologist
  • Nurse Anesthetist
  • Circulating Nurse
  • Scrub Nurse/Technician
  • Radiologic Technologist
• Disinfection


  The elimination of as many microorganisms as possible
• Sterilization


  The process of killing all microorganisms and their spores
• Methods of sterilization


  • Chemical
  • Dry heat
  • Gas
  • Plasma technology
  • Autoclaving (steam)
• Chemical sterilization


  Involves immersion and soaking of clean objects in a germicidal solution followed by a sterile water rinse
• Chemical sterilization is one of the less satisfactory methods for providing surgical asepsis and is not recommended
• Dry heat sterilization


  Required to sterilize some sharp instruments, takes 1-6 hours at 329°F-338°F (165°C-170°C)
• Boiling water at 100°C has a boiling point of 78°C
• Conventional gas sterilization


  Uses Freon and ethylene oxide at 135°F (57°C), used for items like telephones and stethoscopes
• Conventional gas sterilization has the disadvantage of producing toxic fumes
• Gas plasma technology


  A new and safer method of sterilization that uses vaporized hydrogen peroxide subjected to radiofrequency energy, used for endoscopes, fiberoptic devices, and microsurgical instruments
• Gas plasma technology has the advantage of not producing toxic fumes
• Autoclaving


  Steam sterilization under pressure, the quickest and most convenient means of sterilization, at 250-275°F (121-135°C)
• Sterile field


  A microorganism-free area prepared for the use of sterile supplies and equipment
• Criteria for a sterile package


  • Clean, dry, and unopened
  • Expiration date not exceeded
  • Sterility indicators have changed to a predetermined color
• Skin preparation


  The purpose is to minimize the introduction of pathogens to the body via a puncture or incision, thus reducing the likelihood of infection
• Solutions used for skin preparation

  • Betadine
  • Zephiran
• Standard principles of surgical asepsis

  • Any sterile object or field touched by an unsterile object or person becomes contaminated
  • Never reach into a sterile field
  • Suspect an item is contaminated, discard it
  • Do not pass between the physician and the sterile field
  • Never leave a sterile area unattended
  • 1-inch border at the perimeter of the sterile field is considered a "buffer zone" and treated as contaminated
• Removing and applying dressings

  1. Perform hand hygiene

  2. Don gloves

  3. Inform the patient

  4. Practice care in removing the dressing

  5. Place soiled dressing in a plastic bag and seal before adding to biohazard container
• Microorganisms that live on or inside the body without causing disease

  Microbial flora
• Types of microorganisms


  • Bacteria
  • Viruses
  • Protozoa
  • Prions
  • Fungi
  • Helminths
• Most microorganisms do not cause infection or disease and are essential for our well-being
• Pathogens

  Microorganisms that cause infections and disease
• Bacteria


  Colorless, minute, one-celled organisms with a typical nucleus, classified as gram-positive or gram-negative
• Gram-positive bacteria


  • Non-acid fast, retain dye when treated with alcohol, e.g. streptococci, staphylococci
• Gram-negative bacteria


  • Acid-fast, dye is washed out by alcohol, e.g. E. coli, Bacillus, Mycobacterium tuberculosis
• Endospores


  The ability of bacteria to generate a resistant form to survive unfavourable environments
• Significant diseases caused by bacteria

  • Tuberculosis
  • Streptococcal pharyngitis and necrotizing fasciitis
  • Infectious diarrhea and hemolytic uremic syndrome