CSFA flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Surgical time-out

A verbal pause immediately before incision in which the team confirms patient identity, procedure, site and side, consent, allergies, positioning, implants, and antibiotic prophylaxis.

Clear liquid fast

Elective surgery requires abstaining from clear liquids for at least 2 hours; a light meal requires 6 hours and a fatty meal 8 hours under ASA guidance.

Chlorhexidine-alcohol prep drying

Chlorhexidine gluconate in an alcohol base must dry completely before draping; pooling in skin folds or beneath drapes can cause chemical burns and creates a fire hazard.

ASA class III

A patient with severe systemic disease that is not incapacitating, such as poorly controlled diabetes, chronic obstructive pulmonary disease, or stage 3 chronic kidney disease.

Malignant hyperthermia triggers

Volatile inhalational anesthetics and succinylcholine trigger malignant hyperthermia in genetically susceptible patients; the earliest sign is an unexplained rise in end-tidal carbon dioxide.

Skin prep direction

Begin at the planned incision and move outward in concentric circles; when a stoma or draining wound is present, treat that contaminated area last.

Surgical hand scrub technique

Antimicrobial scrub of hands and forearms to 2 inches above the elbows, keeping hands higher than the elbows, for the duration stated on the product label, typically 3 to 5 minutes.

Delayed primary closure

A contaminated or dirty wound is left open and packed, then closed surgically 3 to 5 days later once a clean, granulating wound bed has formed.

Taper needle use

Taper-point needles have a smooth rounded tip that separates rather than cuts tissue, so they are chosen for bowel, blood vessels, fascia, and other soft tissue.

Bipolar electrocautery advantage

Current flows only between the two tips, so no return electrode is required and the risk of injury to pacemakers, nerves, and adjacent structures is lower.

Suture size numbering

As the number before the zero increases, suture diameter decreases; therefore 2-0 is thicker than 4-0, and 4-0 is thicker than 6-0.

Lidocaine maximum dose

Without epinephrine, lidocaine is limited to 4.5 mg per kg; with epinephrine the limit rises to 7 mg per kg. Calculate the dose before infiltrating.

Pneumoperitoneum pressure target

Laparoscopic insufflation is typically maintained at 12 to 15 mmHg; higher intra-abdominal pressure reduces venous return and can impair ventilation.

Class II wound

Clean-contaminated: controlled entry into the gastrointestinal, respiratory, or genitourinary tract without unusual contamination, such as an elective cholecystectomy.

Surgical count timing

Sponges, sharps, and instruments are counted at baseline before incision, before closure of any body cavity, and at skin closure, with the scrub person and circulating nurse counting together.

Tourniquet inflation limit

Upper extremity tourniquets are generally limited to about 2 hours; elapsed inflation time is announced and documented, and deflation follows the surgeon's order.

Proliferative healing phase

Days 3 to 21 after injury, when fibroblasts deposit collagen, new capillaries form, and granulation tissue fills the wound; wound strength remains low during this phase.

Evisceration first response

Cover the extruded viscera with sterile gauze soaked in normal saline, place the patient supine with knees flexed, keep the patient NPO, and notify the surgeon immediately.

Facial suture removal timing

Facial sutures are typically removed at 4 to 5 days to prevent epithelial track marks; scalp, trunk, and extremity sutures remain 7 to 14 days depending on site and tension.

Postoperative atelectasis fever

Atelectasis is the most common cause of fever in the first 48 hours after surgery; management includes incentive spirometry, deep breathing, coughing, and early ambulation.

Negative pressure wound therapy

Applies subatmospheric pressure, usually -125 mmHg, to promote granulation and remove exudate; contraindicated over exposed vessels, nerves, anastomoses, or malignancy.

Wet-to-dry dressing

Moist gauze is packed into the wound and removed after it dries, giving non-selective mechanical debridement of necrotic tissue; not appropriate for clean granulating wounds.

Superficial incisional SSI

Infection involving only skin and subcutaneous tissue within 30 days of surgery, with purulent drainage, pain, tenderness, localized swelling, redness, or heat.

Seroma versus hematoma

A seroma is a collection of serous fluid beneath the incision, while a hematoma is a collection of blood; both cause swelling and may need aspiration or drainage.

Standard precautions scope

Standard precautions apply to every patient regardless of diagnosis and include hand hygiene plus gloves, gown, mask, and eye protection when blood or body fluid exposure is anticipated.

Needlestick immediate action

Wash the site with soap and water without squeezing or scrubbing, report the exposure immediately, and initiate source evaluation and post-exposure prophylaxis assessment.

Surgical fire triangle

Combustion requires an oxidizer such as oxygen or nitrous oxide, an ignition source such as electrocautery or laser, and fuel such as drapes, hair, or alcohol-based prep.

Specimen labeling requirements

Each specimen container is labeled with two patient identifiers, the anatomic source, orientation if relevant, and collection time before it leaves the operating room.

First assistant scope

The surgical first assistant's duties are defined by state law, hospital policy, and privileging; certification alone does not expand the legal scope of practice.

Principle of autonomy

Autonomy is the patient's right to make informed decisions about their own care, including the right to refuse or withdraw consent at any time.

Electrosurgical pad placement

Place the return electrode on clean, dry skin over a large muscle mass near the surgical site, avoiding bony prominences, scars, and metal implants.

Sharps neutral zone

A designated area such as a basin or tray where the surgeon and scrub person place and retrieve sharps instead of passing hand to hand, reducing needlestick injuries.