CSCT key terms

A set of practices that keep sterile surfaces, instruments, and the surgical field free of microorganisms during a procedure, including how sterile team members move, gown, glove, and handle equipment.

The designated area of draped patient and equipment considered free of microorganisms. Only sterile items and properly attired sterile team members may contact it, and any break in sterility requires correction.

The internal standard by which each team member honestly reports and corrects their own breaks in sterile technique, even when no one else observes the error.

Any contact, splash, drape strike-through, or unrecognized exposure that renders a sterile item or area non-sterile; the item is removed or re-draped and the event is reported.

Moisture that soaks through a sterile barrier such as a gown or drape, allowing microorganisms to pass from the non-sterile side to the sterile side.

The sequence of donning a sterile gown and gloves, using closed or open technique as appropriate, while keeping hands above waist level and avoiding contact with non-sterile surfaces.

Preoperative hand and forearm cleansing with an antimicrobial agent for a specified contact time before donning sterile attire, reducing transient and resident skin flora.

The timed, structured cleansing of hands and forearms using an antimicrobial soap and friction, following a defined sequence from fingertips to elbows before entering the sterile field.

A validated process that destroys all forms of microbial life, including bacterial spores, on an item, verified by physical, chemical, and biological monitoring.

A process that destroys all microorganisms except high numbers of bacterial spores, used for heat-sensitive semi-critical items such as flexible endoscopes after thorough cleaning.

A system that categorizes medical devices as critical, semi-critical, or non-critical according to the risk of infection associated with the tissue they contact, guiding the required processing level.

A prepared population of resistant spores used to monitor whether a sterilization cycle achieved the conditions needed to kill microorganisms; it is the most accepted verification of sterilization efficacy.

The probability that a single item is non-sterile after a validated sterilization process, commonly expressed as a target of one in one million for critical items.

The cleaning process that removes organic soil and bioburden from instruments before disinfection or sterilization, since residual debris can shield microorganisms and inactivate chemical agents.

A detergent containing enzymes that break down blood, fat, and protein soil on instruments, typically used during manual or ultrasonic cleaning before terminal processing.

A device that uses high-frequency sound waves to create cavitation bubbles that lift soil from instrument surfaces, hinges, and lumens during decontamination.

Documentation linking each processed instrument set to its cleaning, packaging, cycle parameters, and monitoring results, enabling traceability and recall if a sterilization failure is identified.

A structured verbal pause by the team before induction, before incision, and before the patient leaves the room to confirm identity, site, procedure, allergies, antibiotics, counts, and specimen labeling.

A brief, team-wide verbal confirmation immediately before the procedure begins that the patient, site, side, procedure, consent, and imaging match the schedule.

Visible marking of the operative site by the responsible practitioner before the patient is sedated or positioned, especially for laterality, multiple structures, or levels.

Placing and supporting the patient for surgery to provide access while protecting skin, nerves, joints, eyes, and circulation, using padding, alignment, and secure restraints.

Localized damage to skin and underlying tissue caused by sustained pressure, shear, or friction, often over bony prominences; prevention requires padding, repositioning, and moisture control.

Moving a patient between bed, stretcher, and table using adequate personnel, locking devices, secured lines, and communication to prevent falls, shearing, and equipment dislodgement.

A systematic tally of sponges, sharps, and instruments by the circulating and scrub team at defined points, compared against baseline, to prevent retained items.

The process of resolving an incorrect count by recounting, searching the field, floor, and linen, and notifying the surgeon; an unresolved count requires imaging before closure.

A surgical item such as a sponge, needle, or instrument unintentionally left inside a patient after a procedure, a preventable event associated with serious harm.

Applying patient identifiers, specimen source, laterality when relevant, and collection time to the container in the presence of the patient whenever possible, with documentation of the chain of custody.

A documented, unbroken record of who handled a specimen and when, from collection through transport and receipt by the laboratory, supporting identity and legal integrity.

A rapid intraoperative pathology examination used to guide immediate surgical decisions; the specimen is sent fresh, correctly oriented, and labeled with the question to be answered.

Infection control practices applied to all patients, including hand hygiene, gloves, gowns, masks, eye protection, and safe handling of sharps and body fluids.

Barrier garments and devices such as gloves, gowns, masks, respirators, and eye protection worn to prevent contact with bloodborne pathogens and other hazardous materials.

A percutaneous exposure from a needle, scalpel, or other sharp; it requires immediate washing, reporting, source evaluation, and post-exposure prophylaxis assessment.

A designated area on the sterile field where sharps are placed and retrieved without hand-to-hand passing, reducing the risk of needlestick and cut injuries.

Removal of plume generated by electrosurgery or lasers using a dedicated evacuator and respiratory protection, since the plume may contain infectious and chemical material.

A life-threatening hypermetabolic reaction to certain anesthetic agents marked by rising temperature, rigidity, and tachycardia, treated urgently with dantrolene and supportive cooling.

A neurologic and cardiac reaction to local anesthetic absorption or inadvertent intravascular injection, managed with airway support, seizure control, and lipid emulsion rescue.

The combination of an oxidizer, ignition source, and fuel present during surgery; prevention includes allowing alcohol-based prep to dry and keeping ignition sources away from enriched oxygen.

A patient's voluntary agreement to a procedure after receiving information about its nature, risks, benefits, and alternatives; it is documented before sedation and verified at the time-out.

The contemporaneous record of the procedure, including personnel, implants, counts, specimens, medications, and events, completed accurately and without alteration after the fact.