Term
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Definition
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Term
1. Anesthetic Machine
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Definition
Use: Delivers inhalant anesthetics and oxygen to a patient during anesthesia.
Operating Procedure:
1. Assemble machine - attach the vaporizer inlet and outlet port hoses, reservior bag, corrugated breathing tubes, scavanging system hoses and any other required parts.
2. Turn on Oxygen and Check for leaks - For a rebreathing system, occlude patient connector and popoff valve. Turn on oxygen to fill the reservior bag. When the bag is full turn the flowmeter off. keep pressure connector occluded for at least 10 seconds. If there are no leaks if the pressure in the pressure manometer does not decrease by more than 5cm of water over 10 seconds.
3. Set popoff valve - Adjust the popoff valve with the patient connector still occluded. Turn the oxygen flow back on to the anticipated maximun needed for the procedure. Then gradually reopen popoff valve until the pressure manometer indicates a pressure of 1-2cm of water.
4. Adjust oxygen and vaprozer settings as needed.
Maintenance: Have machine inspected and maintained yearly. Clean corrugated breathing tubes, reservoir bag and detachable rubber parts periodically with chlorhexidine or other mild disinfectant then rinse, dry and inspect for holes or defects. Inspect unidirectional flow valves and disinfect with isopropyl alcohol or chlorhexidine. |
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Term
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Definition
Use: Estimates the partial pressure of CO2 in the bloodstream which aids in assessing patient ventilation.
Operating Procedure:
1. Insert CO2 probe cable connector into the CO2 receptacle.
2. Select the correct sized adapter to minimize dead space and connect to the sensor.
4. Install the airway adapter between the ET tube connector and the patient anesthesia hose.
5. Wait 2 minutes for the sensor to warm up.
Maintenance: After use wipe down sensor with mild disinfectant then water with a damp cloth. Rinse airway adapter in warm soapy solution then soak in liquid disinfeactnat, rinse with sterile water and dry. Before using check for mosture, residue or damage. Do not insert any objects into the airway adapter.
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Term
3. Cautery Machine
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Definition
Use: To cut tissue and provide hemostasis by using a high-frequency electrical current by burning tissue and sealing off blood vessels.
Operating Procedures:
1. Place foot plate on the floor near the surgeon's foot.
2. Place ground plate, if using a unipolar device. on the surgery table underneath the patient.
3. Ensure good patient contact with the ground plate with gel if necessary.
4. The hand piece is sterilized and given to the surgeon.
5. The surgeon then passes the end of the cord to a nonsterile assistant who plus it into the electrocautery unit.
6. The machine is turned on and the settings are adjusted as needed.
Maintenance: Regularly check handpiece and cords for damage. Sterilize the handpiece after each use.
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Term
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Definition
Use:
Operating Procedure:
1. Plug in the device
2. Turn the machine on
3. Set the amount of joules to the patient's weight
4. Place patient in dorsal recumbancy if necessary.
5. Apply designated electrode gel to paddles
6. Press charge button on the apex paddle
7. Once charge is set, place paddles on either side of the sternum and press the button on both.
Maintenance: Wipe with a damp cloth after use. Periodically check ECG electrodes, cables and paddles for wear and tear after use + replace every 3 years. Manual test evey 6 months. Ensure all supplies such as gel, electrodes, ECG paper etc. are present. Electrical safety tests, performance inspection and calibration by a service professional annually and as needed. |
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Term
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Definition
Use: Detects the flow of blood through small arteries and converts the motion of the blood into an audible signal. Often used with a sphygmomanometer to measure blood pressure.
Operating Instructions:
1. Clip and cleanse the skin overlying a small artery in the distal limb of tail base
2. Cover the site with a generous of ultrasonic gel
3. carefully position the probe precisely over and parallell to the artery until an audible signal can be detected.
4. Place a sphygmomanometer with a properly fitting blood pressure cuff just proximal to the probe and measure systolic and diastolic blood pressure.
Maintenance: Handle very carefully! Gently clean with tap water and a gauze sponge after use. Do not immerse, scrub or autoclave. |
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Term
6. Electrocardiograph
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Definition
Use: Record and monitor heart rate and rhythm.
Operating Procedure:
1. Connect alligator clips to the banana plugs at the end of each leadwire.
2. Connect lead wire set to the corrsponding color-coded receptacle on the ECG trunk cable
3. Plug ECG trunk cable into receptacle on monitor
4. Prepare lead sites on the skin caudal to the elbows and stfles with isopropyl alcohol and apply electrode gel for better contact
5. Apply electrodes
6. Attach alligator clips to approriate leads
Maintenance: Clean lead clips with isopropyl alcohol after each use to prevent buildup of conduction gel which reduces their conductivity. Wipe monitor with damp cloth, do not immerse any part of the machine in water or allow water to get inside the machine. Before each use, inspect monitor, connectors, cables, leads and electrodes for damage or wear.
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Term
7. Endotracheal Tube
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Definition
Use: Inserted through the mouth into the trachea to administer oxygen and anesthetic gasses, help maintain an open airway, facilitate supplemental oxygen and allow the anetshetist to manually ventilate a patient.
Operating Procedure:
1. Select tube of appropriate length and diameter
2. Check tube for blockages, holes or other damage + check cuff for leaks
3. With the patient in sternal recumbency, grasp tongue with gauze sponge and pull it out and down to visualize the larynx.
4. With the tube or laryngoscope displace the epiglottis downward.
5. Gently insert tube past the vocal cords using a rotating motion
6. Place patient in lateral recumbency and check for proper tube placement.
7. Secure tube with roll gauze over the nose or behind the ears and connect the connector to the breathing circuit.
Maintenance: Scrub gently with a mild detergent and soft brush as soon as possible after use. Inspect tube for damage and inflate cuff under water to check for leaks. Store in a clean and readily accessable location that is protected from dust and other contaminants. |
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Term
8. Esophageal Stehoscope
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Definition
Use: To listen to a patient's heart sounds during surgeries where the thorax is inaccessable.
Operating Procedure:
1. Lubricate the closed end of the catheter.
2. Insert the catheter into the esophagus to about the level of the heart.
3. Attach the free end of the catheter to the electronic base.
4. ADjust the position of the catheter and volume until the signal is audible.
Maintenance:
Clean the base as needed and change batteries periodically. Wash the catheter with a disinfectant and dry after use. Avoid immersing the catheter in water or getting water inside the catheter. |
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Term
9. Fiberoptic Equipment
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Definition
Use: To viualize inside the body from the outside through small incisions.
Operating Procedure:
1. Check scope for proper functioning. Verify that air/water and suction valves are functional by placing the distal tip in a bowl of water and testing each function individually.
2. Test distal defelction controlls for functionality and check objective lens for clouding or moisture.
3. Check equipment for leaks
4. Have all needed ancillary equipment ready before the procedure
Maintenance: Completely dissassemble all cannulas and hand implements after use. Scrub with instrument cleaner, paying special attention to the jaws. Most hand instruments can be steam, gas or cold sterilized. Don't use the autoclave for the fiber optic scope, light cable and camera, use only ethylene oxide or gluteraldehyde.When not in use, instrument components should be kept in their case. |
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Term
10. IV Fluid Pump
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Definition
Use: Can be programmed to accurately and precicely control the dose and rate of IV fluids given to a patient.
Operating Procedures:
1. Place IV pole and pump near patient.
2. Connect the pump to a power outlet.
3. Switch on the pump
4. Press arrow keys to set prescribed fluid rate
5. Press "prime" to prime the infusion set
6. Press "select" and use arrow keys to set the time limit and fluid rate
7. Press "run/hold" to begin infusion
8. Verify that infusion is proceeding normally before leaving the pump unattended.
Maintenence: Check occlusion and air sensors, backup batteries and display segments at least once a year. Check pump housing, press plates, battery time, power cord for damage and clean or replace components as necessary |
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Term
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Definition
Use: Crystalloids contain electrolytes in water and are either hyoptonic, hypertonic or isotonic. These are used for fluid resuscitation, rehydration and replacement of fluid losses. Colloids contain high molecular weight molecules that increase osmotic pressure inside the blood vessels. These are well suited for fluid resuscitation to raise the blood pressure.
Operating Procedures:
Maintenance"
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Term
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Definition
Use: To facilitate endotracheal intubation by allowing direct visulaization of the larynx.
Operating Procedure:
1. Select the approriate sized blade
2. Attach the blade to the handle
3. With the patient in sternal recumbency, hold the mouth wide open and pull the tongue out and down
4. Insert the scope through the mouth to visualize the larynx
5. Depress the epiglottis with the scope, then insert endo tracheal tube.
Maintenance: Clean handle (remove battery compartment before cleaning) and blade with disinfectant and a soft brush after use. Keep stored in its case. Blades may be autoclaved or gas sterilized. May also use ultrasonic cleaner. |
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Term
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Definition
Use: To cut tissue by vaporizing it and providing hemostasis by sealing off blood vessels.
Operating Procedure:
1. Move laser system to desired location
2. Attach the system to the installation platform
3. Plug the power cord into the power eceptacle then to the wall outlet
4. Plug the footswitch into the footswitch receptacle on the power panel and verify secure connection.
5. Perform fiber verification to ensure outlet power
6. Use tongue depressor to test laser peformance
7. Maintain an appropriate minimum power setting and maximum spot size
Maintenance: Inspection and servicing by a professional when needed. Inspect fiber, handpiece and all external surfaces for damage. before use Check fiber interlock, footswitch interlock, emergency stop switch, optical port window and air flow. Lean external surfaces daily or as needed with a ligtly dampened cloth. Clean optical port window with a cotton swan mostened with alcohol.
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Term
14. Anesthetic Mask
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Definition
Use: To deliver anesthetic gas and oxygen to a nonintubated patient.
Operating Procedure:
1. Select the smallest mask that will fit comfortably
2. Attach the connector end to the breathing circuit
3. Slide the open end over the snout and hold in place for as long as needed.
Maintenance: Clean and disinfect after use, regularly check for damage and store in a clean and readily accessable place.
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Term
15. Nonrebreathing System
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Definition
Use: Delivers oxygen and anesthetic gas without recycling exhaled gasses which go straight into the scavenging system. It is used for patients under 7 kg.
Operating Procedure:
1. Connect the nonrebreathing circuit to the outlet port of the vaporizer in place of the rebreathing circuit
2. Perform a leak check
3. Connect corrugated breathing tube to endotracheal tube connector.
Maintenance:Check tubes and reservior bag for damage before use. Clean and disinfect after use.
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Term
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Definition
Use: Measure blood pressure with a cuff and a computerized base unit that inflates and deflates the cuff automatically.
Operating Pocedure:
1. Place the cuff around a leg or the tail with the balloon centered over an artery.
2. Turn the unit on.
Maintenance: Clean by wiping with a slightly damp cloth, do not immerse in water! Disinfect the cuff after use.
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Term
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Definition
Use: To store the oxygen used by the anesthetic machine at high pressure.
Operating Procedure:
1. Open the outlet valve by turning the vale stem counterclockwise
2. Check tank pressure to verify adequate oxygen supply during a procedure.
Maintenance:
Keep stored on the yoke of the anesthetic machine or in a rack. Never leave an unsupported oxygen tank or one lying on its side unattended. Never attempt to remove the valve or index pins. Keeps tanks away from sorces of ignition. |
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Term
18. Pulse Oximeter
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Definition
Use: Measures the oxygen saturation of the blood by estimating the percentage of hemoglobin bound to oxygen.
Operating Procedure:
1. Connect probe to the receptacle on the monitor.
2. Place probe on a nonpigmented area of skin or the tongue.
Maintenance:Handle carefully. Clean probes with alcohol after use, do not immerse in water, scrub or autoclave! |
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Term
19. Rebreathing System
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Definition
Use: Delivers fresh oxygen and waste gasses while recycling exhaled air to conserve oxygen.
Operating Procedures:
1. Connect corrugated breathing tubes to the inhalation and exhalation unidirectional flow valves.
2. Select and attach appropriate sized reservior bag
3. Perform a leak check.
4. Connect the breathing tube to the endotracheal tube connector.
Maintenance:
Regularly inspect the unidirectional flow valves for proper functioning. Check tubes and reservior bag for wear or damage before use. Disinfect breathing tubes after use. |
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20. Resuscitation Bag
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Definition
Use: To provide ventilatory support to a patient in respiratory arrest.
Operating Procedure: Connect device
1. Verify and open aireay in the patient
2. Connect to face mask to enotracheal tube
3. Give 10 breaths per minute until breathing resumes.
Maintenance: Clean and sterilize after use.
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Term
21. Scavenging System
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Definition
Use: Transfers excess waste gasses to outside the building or into a canister of activated charcoal or absorbent material.
Operating Procedure:
1. Turn on the fan if using an active system
2. Check tube for blockage and for proper adjustment of the vacuum before starting procedures for the day.
Maintenance: If using an activated charcoal canister, weight it before each use and replace if it has gained 50g. Have the system serviced by a professional annually.
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Term
| 22. Skin Staples[image][image] |
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Definition
Use: Provides fast and easy closure of surgical wounds in place of sutures.
Operating Procedure:
1. Avert and approximate skin edges
2. Position stapler over enter of skin edges
3. Close by squeezing the trigger fully until motion stops
4. Release trigger fully to release the staple.
Maintenance: Wipe down with alcohol after use. Do not place in an autoclave. |
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Term
23. Skin Sutures
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Definition
Use: To close surgical incisions made in the skin and body tissues. Types include absorbable natural and symthetic and nonabsorbable natural and synthetic.
Operating Procedure:
1. Open suture material package aseptically away from the body and let it drop on the instrument table for the surgeon to pick up with a needle driver.
2. During suturing the suture scissors should be handled by the assistant
Maintenance:Store suture material in its package and keep in a clean environment. |
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Term
24. Sphygmomanometer
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Definition
Use: To measure blood pressure in conjunction with a doppler or sthethoscope.
Operating Procedure:
1. Place cuff around distal limb or tail base with cuff ballon over artery.
2. After establishing a good doppler signal, inflate the cuff until the artery is occluded and the signal can no longer be heard. Record systolic BP.
3. Gradually deflate the cuff until the signal can be heard again Record Diastolic BP.
Maintenance: Periodically check tubing for leaks and disinfect cuff after use. |
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Term
25. Suction Machine
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Definition
Use: To remove excess blood and fluids from a surgical site by suction which improve visualization.
Operating Instructions:
1. Plug the aspirator into a power outlet
2. Switch on/off switch to "I" position
3. Adjust the vacuum level by turning the vacuum adjust knob
4. Position suction tubing appropriately and begin suction
5. Switch on/off switch to "off"
6. Unplug the aspirator
7. Remove liquid from collection bottle after motor stops completely
8. Switch on/off switch to "on" and run the aspirator briefly
Maintenance: Regularly check system for leaks or other damage and have machine serviced as needed. |
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Term
26. Surgical Glue
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Definition
Use: For closing the skin as an alternative to sutures and staples.
Operating Procedure:
1. Oppose the wound edges
2. Apply the glue over the incision and allow it to set for 30 seconds.
Maintenance:Remove excess adhesive in the vial tip after use to prevent clogging of the tip. Do this by holding the bottle upright and squeezing the drop inside the tip onto a paper towel. Then attach a 3 mL syringe to remove any remaining adhesive. Replace cap. Store bottle upright on a shelf away from heat
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Term
27. Temperature Monitor
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Definition
Use: To monotior body temperature during surgery.
Operating Procedure:
1. Lubricate the end of the probe about 2 inches from the tio.
2.Insert lubricated end into the rectum or esophagus
3. Wait 1-2 minutes for the monitor to read.
Maintenance: Clean excess gel off of probe with alcohol. Check probe for any damage and wrap accordion style before storing.
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Term
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Definition
Uses: To force air into the lungs whenever a patient in not breathin on its own.
Operating Procedure:
1. Connect ventillator to an electrical source, oxygen supply, and scavenging system
2. Insert pressure feedback sensor between the expiratory valve and breathing tube.
3. Remove reservoir bag from the anestshetic machine and attach in its place tubes that connect to the bellows of the ventilator
4. Close the popoff valve
5. Check endotracheal tube for proper inflation and the the breathing circuit remains uptight
6. Set respiratory rate, maximum respiratory pressure and/or ventilatory time indicvated in the owner's manual
7. Turn on the ventilatorn and adjust the setting to achieve the target volume, pressure and time.
Maintenance: Wipe down and disinfect after use with a lightly dampened cloth. Wipe with water afterwards. Check annually for damage and proper function, check and replace betteries as needed.
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Term
29. Autoclave - Automatic + Manual
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Definition
Use: Uses high heat steam and pressure to destroy all microorganisms and other materials such as gowns and sututre materials that can withstand autoclaving and their spores from instrument packs to prepare them for aseptic procedures.
Operating Procedure:
For automatic
1. Load the autoclave appropriately
2. Turn the door handle to the right until tight or shut the door snugly
3. Select appropriate setting to begin sterilization
4. Wait for pressure to release before craking open the door and leaving it ajaor for 20 minutes to allow moisture to evaporate
For manual
1. Load the autoclave appropriately
2. Close fdoor firmly
3. Choose appropriate cycle (liquid or dry)
4. Set appropriate time and temperature for the cycle
5. Press "cycle" button to start cycle
6. When cycle is complete close steam valve
7. Allow autoclave pressure to return to zero before opening the door.
Maintenenace:Inspect and clean door gasket daily with a cloth lightly dampened with water and mild detergent. Avoid overloading sterilizer trays. Use a class 5 indicator strip with each cycle to ensure correct sterilization parameters. Clean trays and rack weekly with a non-scratch scour pad and mild dertgent then rinse well. Completely drain water from the reservoir once a week and replenish with frech distilled water. Clean chamber and flush lines once a month and check power cord and plug for damage. Have autoclave inspected, cleaned, tested and calibrated by a professional yearly. |
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