If a frozen section is indicated, the specimen must be ____.
preserved in a fixative
submerged in formalin
moistened with sterile water
sent to pathology dry
Proper care of the specimen is the responsibility of whom?
Joint Commission on Accreditation of Hospitals- JCAHO
CST
Circulator
The Operating Room Team
When prepping the abdomen for a laparotomy, which of the following areas is prepped first?
Incision Site
Bedside
Stoma
Umbilicus
All instruments and items must be removed from a specimen before it is sent to the pathology lab. Which of the following specimens is the exception to this rule, where an item will purposefully be left in the specimen as a reference point?
Needle Localization
Muscle Biopsy
Products of Conception
Amputated Limb
Prepping of the surgical patient occurs right before which of the following tasks?
Anesthesia Administration
Urethral Catheterization
Positioning
Draping
Which of the following types of specimens CAN be submerged in formalin?
Frozen Section
Culture and Sensitivity
Bronchial Washings
Permanent Section
Breast tissue removed during a breast reduction for breast hypertrophy will be processed as which of the following types of specimens?
Amputation
When is the best time for the CST to hand the specimen off the sterile field to the circulating nurse?
Whenever the CST has time
As soon as all of the specimen is excised and the surgeon gives permission to have the specimen handed off the field
A.S.A.P.
Following the completion of the procedure
Who generally accepts responsibility for prepping traumatic wounds?
Surgical Technologist
Surgical Assistant
surgeon
For which of the following prepping agents must the applicator be removed from the operating room following application of the prep?
Betadine Paint Sticks
Duraprep
Hibiclense Scrub Sponges
Exidine Scrub Sponges
A surgeon sends a specimen for frozen section and the results come back from the pathologist stating that the “margins are not clear”. What does this mean and how does it affect you as the 1st scrub on the procedure?
It means that cancerous tissue still remains in the patient and more tissue needs to be excised to leave only healthy tissue behind
It means that cancerous tissue still remains in the patient and no more tissue needs to be excised
Describe the anatomical areas that are prepped for vaginal surgery.
prep starts at pubic area. Inner thighs preped next, sponge stick used for vagina, dried with sponge stick. Painting applied to all areas except vaginal canal. seperate sticks used for pubic area.
painting applied first then area dried with stick sponge.
Check the boxes of pieces of information to be included on a label to identify a specimen.
patients name
patient address
what the specimen is
where the specimen came from anatomically
hospital of where surgical procedure is being performed
The basic rule of prepping is to proceed from what to what?
clean to dirty
dirty to clean
Check the boxes that list duties of the CST in the first scrub role while caring and handling surgical specimens.
obtain specimen from surgeon
clean specimen with sterile water only if needed
place specimen in basin or telfa
notify surgeon of specimen dimensions and structure if needed
if not sending specimen fresh, we can keep specimen in saline
ask surgeon before handing specimen off to circulator
What is the minimum amount of time Duraprep solution must be allowed to dry on hairless skin prior to the application of the surgical drapes? How long can it take to dry in hair?
2 minutes minimum
3 minutes minimum
5 minutes minimum
10 minutes minimum
Describe the anatomical areas that are prepped for a knee arthroscopy. BE DESCRIPTIVE!
lower hip down around the entire leg, not the foot though
lower hip down around the entire leg, including the foot
upper hip down around the entire leg, not the foot though
Describe what a surgeon may do to a specimen to assist the pathologist in identifying how the specimen was oriented when it was in the patient’s body.
surgeon may mark edges with suture on the specimen. Then surgeon will communicate with Circulator what the marks mean anatomically. Their needs to be clear margins for the pathologist.
surgeon may tell the ST where the edges are on the specimen. Then surgeon will communicate with Circulator what the marks mean anatomically. Their needs to be clear margins for the pathologist.
Identify the purpose of performing a prep on a surgical patient.
Transient flora are reduced that live on the skin and resident flora that live underneeth the skin which make their way to the surface are reduced. It reduces/prevents infection from occuring as a result of the procedure.
none.
What is the difference between a permanent section and a frozen section?
permanent sections are sections taken that are not diagnosed intra-operativly and can be sent offgrounds for further analysis in formalin. Frozen sections are diagnosed intra-operatively and are sent to patholgy fresh and dry.
frozen sections can be sent off grounds for further analysis, permanent sections are diagnosed intra-operatively
Duraprep can be very dangerous and pose a fire risk to the patient if not utilized properly. Identify two safety techniques that are utilized to minimize the risk posed by duraprep.
avoid pooling and allow prep solution to dry completely.
if pooling occurs its ok if you allow it to dry all the way
When should hair be removed from the surgical site to minimize the risk associated with hair removal?
As close as possible to the planned start and right before the prep is applied.
As close as possible to the planned start of the procedure but not in the OR
Match the specimen type to the correct description.
A separate consent form is required for this type of specimen related to cultural concerns that may need to be addressed.
chromosomal studues
amputated limb
culture and sensitivity
Patients will go to the radiology department prior to coming to surgery to have this type of specimen excised.
chromosomal studies
needle localization
This type of test will be performed on the products of conception for patients who have had multiple miscarriages.
culture ad sensitivity
muscle biopsy
An infected wound would often require this type of test.
The gallbladder that is removed during a Laparoscopic Cholecystectomy for cholecystitis will have this type of examine performed on it.
culture sensitivity
routine/permanent section
The lab must be notified at least 24hrs in advance prior to harvesting this type of specimen.
culture sensitivty
A luki tube is often utilized to obtain this type of specimen.
bronchial washings
frozen section
Excision of a melanoma from the scalp would have this type of study performed on the specimen where the results would be reported intraoperatively.
permanent section
check the boxes of types of cultures
biological culture
anaerobic culture
aerobic culture
micro flora
transient flora
Check the boxes of the combination of what duraprep is made of?
iodine
bedadine
isopropyl
hibiclense
Check the boxes of he reasons why the prep solution must not be allowed to pool under the patient.
fire hazard
strike through contamination
infection
irritant to skin
Chlorhexidine Gluconate is commonly known as?
duraprep
betadine
sodium chloride
Name the best method to remove hair without skin injury.
scissors
sharp blade that protects skin
surgically prepared razer
clippers
When performing the prep for a pelviscopy procedure during which the abdomen and the perineal area must both be prepped, which area is prepped first? Why?
perineum is prepped first, then the abdomen from under breast to thighs. Genital contamination can spray to the cleaned area. if prepped the other way around.
perineum is prepped last, the abdomen first because we always prep from clean to dirt
Identify two contaminated areas that need special consideration when performing the surgical skin prep. When during the prepping procedure are these areas prepped (first, last, middle, etc.)?
The vagina is prepped first so that contamination does not occure through spray to the abdomen.
The anus is considered the dirtiest and sponges need to be discarded once touched.
The vagina is prepped last since we always prep clean to dirty. The anus is considered the dirtiest and sponges need to be discarded once touched.
Match the prepping agent with its proper description.
Agent most commonly utilized to degrease the patient’s skin prior to the application of the prepping solution.
isopropyl alcohol
exidine
chloraprep
This type of prep solution only works through a cumulative action through multiple uses and only offers bacteriostatic action against microbes.
phisohex/phisoderm
actiprep
This type of prep solution is ototoxic and neurotoxic and cannot be utilized for facial preps.
hibiclense/chlorahexadine gluconate
This prep is a good alternative to use on a patient who has an iodine allergy for a surgeon whose normal preference is to use Duraprep.
If a patient is to be scrubbed and painted this type of prep solution will be utilized.
provodone-betadine/iiodine
This type of prep solution is applied by scrubbing the prep area for 2 minutes, drying, and then scrubbing the area for another 2 minutes
The active ingredients in this type of prep solution are Trizenol and alcohol – It is effective against multi-drug resistant microorganisms
This prep solution contains a patented sticky substance, which prevents the solution from being removed during the procedure prolonging its effectiveness and requiring a special remover to take it off the skin.
