Disinfection- killing microorganism excepts

spores
Sterilization – Destroying all m.o. including
spores
Spores- vegetative stage with protective
covering-heat and chem. Resistant (130 ‘c or
270 ‘F to kill spores)
Disinfection:
Physical:
-Boiling – 10 min. average
-Steaming – moist heat
-Sunlight –
Chemical:
-Alcohol – 70% (dries the protein of the
m.o)
Non-physician asst- clerks
-Chlorine- For bedlinens
-Iodine- Betadine 7.5% antiseptic,
yellowish and Betadine 10% skin cleanser,
dark brown (Lumbar prep- 10%, Abd. prep-
7.5 removes then 10)
-Phenol- for appendectomy (alcohol is the
antidote of phenol)
Sterilization:
Physical:
-Autoclave- (except: needles, scissors and
with lens)
-Radiation- UV light
 -Gas- ex. Sterrad, Ethylene oxide
Chemical:
-Soaking/immersion- Ex. Cidex

Activated cidex is the mostly used in hosp.

What type of m.o killed during low level
dis.?
-Fungi but some viruses and not bacteria
During intermediate level dis.?
-Fungi, viruses and some bacteria
High level?
-All except spores
Sterilization?
-All include spores
Day 03 Crile Forceps
- medium; used for shallow layers
Mosquito Forceps
- shortest; used for minor surgery,
pediatrics, and superficial layers
Mixter Forceps -used to reach around and
ligate blood vessels.
Ochsner Forceps- used to grasp medium to
Baliktad si thumb and tissue f. heavy tissue or occlude heavy, dense vessels

Who determines the position that used by Grasping and Holding (Graspers)
the PT? Adson Forceps (Toothed)
-Must benefit the surgeon and anes. -used for handling dense tissue, such as in
Who determines the incision? skin closures

-surgeon Adson Forceps (Toothless)

Knife / Scalpel -used for fine surgical procedures to hold

delicate or superficial tissues
Handle #4 is the first knife used to cut tough
tissues. Thumb Forceps

Handle #3 is the second knife used to cut -used for grasping, holding or manipulating
delicate tissues, and is used for minor body tissue
surgeries. Tissue Forceps
Scissors -used in surgical procedures for grasping
Mayo Scissors (Straight / Curved) tissue

– used to cut tough tissues -designed to minimize damage to biological

tissue
Metzenbaum Scissors (Straight / Curved)
Allis Forceps
– used to cut delicate tissues.
-used to hold or grasp heavy tissue like
Bandage Scissors bones, tendons, uterus, and fascia
– used to cut the uterus and umbilical cord Pennington Forceps
Clamping and Occluding (Clamps) -used for grasping tissue, particularly during
rectal operations
Kelly Forceps
Babcock Forceps
- longest; used for deep abdominal
layers and cavities -used to grasp delicate tissue and hold
tubular organs
-used with intestinal and laparotomy Murphy Rake Retractor
procedures
- used to gently retract tissue and
Ovum Forceps give better visibility to the surgical field
-used to remove placental fragments inside Non-Self Retaining Retractors
the uterus
Malleable Retractor
Towel Clips
- used to retract deep wounds, and
-used to hold drapes in place, to keep only may be bent to various shapes
the operating field exposed
Suturing and Stapling
Exposing and Retracting (Retractors)
Needle Holder
Balfour Abdominal Retractor
-used to hold a suturing needle for closing
- used in laparotomy procedures, and wounds during suturing and surgical
for specific abdominal procedures where the procedures
abdomen needs to be held open for
examination or evaluation, such as cesarean Skin Stapler
sections and bowel resection -used to close incisions after surgery
Mastoid Retractor
- used to retract the external canal
skin anteriorly for better visualization of
external canal and middle ear
Gelpi Retractor
- used for holding back organs and
tissues while accessing areas below an
incision during lumbar spine procedures
Army Navy Retractor
- used for shallow or superficial
wounds, and to retract skin or bones
Richardson Retractor
- used to retract, expose or push
tissue, muscles, organs or bones during
surgery
Deaver Retractor
- used to hold back the abdominal
wall during abdominal or thoracic
procedures, and to move or hold organs
away from the surgical site
Gastrectomy, billroth 1&2, expletory
laparotomy

Hysterectomy, CS, tubal ligation,

Nephrectomy
Expletory laparotomy
Right upper oblique (subcostal), right lower
oblique (inguinal)
Left upper oblique (subcostal), left lower
oblique (inguinal)

Benefits the surgeon?

-Maximum exposure of the operative site
-ease of entry and exit from the operative
site
For appendectomy, if appendix is still intact
-minimum tissue trauma
If ruptured right lower paramedian
Benefits the anest?
-the position should not impede the blood
circulation and chest expansion (respiration
and circulation)
-for the delivery of anesthesia
Are we allowed to break the table?
Endoscopy
-breaking the table means position the table
based on the surgical pos. of the pt

Perineal surgery

Lumbar laminectomy

Abd paracentesis, CTT close tube

thoracostomy, bronchoscopy
Who gives inform consent? -Surgeon
Nurse role is to witness

Cbc is the first to ensure in lab test

Cardio clearance – ECG, stress test,
Pulmonary clearance – Chest x-ray, ABG,
TFP pulmonary function test
Pre requisite
-No skin disease
-no open wound/cuts
-short fingernails/ no nail polish
-no persistent cough
Intervention:
Begin prep long upon the signal of the
anesthesiologist
Spinal head- Flat on bed w/out pillow for 6-
8 hrs
Spinal anes.- motor nerve and sensory nerve
are affected
Epidural anes- only affect sensory for
painless vaginal delivery.