Surgical Nursing and Asepsis
This domain tests sterile technique, patient preparation, instrument handling, and the maintenance of asepsis from setup to closure.
Core rules
- A sterile field includes only sterile items. Gowned and gloved personnel do not reach over the field, do not let hands drop below waist level, and do not touch nonsterile surfaces. Pass instruments within the field without contaminating the handles.
- Patient prep: clip hair widely, remove loose hair, and scrub with chlorhexidine or povidone-iodine according to protocol, alternating with alcohol where appropriate. Do not let prep solution pool under the patient.
- Check pack indicators and event-related sterility. Open packs without touching the inner contents.
Worked example
During a feline ovariohysterectomy, the surgeon's glove touches the nonsterile Mayo stand. The glove is contaminated. The technician does not wipe it with alcohol; the surgeon changes the glove before continuing. If the gown sleeve had touched the stand, the gown would also be contaminated and would need replacement. The reasoning: alcohol does not restore sterility to a visibly contaminated glove, and the field must be protected before the incision is made.
Traps
Talking over the field, reaching across it, wetting the drape, and turning away from the field all break asepsis. Clipping after the scrub recontaminates skin. Wearing jewelry or chipped nail polish under gloves is a common missed point.