Al H 116

Adler/Carlton Ch 15 and 17

Aseptic Techniques

Medical Emergencies

Aseptic Technique

• The purpose of aseptic technique is to reduce the number of microorganisms.– Surgical asepsis – protection against infection

before, during, and after a procedure using sterile technique.

– Medical asepsis – removal or destruction of infected material

Radiology Procedures Requiring Sterile Technique

• Angiography

• Arthrography

• Hysterosalpingography

• Surgical procedures

Sterile Field

• A microorganism free area that can receive sterile supplies– Sterile drape– Sterile packages– Surgical scrub

• This will be dependent on the facility which exams require surgical scrub

– Numbered stroke

– Timed scrub

– Sterile gowning• Follows sterile scrubbing

Basic Principles of Sterile Technique

• Only sterile items in sterile fields• If you doubt the sterility considered it un-sterile• Create the field when ready not long before• Below the table or waist is considered un-sterile• Gowns are sterile on the sleeves and front from

the waist up• Un-sterile personnel cannot reach over or above

a sterile field• Sterile materials must be kept dry

Surgical Radiography

• Sterile Corridor– The area between the patient drape and

instrument table

What is an emergency?

• Sudden change in medical status that requires immediate attention

General Priorities

• Ensure an open airway• Control bleeding• Take measures to prevent or treat shock• Attend to wounds or fractures• Provide emotional support• Continually re-evaluate

• Know the location of the nearest crash/emergency cart

Head Injuries

• Level of Consciousness– Any patient who has suffered a head injury

needs to be constantly monitored for changes to their level of consciousness

Types of Shock

• Hypovolemic– Loss of blood or tissue fluid

• Cardiogenic– Due to any number of cardiac problems

• Neurogenic– Spinal anesthesia or upper spinal cord trauma

• Vasogenic– Sepsis, deep anesthesia, or anaphylaxis

Signs and Symptoms of Shock

• Restlessness,

• Apprehension or general anxiety

• Tachycardia

• Decreasing blood pressure

• Cold and/or clammy skin

• Pallor

Contrast Media Reactions

• Anaphylactic or vasogenic shock

• Ranges from mild to severe– Impossible to accurately predict

• Generally, the longer it takes to develop the less severe

• If you suspect a reaction don’t hesitate call for help

Diabetic Crises

• Hypogylcemia– Excessive insulin

• Confusion, irritablility, • Patient needs carbohydrates

• Hypergylcemia– Excessive sugar in the blood

• Takes time to develop• Excessive thirst and urination• Can lead to diabetic coma

Respiratory Distress/Arrest

• Asthma– Stress may trigger an attack

• Allow the patient self-medicate, get them is a sitting position

• Choking– Heimlich maneuver

Cardiac Arrest

• ABCs

• Remember, the first step is to call for help before beginning CPR

CVA

• Sudden or protracted onset– Slurred speech, dizziness, confusion, loss or

blurred vision

Minor Medical Emergencies

• Nausea and vomiting– Maintain airway, patient on side

• Epistaxis– Lean forward and pinch the nose

• Vertigo and syncope– Recumbent, loosen clothing

• Seizures– Protect the patient from falling

Wounds

• Hemorrhage– Notice dressings, saturated dressings should not be

removed, a new one should be applied over the existing one

– Extremity- if possible put the extremity above the level of the heart

• Burns– Maintain sterile precautions

• Dehiscence– Sutures separate